Perioperativ kommunikation. En observationsstudie angående operationsteamets följsamhet vid Kontroll inför operationsstart av checklistan för säker kirurgi 2.0

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Sammanfattning: Background: Medical errors caused by the Healthcare is a problem that entails unnecessarily suffering, death and large economic loss. World Health Organization started a global collaboration to improve safety in surgery which resulted in the Surgical Safety Checklist (SSC). The implementation has led to improvement in patient safety, teamwork, and communication and as a result decreased mortality and morbidity. SSC has been modified during time, where compliance with the design is important for its outcome. Increased need for change resulted in a new Swedish version: Surgical Safety Checklist 2.0. Aim: To illustrate the compliance of the surgery team using the Surgical Safety Checklist 2.0 regarding the part Control before surgery. Method: A quantitative and non-participant structured observational study was performed at one surgery unit on 22 occasions. A structured observation schedule was used to document the compliance of the surgical team. Results: Compliance with Control before surgery was measured at 72%. Initiation was performed by the assistant nurse twelve times compared to eight times for the surgeon. Average time required for rewiev was 1 minute and 24 seconds and all ordinary team members had full presence except for the anaesthesiologist that participated in four times out of 22. All items were answered in the correct order and by the recommended professions from the instruction manual. Fourteen items were neglected, and 60 items was incomplete out of total 264. Conclusion: The new version is used correctly for the section Control before surgery, regarding the point review and which profession who answered which point. Compliance is relatively high although the information from the new manual has not been fully complied and correct used regarding the items: Presentation of the patient and Planned surgery and site. The recommendation that initiation should take place by the surgeon is not followed and the presence of anaesthesiologist during the current study is exceptionally low. The checklist contributes to information transfer and communication opportunities for the team, which exhibits a patient safety culture with good quality teamwork where both patient safety and patient centred care can be seen.

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