Surgical safety checklists (SSCs) are designed to improve inter professional communications and ultimately avoiding catastrophic errors that often characterizes the culture of surgical teams.
However, data on effect of surgical checklists implementation are scarce in the study area. The purpose of this research project was to directly examine the effect of utilization surgical safety checklist on patient outcomes at University of Gondar Hospital, in Northwest Ethiopia.
Material and methods: Institution based cross sectional study was done at Gondar university teaching hospitals from January to May 2013. We reviewed medical records of all consecutive patients admitted to the surgery department (N=403). For those who have clinical symptoms of surgical site infection a laboratory diagnosis were performed to compare occurrences of all postoperative complication among patients with and without utilization of surgical safety checklist.
Multiple Hepatic abscesses from a ruptured gallbladder Empyema
Results: During the study period from 403 patients operated, SSCs were attached for only 158 (39.2%) of the surgical patients. Post-operative complication were observed in 238 (59 %) of the patients and postoperative fever was the major complication accounting for 70 (17.3%) of all the complication. Surgical wound infection and pneumonia accounted for 47(16.6%) and 33(11.7%) respectively. S. aurous was the predominant isolated bacteria accounted for 7(30%), In addition, a statistically non-significant 11.2% decline the rate of surgical wound infection in the checklist group. In a logistic regression model of postoperative fever, the SSCs emerged as a significant independent predictor of this outcome: (OR = 0.49, 95% CI 0.31–0.75, and P value = 0.001).
Conclusions and recommendation: patients with checklist have observed significant reductions of post operative complication particularly bacterial infection. It is possible to some extent that the improved usage of check list and preoperative prophylactic antibiotics may be implicated in the reduction of postoperative fever and bacterial infection.
Authors: Birhanemeskel Tegene Adankie1, Tadesse Belayneh Melekie2, Gashaw Mesele Getahune3
Affiliations: 1) Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Ethiopia.
2) Department of Medical Anesthesiology, College of Medicine and Health Sciences, University of Gondar, Ethiopia.
3) Department of Surgery, College of Medicine and Health Sciences, University of Gondar, Ethiopia.
Disclosure: The author has declared no conflicts of interest.
Received: 08.10.16 Accepted: 16.11.16
Citation: 10.5455/ijsm.postoperative-complications-surgery
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References
1. Mona Boaz, Alexander Bermant, TiberiuEzri, DrorLakstein, Yitzhak Berlovitz, Iris Laniado and ZeevFeldbrin, IMAJ. Effect of Surgical Safety Checklist Implementation on the
Occurrence of Postoperative Complications in Orthopedic Patients: JMAJ.2014 JAN:16(issue number here): page number here.
2. Dante M Conley, MD, Sara J Singer, Ph.D., MBA, Lizabeth Edmondson, BA, William R Berry, MD, MPH, FACS, Atul A Gawande, MD, MPH, FACS, Effective Surgical Safety Checklist Implementation ( J Am CollSurg 2011;212:873–879.
3. World Health Organization. Patient safety: surgical safety Web map. Available at: http://maps.cga.harvard.edu:8080/Hospital/.Accessed February 10, 2013.
4. Brigid M.Gillespie, Ph.D.,R.N.,Wendy Chaboyer,Ph.D.,R.N.,LukmanThalib, Ph.D.,B.Sc., Melinda John, B.Sc.,Nicole Fairweather,F.A.N.Z.C.A., M.D.,Kellee Slater, F.R.A.C.S.,M.D. Effect of Using a Safety Checklist on Patient Complications after Surgery:4. A Systematic Review and Meta-analysis the American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins. Anesthesiology 2014; 120:1380-9.
5. Treadwell J, Lucas S, Tsou A: Surgical checklists: A systematic review of impacts and implementation. BMJ QualSaf 2014;23:299–318.
6. Pronovost PJ, Goeschel CA, Marsteller JA, Sexton JB, Pham JC, Berenholtz SM: Framework for patient safety research
and improvement. Circulation 2009; 119:330–7.
7. Lingard L, Regehr G, Cartmill C, Orser B, Espin S, Bohnen J, Reznick R, Baker R, Rotstein L, Doran D: Evaluation of a preoperative team briefing: A new communication routine results in improved clinical practice. BMJ QualSaf 2011;20:475–82.
8. Fourcade A, Blache JL, Grenier C, Bourgain JL, Minvielle E: Barriers to staff adoption of a surgical safety checklist. BMJ QualSaf 2012; 21:191–7.
9. Weiser TG, Regenbogen SE, Thompson KD, et al. An estimation of the global volume of surgery: a modeling strategy based on available data. Lancet 2008; 372 (9633): 139-44.
10. Haynes AB, Weiser TG, Berry WR, et al.: Changes in safety attitude and relationship to decreased postoperative morbidity and mortality following implementation of
a checklist-based surgical safety intervention. BMJ QualSaf 2011;20:102–107.
11. Haynes AB, Weiser TG, Berry WR, et al.: A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med 2009;360:491–499.
12. Burnichon G, Lietard C, L’Azou D, et al.: Results of a survey system for neurosurgical site infections, October 1998–January 2003. Neurochirurgie 2007;53:470–476.
13. Korinek AM, Baugnon T, Golmard JL et al: Risk factors for adult nosocomial meningitis after craniotomy: Role of antibiotic prophylaxis. Neurosurgery 2008;62(Suppl. 2):532 539.
14. Pelczar JR, Harley JP, and Klein DA. Microbiology: Concepts and Applications. New York: McGraw-Hill Inc.; 1993. p. 591-603.
15. Aschalew Gelaw1 , Solomon Gebre-Selassie2 , Moges Tiruneh1 , Eshetu Mathios3 , Sisay Yifru4. Isolation of bacterial pathogens from patients with postoperative surgical site infections and possible sources of infections at the University of Gondar Hospital, Northwest Ethiopia. Journal of Environmental and Occupational Science. 2014 , vol 3. Issu 2.
16. Mulu A, Moges F, Tessema B, Kassu A. Pattern and multiple drug resistance of bacterial pathogens isolated from wound infection at University of Gondar Teaching Hospital,
Northwest Ethiopia. Ethiop Med J 2006; 44:125-31.
17. Oguntibeju OO, Nwobu RA. Occurrence of Pseudomonas aeruginosa in post-operative wound infection. Pak J Med Sci 2004; 20:187-91.
18. Endalafer N, Gebre-Selassie S, Kotiso B. Nosocomial bacterial infections in a tertiary hospital in Ethiopia. J Infect Prev 2011;12:38-43
How to Cite this Article
Bibliography
Adankie, B., Melekie, T. and Getahune, G. (2016) ‘EFFECT OF CHECKLIST ON THE OCCURRENCE OF POSTOPERATIVE COMPLICATION ON SURGICAL PATIENT’, International Journal of Surgery and Medicine, 3(1). doi: 10.5455/ijsm.postoperative-complications-surgery.
Citations, Quotes & Annotations
Adankie, B., Melekie, T. and Getahune, G. (2016) ‘EFFECT OF CHECKLIST ON THE OCCURRENCE OF POSTOPERATIVE COMPLICATION ON SURGICAL PATIENT’, International Journal of Surgery and Medicine, 3(1). doi: 10.5455/ijsm.postoperative-complications-surgery.
(Adankie, Melekie, and Getahune, 2016)
