Surgical safety check list: the italian experience

Introduction: The University Hospital of Modena is one of the largest hospitals in the Emilia Romagna region and each yearabout 15.000 surgery procedures are performed. We have been working on safety surgery, for safety of patients throughoutthe control of the correct function of surgical devices and sterilization of surgical instruments.In particular we have created andapplied a project called "SOS surgery" that included all the 4 objectives of the second Global Patient Safety Challenge "SafeSurgery Save Life" that are: Clean Surgery, Safe Anesthesia, Safe Surgical Teams, and Measurement. In agreement with theW.H.O. program we have decided to use the surgical safety check list to improve communication between all members of thesurgical team.Material and Methods: In October 2008 we started a trial for the application of the surgical check list. We have involved onegeneral surgery unit and we've appropriately trained the whole surgical team involved. We have identi\ufb01ed as check listcoordinatora circulating nurse who con\ufb01rms completion of each step of the check list. At the end of procedures the whole teamagree and sign the check list.Results: During a period of three months we collected 175 check lists. The analysis of the data has highlighted 30 criticalevents (17%) represented by surgical site not market in two cases, laterality not reported on the surgical note in one, change inanaesthesiological technique not reported on the surgical note in three, an inversion in the order of the procedures as plannedin another three, patient without the ID tag in one, the antibiotic prophylaxis not reported on the surgical note in seven, theabsence of the anaesthesiological consent in one, the absence of blood risk evaluation in three, a surgical team di\ufb00erent fromwhich on the surgical note in six, procedure not properly indicated on the surgical note in two and lack of preoperative patientpreparation in one case. In any case the critical events reported had clinical negative consequences on patients.Conclusions: The compliance of the whole surgical team in the application of the checklist has been satisfactory and itsapplication has been useful to check and avert critical events. It's our aim to extend its use \ufb01rst of all to the other generalsurgery units and then to the other surgical specialties