Assessment Of The Implementation Of Surgery And Anesthesia Adverse Events Associated With Surgical Safety Checklist System

Background:In order to improve surgical patient safety, it is essential to conduct a comprehensive assessment of the current status of surgical adverse events and the WHO checklist.Objective:This study evaluated the status of surgical adverse events at PUMCH, aiming to①identify an assessment method of both objectivity and efficiency,②assess the predication method on the risk of surgical adverse events,③evaluate the current performance of the WHO checklist.Method:A total of464patients undergoing elective surgery (including general surgery, thoracic surgery and hepatic surgery) at PUMCH from February2012to March2012were enrolled in this study. Several specifically designed questionnaires were distributed to these patients’corresponding residents, anesthesiologists and the researchers to evaluate the situation of surgical adverse events as well as the performance of the WHO checklist.Results:Using the chart review method, we found132surgical adverse events (28.4per100cases) occurred in98patients (21.1%), with infection as the leading of the list. There are significant differences in the results between the data gathered from questionnaire and that extracted from the chart review. The surgical risk grading system of national nosocomial infections surveillance (NNIS) was useful in identifying the risk of surgical adverse events. Only27.0%of the surgical teams accomplished all the items on the WHO checklist, while Only47.3%of them performed the sign out stage as well.Conclusion:The incidence of surgical adverse events in our study is higher than that from previous references. Although the traditional chart review method used in this study requires further modification, it cannot be replaced by the questionnaire of complications in the setting of monitoring surgical adverse events. The current performance of the WHO surgical checklist is far from perfect and needs to be improved.