Archive June 2018 XIX, No. 6

The Soul of a Surgical Safety Checklist

What started as steps on a static piece of paper is now a digital tool that enhances patient safety.

JoEllen McBride

JoEllen McBride, PhD

BIO

In View
IN VIEW Posting your checklist in the areas where it's used increases compliance.

Checklists can be great tools, but how do you bring a laminated piece of paper that hangs on the wall to life so that it's a critical part of every case? We asked the team at Saint Peter's University Hospital in New Brunswick, N.J., for the keys to their success.

First things first. Don't reinvent the wheel. Visit the World Health Organization (osmag.net/fQMc9R) or AORN (osmag.net/Mnn6QQ), where you'll find tools to help your facility frame out a checklist. A boilerplate checklist is a good place to start, but you'll want to customize it by adding and subtracting elements to fit your needs, says Beverly Johnson, MSN, RN, CNOR, the perioperative instructor at Saint Peter's.

Let each department help create and implement the checklist, she says. Enlist the help of surgeons, anesthesiologists and nurses to make sure you've covered all aspects of patient care, including wound classification, confirming sterilization indicators, establishing a sharps safe zone before each case and all phases of antibiotic administration, from pre-op to just before the first incision is made. Anesthesia looked at steps that addressed airway concerns and availability of equipment, blood loss, medication checks, status of the pulse oximeter, the type of anesthesia to be administered and fire risk assessment. It also added a time out before the administration of anesthesia.

If you're thinking that some of these steps may not seem like patient safety issues, you're not alone. Saint Peter's debated whether each aspect needed to be in the checklist.

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