Listas de seguridad/Safety checklists

Revisión sistemática de las listas de control de seguridad para el uso de los equipos de atención médica en los hospitales agudos - pruebas limitadas de su efectividad.


Systematic review of safety checklists for use by medical care teams in acute hospital settings--limited evidence of effectiveness.
Ko HC, Turner TJ, Finnigan MA.
Centre for Clinical Effectiveness, Southern Health, Locked Bag 29, Clayton, Victoria, 3168, Australia. henry.ko@ctc.usyd.edu.au
BMC Health Serv Res. 2011 Sep 2;11:211. doi: 10.1186/1472-6963-11-211.
Abstract
BACKGROUND: Patient safety is a fundamental component of good quality health care. Checklists have been proposed as a method of improving patient safety. This systematic review, asked "In acute hospital settings, would the use of safety checklists applied by medical care teams, compared to not using checklists, improve patient safety?" METHODS: We searched the Cochrane Library, MEDLINE, CINAHL, and EMBASE for randomised controlled trials published in English before September 2009. Studies were selected and appraised by two reviewers independently in consultation with colleagues, using inclusion, exclusion and appraisal criteria established a priori. RESULTS: Nine cohort studies with historical controls studies from four hospital care settings were included-intensive care unit, emergency department, surgery, and acute care. The studies used a variety of designs of safety checklists, and implemented them in different ways, however most incorporated an educational component to teach the staff how to use the checklist. The studies assessed outcomes occurring a few weeks to a maximum of 12 months post-implementation, and these outcomes were diverse.The studies were generally of low to moderate quality and of low levels of evidence, with all but one of the studies containing a high risk of bias.The results of these studies suggest some improvements in patient safety arising from use of safety checklists, but these were not consistent across all studies or for all outcomes. Some studies showed no difference in outcomes between checklist use and standard care without a checklist. Due to the variations in setting, checklist design, educational training given, and outcomes measured, it was unfeasible to accurately summarise any trends across all studies.
CONCLUSIONS: The included studies suggest some benefits of using safety checklists to improve protocol adherence and patient safety, but due to the risk of bias in these studies, their results should be interpreted with caution. More high quality and studies, are needed to enable confident conclusions about the effectiveness of safety checklists in acute hospital settings.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3176176/pdf/1472-6963-11-211.pdf


Listas de control de neurocirugía: una revisión

Neurosurgical checklists: a review.
Zuckerman SL, Green CS, Carr KR, Dewan MC, Morone PJ, Mocco J.
Department of Neurological Surgery, Vanderbilt University School of Medicine, Tennessee, USA.
Neurosurg Focus. 2012 Nov;33(5):E2. doi: 10.3171/2012.9.FOCUS12257.
Abstract
Morbidity due to avoidable medical errors is a crippling reality intrinsic to health care. In particular, iatrogenic surgical errors lead to significant morbidity, decreased quality of life, and attendant costs. In recent decades there has been an increased focus on health care quality improvement, with a concomitant focus on mitigating avoidable medical errors. The most notable tool developed to this end is the surgical checklist. Checklists have been implemented in various operating rooms internationally, with overwhelmingly positive results. Comparatively, the field of neurosurgery has only minimally addressed the utility of checklists as a health care improvement measure. Literature on the use of checklists in this field has been sparse. Considering the widespread efficacy of this tool in other fields, the authors seek to raise neurosurgical awareness regarding checklists by reviewing the current literature.
http://thejns.org/doi/pdf/10.3171/2012.9.FOCUS12257




Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org