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. 2022 Jun 1:49:e20223286.
doi: 10.1590/0100-6991e-20223286_en. eCollection 2022.

Effect of the Surgical Safety Checklist on the incidence of adverse events: contributions from a national study

[Article in English, Portuguese]
Luciane Ribeiro DE Faria  1 , Tiago Ricardo Moreira  2 , Fábio DA Costa Carbogim  1 , Ronaldo Rocha Bastos  3
Affiliations

Effect of the Surgical Safety Checklist on the incidence of adverse events: contributions from a national study

[Article in English, Portuguese]
Luciane Ribeiro DE Faria et al. Rev Col Bras Cir. .

Abstract
in English, Portuguese

Objective: the study evaluated the effect of using the safe surgery checklist (CL) on the incidence of adverse events (AE).

Methods: cross-sectional and retrospective research with 851 patients undergoing surgical procedures in 2012 (n=428) and 2015 (n=423), representing the periods before and after CL implantation. The AE incidences for each year were estimated and compared. The association between the occurrence of AE and the presence of CL in the medical record was analyzed.

Results: a reduction in the point estimate of AE was observed from 13.6% (before using the CL) to 11.8% (with the use of the CL). The difference between the proportions of AE in the periods before and after the use of CL was not significant (p=0.213). The occurrence of AE showed association with the following characteristics: anesthetic risk of the patient, length of stay, surgery time and classification of the procedure according to the potential for contamination. Considering the proportion of deaths, there was a significant reduction in deaths (p=0.007) in patients whose CL was used when compared to those without the use of the instrument. There was no significant association between the presence of CL and the occurrence of AE. It was concluded that the presence of CL in the medical record did not guarantee an expected reduction in the incidence of AE.

Conclusion: however, it is believed that the use of the instrument integrated with other patient safety strategies can improve the safety/quality of surgical care in the long term.

Objetivo:: o estudo objetivou avaliar o efeito da utilização do checklist (CL) de cirurgia segura na incidência de eventos adversos (EA).

Método:: pesquisa transversal e retrospectiva com 851 pacientes submetidos a procedimentos cirúrgicos nos anos de 2012 (n=428) e 2015 (n=423), representando os períodos antes e após a implantação do CL. As incidências de EA para cada ano foram estimadas e posteriormente comparadas. Também foi analisada a associação entre a ocorrência do EA e a presença do CL no prontuário.

Resultados:: observou-se uma redução na estimativa pontual de EA de 13,6% (antes do uso do CL) para 11,8% (com a utilização do CL). No entanto, a diferença entre as proporções de EA nos períodos antes e após a utilização do CL não foi significativa (p=0,213). A ocorrência do EA mostrou associação significativa às seguintes características: risco anestésico do paciente, tempo de internação, tempo de cirurgia e classificação do procedimento segundo o potencial de contaminação. Considerando a proporção de óbitos ocorridos nas amostras, observou-se uma redução significativa de mortes (p=0,007) em pacientes cujo CL foi utilizado quando comparados aqueles sem o uso do instrumento. Não foi verificada associação significativa entre a presença do CL no prontuário e a ocorrência do EA de forma geral.

Conclusão:: a presença do CL no prontuário não garantiu uma redução esperada na incidência de EA. No entanto, acredita-se que o uso do instrumento integrado às demais estratégias de segurança do paciente possa melhorar a segurança/qualidade da assistência cirúrgica em longo prazo.

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Conflict of interest statement

Conflict of interest: no.

Figures

Figure 1
Figure 1. Flowchart of tracking of adverse events in the surgical patients’ sample in the periods before and after the use of the CL.
See this image and copyright information in PMC

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