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. 2013 Dec 21;48(6):554-562.
doi: 10.1016/j.rboe.2013.12.010. eCollection 2013 Nov-Dec.

The WHO Surgical Safety Checklist: knowledge and use by Brazilian orthopedists

Geraldo da Rocha Motta Filho  1   2 , Lúcia de Fátima Neves da Silva  3   4   5 , Antônio Marcos Ferracini  2   6 , Germana Lyra Bähr  3   7   8
Affiliations

The WHO Surgical Safety Checklist: knowledge and use by Brazilian orthopedists

Geraldo da Rocha Motta Filho et al. Rev Bras Ortop. .

Abstract
in English, Portuguese

Objective: The research examined Brazilian orthopedists' degree of knowledge of the World Health Organization Surgical Safety Checklist.

Methods: A voluntary survey was conducted among the 3231 orthopedists taking part in the 44th Brazilian Congress of Orthopedics and Traumatology in November 2012, using a questionnaire on the use of WHO Surgical Safety Checklist. A statistical analysis was done upon receipt of 502 completed questionnaires.

Results: Among the 502 orthopedists, 40.8% reported the experience of wrong site or wrong patient surgery and 25.6% of them indicated "miscommunication" as the main cause for the error. 35.5% of the respondents do not mark the surgical site before sending the patient to the operating room and 65.3% reported lack of knowledge of the World Health Organization (WHO) Surgical Safety Checklist, fully or partially. 72.1% of the orthopedists have never been trained to use this protocol.

Discussion: Medical errors are more common in the surgical environment and represent a high risk to patient safety. Orthopedic surgery is a high volume specialty with major technical complexity and therefore with increased propensity for errors. Most errors are avoidable through the use of the WHO Surgical Safety Checklist. The study showed that 65.3% of Brazilian orthopedists are unaware of this protocol, despite the efforts of WHO for its disclosure.

Objetivo: A pesquisa analisou o grau de conhecimento do Protocolo de Cirurgia Segura da OMS pelos ortopedistas brasileiros.

Métodos: Foi feita uma pesquisa voluntária entre os 3.231 ortopedistas participantes do 44° Congresso Brasileiro de Ortopedia e Traumatologia (CBOT), em novembro de 2012, por meio de um questionário sobre o uso do Protocolo de Cirurgia Segura da OMS. Após o recebimento de 502 questionários respondidos, foi feita a análise estatística dos resultados.

Resultados: Dentre os 502 ortopedistas respondentes, 40,8% relataram ter vivenciado a experiência de cirurgia em paciente ou em local errado e 25,6% deles apontaram “falhas de comunicação” como responsáveis pelo erro. Do total de respondentes, 36,5% relataram não marcar o local da cirurgia antes de encaminhar o paciente ao centro cirúrgico e 65,3%, desconhecer total ou parcialmente o Protocolo de Cirurgia Segura da OMS. Desses ortopedistas, 72,1% nunca foram treinados para o uso do protocolo.

Discussão: Erros médicos ocorrem, principalmente em ambiente cirúrgico, e representam um alto risco para a segurança dos pacientes. Considerando que a cirurgia ortopédica é uma especialidade de grande volume e frequentemente de alta complexidade, envolve uma probabilidade grande de ocorrência de erros, a maioria evitável por meio do uso do Protocolo de Cirurgia Segura da OMS. Na amostra pesquisada, restou evidenciado que 65,3% dos ortopedistas brasileiros desconhecem tal protocolo, apesar dos esforços da OMS para a sua divulgação.

Keywords: Checklist; Medical errors; Operative; Patient safety; Surgical procedures.

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Figures

Fig. 1
Fig. 1
Checklist before starting anesthesia (Sign In).
Fig. 2
Fig. 2
Checklist before making the skin incision (Time Out).
Fig. 3
Fig. 3
Checklist before the patient is taken out of the operating theater (Sign Out).
Fig. 4
Fig. 4
Classification of the types of incidents.
See this image and copyright information in PMC

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