The Status of Use of Surgical Safety Check List and Opinions of Nurses

Öz

Objective: To determine “the status of use of surgical safety check list SSCL and opinions of nurses”. Surgical safety check list that is developed by World Health Organization helps the surgical team to decrease the number of patient safety related adverse incidents. Methods: The study was performed at a private university hospital between August-September 2013 and included all intensive care units, clinics, and operating rooms where adult patients who underwent surgical procedure received care. The design of the first part of the research was retrospective and 383 patient files were examined for SSCL. The second part was cross sectional and descriptive and 105 69% nurses participated in the study. Results: Patient files were examined and it was found that 20.1% of the nurses completely filled all of the corresponding parts in the SSCL; while the ratios were 2.3% and 42.0% in surgical doctors and anesthetists, respectively. Most of the nurses 92.4% used SSCL, and according to 78.1% of the nurses, SSCL was effective in the prevention of medical errors. Conclusions: Although nurses used the surgical safety check list effectively, it was determined that there were problems in the application of surgical safety check list; hence, development of programs to increase the effective use of surgical safety check list was suggested

Anahtar Kelimeler

• Nursing,surgery,patient safety,surgical safety check list

Güvenli Cerrahi Kontrol Listesinin Kullanılma Durumu ve Hemşirelerin Görüşleri

Öz

Amaç: Güvenli cerrahi kontrol listesinin kullanılma durumunun ve hemşirelerin güvenli cerrahi kontrol listesine yönelik görüşlerinin belirlenmesidir. Dünya Sağlık Örgütü tarafından geliştirilen güvenli cerrahi kontrol listesi, hasta güvenliği ile ilgili olumsuz olayların sayısını azaltmak için cerrahi ekibe yardımcı olur. Yöntem: Bu çalışma, Ağustos-Eylül 2013 tarihinde Ankara’da bir özel üniversite hastanesinde cerrahi girişim geçiren erişkin hastaların yattığı tüm yoğun bakımlar, klinikler ve ameliyathanede yapılmıştır. Çalışmanın birinci bölümü retrospektif olup, 383 hasta dosyası güvenli cerrahi kontrol listesi bakımından incelenmiştir. İkinci bölümü kesitsel ve tanımlayıcı olup, 105 %69 hemşire çalışmaya katılmıştır. Bulgular: Hasta dosyaları incelenmiş, güvenli cerrahi kontrol listesinin hemşirelere ait bölümünün tamamının işaretlenme oranının %20,1; cerrahlara ve anestezi doktorlarına ait bölümlerin ise %2,3-%42,0 olduğu belirlenmiştir. Hemşirelerin çoğu %92,4 güvenli cerrahi kontrol listesi kullanmış ve %78,1’i güvenli cerrahi kontrol listesinin tıbbi hataların önlenmesinde etkili olduğunu belirtmiştir. Sonuç: Hemşirelerin güvenli cerrahi kontrol listesini etkin bir şekilde kullandıklarını belirtmesine rağmen güvenli cerrahi kontrol listesinin uygulamasında problemler olduğu belirlenmiş ve güvenli cerrahi kontrol listesinin etkin kullanımını artırmaya yönelik programlar geliştirilmesi önerilmiştir

Anahtar Kelimeler

• Güvenli cerrahi kontrol listesi,hemşirelik,cerrahi,hasta güvenliği

Kaynakça

1. 1. World Health Organization (WHO) [Online]. Patient safety curriculum guide multi-professional edition.
2. 2. Available from: http://whqlibdoc.who.int/publications/2011/9789241501958_eng.pdf.
3. 3. (Accessed 2013 June 14).
4. 4. World Health Organization (WHO) [Online]. Patient safety. Available from: http://www.euro.who.int/en/healthtopics/Health-systems/patient-safety/patient-safety. (Accessed 2014 July 15)
5. 5. Sağlık İstatistikleri Yıllığı [Health Statistics Yearbook] [Online]. Sağlık Bakanlığı Sağlık Araştırmaları Genel Müdürlüğü (Health Research General Directorate of The Health Minister) 2013. Available from: http://sbu.saglik.gov.tr/Ekutuphane/kitaplar/istaturk2012.pdf. (Accessed 2014 July 25)
6. 6. Karaöz S. Cerrahi hemşireliği ve etik. [surgical nursing and ethics] C.Ü. Hemşirelik Yüksekokulu Dergisi 2000;4(1):1- 8. Turkish.
7. 7. Martin AJ, Sexton B, Freischlag JA, Millman EA, Pryor D, Holzmueller C, et al. Patient safety in surgery. Ann Srg 2006;243(5):628-635.
8. 8. World Health Organization (WHO) [Online]. Safe surgery. Available from: http://www.who.int/patientsafety/safesurgery/en/. (Accessed 2014 July 5).

9. 9. Belton L, Berter B [Online]. Perioperative nursing. Available from:http://www.nsna.org/Portals/0/Skins/NSNA/pdf/Career_Berter4.pdf. (Accessed 2014 July 25).
10. 10. Anderson O, Davis R, Hanna GB, Vincent CA. Surgical adverse events: A Systematic review. Am J Surg 2012;206(2):253-262.
11. 11. Joint Commission International (JCI). [Online]. Sentinel event data. General information. Available from
12. 12. http://www.jointcommission.org/assets/1/18/General_Information_1995-2Q2013.pdf (Accessed 2014 May 20).
13. 13. Turkish Medical Association. Turkish Medical Association Füsun Sayek Report Patient Safety: Turkey and World. 1st ed. Ankara:TBB Press;2011:13-14. Turkish.
14. 14. World Health Organization (WHO) [Online]. WHO Guidelines for safe surgery. Available from: http://whqlibdoc.who.int/publications/2009/9789241598552_eng.pdf. (Accessed 2013 June 26).
15. 15. World Health Organization (WHO) [Online]. Implementation manual WHO Surgical Safety Checklist. Available from: http://whqlibdoc.who.int/publications/2009/9789241598590_eng.pdf. (Accessed 2013 June 26).
16. 16. World Health Organization (WHO) [Online]. Safe Surgery Saves Lives the Second Global Patient Safety Challenge. Available from: http://www.who.int/patientsafety/safesurgery/en/. (Accessed 2013 July 16).
17. 17. Performans Yönetimi ve Kalite Geliştirme Daire Başkanlığı [Online]. Güvenli Cerrahi Kontrol Listesi Uygulama Rehberi (Performance Management and Quality Improvement Department. Implementation Guideline of The Surgical Safety Check List). Available from
18. 18. http://www.kalite.saglik.gov.tr/content/files/guvenli_cerrahi_2011/guvenli_cerrahi_kontrol_listesi_uygulama_rehberi. pdf. (Accessed 2013 June 24).
19. 19. Carney B, West P, Neıly J, Mılls PD, Bagıan JP. Differences in nurse and surgeon perceptions of teamwork: Implications for use of a briefing checklist in the OR. AORN Journal 2010;91(6):722-729.
20. 20. Böhmer AB, Wappler F, Tinschmann T, Kindermann P, Rixen D, Bellendir M, et al. The Implementation of a perioperative checklist ıncreases patients' perioperative safety and staff satisfaction. Acta Anaesthesiol Scand 2011;56(3):332-338.
21. 21. Conley DM, Singer SJ, Edmondson L, Berry WR, Gawande AA. Effective Surgical Safety Checklist implementation. J Am Coll Surg 2011;212(5):873-879.
22. 22. Rydenfält C, Johansson G, Odenrick P, Åkerman K, Larsson PA. Compliance with the WHO Surgical Safety Checklist: Deviations and possible improvements. Int J Qual Health Care 2013;25(2):182-187.
23. 23. Sümbüloğlu K, Sümbüloğlu V. Biyoistatistik. 5th ed. Ankara:Özdemir Press;1995:60-67.
24. 24. World Health Organization (WHO) [Online]. WHO Surgical Safety Checklist. Available from: http://www.who.int/patientsafety/safesurgery/checklist/en/. (Accessed 2014 July 25).
25. 25. Lingard L, Espin S, Rubin B, Whyte S, Colmenares M, Baker G, et al. Getting teams to talk: Development and pilot implementation of a checklist to promote interprofessional communication in the OR. Qual Saf Health Care 2005;14(5): 340-346.
26. 26. Takala RS, Pauniaho SL, Kotkansalo A, Helmiö P, Blomgren K, Helminen M et al. A Pilot study of the implementation of WHO Surgical Checklist in Finland: Improvements in Aactivities and communication. Acta Anaesthesiol Scand 2011;55(10):1206-1214.
27. 27. Borchard A, Schwappach DLB, Barbir A, Bezzol P. A Systematic review of the effectiveness, compliance, and critical factors for implementation of safety checklists in surgery. Ann Surg 2012;256(6):926-933.
28. 28. Fudickar A, Hörle K, Wiltfang J, Bein B. The Effect of the WHO Surgical Safety Checklist on complication rate and communication. Dtsch Arztebl Int 2012;109(42):695-701.
29. 29. Shauna ML, Casey SE, Russell BH, Jane YZ, Kaitlin D, Lillian S.K et al. Implementing a surgical checklist: More than checking a box. Surgery 2012;152(3):331–336.
30. 30. Siu J, Maran N, Paterson-Brown S. Observation of behavioural markers of nontechnical skills in the operating room and their relationship to intra-operative incidents. The Surgeon 2014;1-10. http://dx.doi.org/10.1016/j.surge.2014.06.005
31. 31. O’Connor P, Reddin C, O’Sullivan M, O’Duffy F, Keogh I. Surgical checklists: The Human factor. Patient Saf Surg 2013;7(1):3-7.
32. 32. Mascherek AC, Schwappach D, Bezzola P. Frequency of use and knowledge of the WHO-Surgical Checklist in Swiss Hospitals: A Cross-Sectional online survey. Patient Saf Surg 2013;7(14):36.
33. 33. Fourcade A, Blache JL, Grenier C, Bourgain JL, Minvielle E. Barriers to Staff Adoption of a Surgical Safety Checklist. BMJ Qual Saf 2012;21(3):191-197.
34. 34. Norton EK, Singer SJ, Sparks W, Ozonoff A, Baxter J, Rangel S. Operating room clinicians' attitudes and perceptions of a pediatric surgical safety checklist at 1 institution. J Patient Saf 2016;12(1):44-50.