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East and Central African Journal of Surgery
Association of Surgeons of East Africa and College of Surgeons of East Central and Southern Africa
ISSN: 1024-297X EISSN: 1024-297X
Vol. 20, No. 3, 2015, pp. 3-11
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Bioline Code: js15044
Full paper language: English
Document type: Research Article
Document available free of charge
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East and Central African Journal of Surgery, Vol. 20, No. 3, 2015, pp. 3-11
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The Effect of a Surgical Safety Checklist on Mortality, Morbidity and Cancellation at a South African Tertiary Institute Orthopaedic Department.
Lisenda, L. & Lukhele, M.
Abstract
Background: Surgical complications are common and most of them are preventable,
especially if one considers that 53% to 70% of surgical errors occur outside theatre.
Recent studies have shown that pre-operative checklists are associated with improved
patient outcome. We hypothesize that in our institution there will be an improvement in
patient outcome if a safety checklist is introduced.
Methods: A modified multidisciplinary WHO safety checklist was introduced at our
institution on the 1st March 2011. The primary focus was on elective patients admitted in
all the units of the division of orthopaedic surgery. We retrospectively collected data from
the daily morbidity and mortality (MM) reports presented by the different units of the
division of orthopaedic surgery from the 1st January to 31st May 2011. In addition a preinduction
and post-induction survey was completed by all registrars.
Results: The mortality rate decreased by 0.42% (from 1.83% to 1.41%) after the
introduction of a surgical safety checklist. There was also a 0.66% reduction in avoidable
morbidity (from 1.83% to 1.17%) and a 1.6% reduction in avoidable cancellation (from
2.3% to 0.7%). Only 77% of registrars acknowledged undertaking pre-operative planning
prior to implementation of the checklist compared with 87.5% post implementation.
Conclusion: The implementation of the modified WHO safety check list was associated with
some reduction in cancellations, avoidable morbidity and mortality. Surgical safety
checklists should be regarded as a standard practice for all orthopaedic procedures in
order to decrease complications, especially in high operation volume and training centers.
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