Establishment and implementation of safety check project for invasive procedures outside the operating room.
Yan Hou, Xiaoyu Di, Chanell Concepcion and 2 others
PMID 33997134WHAT IT FOUND
After implementation, completion of the revised safety checklist for invasive procedures outside the operating room rose, signatures and timing were more often correct, and no wrong patient, procedure, or site errors were reported.
Key findings
01Completed safety checking was 521 (41.7%) before implementation, 3572 (90.4%) in 2018, and 4465 (88.9%) in 2019.
02Correct signature was 218 (41.9%) before implementation, 3501 (98.0%) in 2018, and 4423 (99.0%) in 2019; correct timing was 179 (34.4%), 3489 (97.6%), and 4401 (98.5%).
03No adverse events such as errors in patient identification, procedure, or operative site were reported during the pre-implementation and post-implementation phases.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in one hospital, so the result may not transfer to units with different staffing, patient mix, or electronic records. It compared documentation before and after implementation without a concurrent control group, so other changes at the same time cannot be ruled out. The main outcomes were checklist completion, signatures, and timing, not direct patient harm or clinical outcomes. The report of no wrong patient, procedure, or site errors does not show that the checklist caused that outcome. Compliance was not full; even after implementation, some procedures did not have completed safety checking.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that the checklist prevented wrong patient, procedure, or site errors. The study reports better documentation after implementation and no reported errors, but it had no control group and did not directly measure whether the checklist caused safer care.