Prevalence of adverse events in hip and knee arthroplasties following the implementation of surgical checklists.
Josemar Batista, Elaine Drehmer de Almeida Cruz
PMID 40396844WHAT IT FOUND
Adverse events in hip and knee arthroplasty patients fell from 63.9% before to 36.1% after two checklists and other perioperative changes at one hospital.
Urinary retention and bleeding fell, but skin injuries rose and wound infections did not change.
Key findings
01The prevalence of adverse events among patients was 63.9% before the checklists, 50.5% after the first, and 36.1% after the second, with a significant reduction.
02Urinary retention affected 33%, 14.4%, and 3.1% of patients across the three periods, and hemorrhage affected 9.3%, 7.2%, and 0%.
03Skin lesions increased from 2.1% to 10.3%, while surgical wound infection prevalence did not differ significantly (6.2%, 4.1%, and 5.2%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Retrospective record review depends on the quality of the hospital records. The study was done in a single hospital, so the findings may not apply to other settings. There was no randomised control group; the comparison was before-and-after across different years. Other perioperative practices changed over the same period, including anaesthesia use, so the checklist effect cannot be isolated. The authors also note that multiple factors can affect adverse events and are not restricted to the checklists. The authors note the sample size as a limitation.
Declared interests
No funding or conflict-of-interest statement is provided in the supplied text.
The easy way to misread this
Do not conclude that the checklists alone caused the lower adverse-event rate. This was a before-and-after record review in one hospital, and other perioperative practices also changed, including anaesthesia use, so the contribution of the checklists cannot be separated.