Prevalence of adverse events in hip and knee arthroplasties following the implementation of surgical checklists^*

Objective: to identify the prevalence of adverse events in patients undergoing hip and knee arthroplasties following the implementation of surgical checklists.

Method: an evaluative study, based on effect analysis, conducted over three periods: pre- (0- 2010) and post- intervention (I- 2013; II- 2016), with retrospective consultation of a simple random sample of 291 medical records between November 2020 and March 2022. The Canadian Adverse Events Study and Global Trigger Tool forms were used to track and confirm adverse events. Cases were analyzed using descriptive and inferential statistics; p-values ≤ 0.05 indicated significance.

Results: in the post-implementation periods of surgical checklists, a reduction was observed in the frequency of patients affected by two or more events, from 27.8% to 11.3% (p = 0.002), and in the overall prevalence, from 63.9% to 36.1% (p < 0.001). A decrease in the prevalence of patients affected by urinary retention (33% to 3.1%; p < 0.001) and hemorrhage (9.3% to 0%; p = 0.012) was also noted. There was an increase in the prevalence of skin lesions, from 2.1% to 10.3% (p = 0.043).

Conclusion: there was a reduction in the overall prevalence and frequency of adverse events in patients undergoing arthroplasty following the implementation of surgical checklists.

Descriptors:
Perioperative Care; Medical Errors; Patient Safety; Arthroplasty; Checklist; Outcome and Process Assessment Health Care

Highlights:

(1) High prevalence of adverse events in hip and knee arthroplasties. (2) Surgical checklists reduce the prevalence of adverse events in arthroplasties. (3) There was a significant decrease in patients affected by two or more adverse events. (4) Investigating the impact of interventions contributes to fostering a culture of safety. (5) The results are relevant for strengthening basic perioperative safety measures.