Cultural analysis of surgical safety checklist items in Spain and Argentina

Torres-Manrique, Blanca; Nolasco-Bonmati, Andreu; Maciá-Soler, Loreto; Milberg, Matías; Vilca, Alba Noemi; López-Montesinos, María José; González-Chordá, Víctor Manuel

Acessibilidade / Reportar erro

Brasil

Revista Gaúcha de Enfermagem

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Articles • Rev. Gaúcha Enferm. (Online) 37 (3) • 2016 • https://doi.org/10.1590/1983-1447.2016.03.56359 copy

Cultural analysis of surgical safety checklist items in Spain and Argentina

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To compare the agreement between two surgical checklists implanted in two hospitals in Spain and Argentina, using the international classification for patient safety as a framework.

Method

This was an expert opinion study carried out using an ad hoc questionnaire in electronic format, which included 7 of the 13 categories of the international classification for patient safety. Fifteen surgical security experts from each country participated in this study by classifying the items on the checklists into the selected ICPS categories. The data were analyzed with SPSS V20 software.

Results

There was a greater percentage of classifications in fields related to the prevention of critical events. The category “clinical processes and procedures” was mentioned most frequently in both lists.

Conclusion

The implementation of the surgical safety checklist is variable. Experts considered that the Argentinian list was clearer in every dimension.

Operating room nursing; Patient safety; Operating rooms; Quality of health care

Checklist item	Percentage of agreement*							Proposed category**

	1	2	3	4	5	6	7
Team presentation	40.0	36.7	3.3	3.3	0.0	6.7	10.0	Equivocal (1.2)
Patient identity	13.3	36.7	3.3	0.0	26.7	3.3	16.7	Equivocal (2)
Surgery site	10.0	23.3	13.3	0.0	3.3	13.3	36.7	Equivocal (7)
Procedure	10.0	6.7	3.3	3.3	0.0	6.7	70.0	7
Anesthesia team reviews concerns	13.3	6.7	0.0	10.0	3.3	16.7	50.0	7
Surgeon reviews steps	16.7	6.7	3.3	0.0	6.7	3.3	63.3	7
Nursing reviews sterility	6.7	0.0	46.7	10.0	6.7	6.7	23.3	Equivocal (3)
Antibiotic prophylaxis	3.3	0.0	1343.3	30.0	0.0	10.0	13.3	Equivocal (3.4)
Radiology imaging	3.3	3.3	0.0	0.0	23.3	20.0	50.0	7
Patient identity	10.0	46.7	0.0	0.0	26.7	10.0	6.7	Equivocal (2.5)
Surgical site	10.0	26.7	10.0	0.0	0.0	16.7	36.7	Equivocal (2.7)
Procedure	6.7	10.0	0.0	3.3	0.0	6.7	73.3	7
Consent	3.3	26.7	3.3	3.3	43.3	3.3	16.7	Equivocal (2.5)
Site marked	10.0	23.3	0.0	0.0	3.3	6.7	56.7	7
Pulse oximeter, electrocardiogram, noninvasive arterial pressure, aspiration	3.3	6.7	3.3	6.7	0.0	50.0	30.0	6
Allergies	10.0	30.0	3.3	13.3	10.0	3.3	30.0	Equivocal (2.7)
Difficult airway/ aspiration risk	6.7	10.0	6.7	0.0	0.0	20.0	6.7	7
Risk blood loss (500ml)	3.3	10.0	0.0	16.7	3.3	13.3	53.3	7
Anesthesia safety check	6.7	3.3	0.0	0.0	3.3	26.7	60.0	7
Procedure	23.3	20.0	0.0	3.3	6.7	6.7	40.0	Equivocal (7)
Instrument count	16.7	10.0	0.0	6.7	6.7	20.0	40.0	Equivocal (7)
Gauze/sponge recount	23.3	6.7	6.7	13.3	3.3	6.7	140.0	Equivocal (7)
Specimen label	6.7	13.3	0.0	13.3	36.7	3.3	26.7	Equivocal (5.7)
Treatment recovery	16.7	3.3	0.0	3.3	10.0	6.7	60.0	7
Transportation equipment	13.3	3.3	0.0	0.0	3.3	63.3	16.7	6

Checklist item	Percentage of agreement*							Proposed category**

	1	2	3	4	5	6	7
Patient identity	16.7	26.7	0.0	0.0	36.7	6.7	13.3	Equivocal (2.5)
Type of surgery	10.0	16.7	3.3	0.0	10.0	6.7	53.3	7
Side	6.7	36.7	0.0	0.0	6.7	6.7	43.3	Equivocal (2.7)
Complementary study	0.0	3.3	0.0	3.3	30.0	6.7	56.7	7
Side marked	30.0	13.3	0.0	0.0	3.3	3.3	50.0	7
Blood reserve	6.7	3.3	0.0	60.0	3.3	3.3	23.3	4
Intensive care unit bed	23.3	16.7	0.0	0.0	23.3	30.0	6.7	Equivocal (6)
Fasting	20.0	23.3	0.0	3.3	0.0	6.7	46.7	Equivocal (7)
Anesthesia team check	13.3	6.7	0.0	0.0	0.0	73.3	6.7	6
Oximeter in place and functioning	26.7	6.7	0.0	0.0	0.0	46.7	20.0	Equivocal (1.6)
Allergies	3.3	50.0	0.0	10.0	16.7	3.3	16.7	2
Difficult airway or aspiration risk	26.7	10.0	6.7	0.0	10.0	3.3	43.3	Equivocal (1.7)
FO scope available	16.7	3.3	0.0	10.0	0.0	60.0	10.0	6
Antibiotic prophylaxis	0.0	3.3	66.7	16.7	0.0	3.3	10.0	3
Instrument sterility	6.7	3.3	56.7	0.0	3.3	23.3	6.7	3
Necessary equipment functioning	13.3	0.0	0.0	3.3	6.7	76.7	0.0	6
Prosthesis material available	0.0	3.3	0.0	23.3	6.7	66.7	0.0	6
Entire team present	83.3	13.3	0.0	0.0	3.3	0.0	0.0	1
Team presentation	20.0	70.0	3.3	0.0	0.0	3.3	3.3	2
Decubitus and patient fixation check	26.7	6.7	0.0	0.0	0.0	16.7	50.0	7
Surgeon reviews patient name	3.3	76.7	0.0	3.3	13.3	0.0	3.3	2
Surgeon reviews surgery step	10.0	40.0	0.0	3.3	0.0	3.3	43.3	Equivocal (2.7)
Surgeon reviews unexpected events	16.7	23.3	0.0	3.3	3.3	3.3	50.0	7
Surgeon reviews duration	13.3	23.3	6.7	0.0	3.3	0.0	53.3	7
Anesthesiologist reviews problems	16.7	20.0	0.0	10.0	0.0	0.0	53.3	7
Procedure performed	33.3	3.3	0.0	0.0	3.3	0.0	60.0	7
Instrument, sponge and needle count	16.7	10.0	3.3	0.0	3.3	13.3	53.3	7
Correctly labeled specimen	6.7	10.0	0.0	3.3	36.7	3.3	40.0	Equivocal (5.7)
Specimen labeling	3.3	6.7	0.0	10.0	43.3	3.3	33.3	Equivocal (5.7)
Problem with instruments or equipment	0.0	0.0	0.0	0.0	3.3	93.3	3.3	6
Surgical portion	13.3	16.7	0.0	0.0	60.0	3.3	6.7	5
Anesthesia portion	13.3	16.7	0.0	0.0	56.7	3.3	10.0	5

Surgical checklist	Category chosen by experts*

	1	2	3	4	5	6	7
Spain	11.46%	14.8%	6%	5.6%	9.06%	14%	39.06%
Argentina	15.52%	17.60%	4.58%	5.10%	12.08%	17.91%	21.18%

Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
E-mail: revista@enf.ufrgs.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author: Blanca Torres Manrique. E-mail: torresb@unican.es