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WHO Surgical Safety Checklist -Safe Surgery Saves Lives initiative

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WHOThe aim of the resulting WHO Surgical Safety Checklist First Edition is to reinforce accepted safety practices and foster better communication and teamwork between clinical disciplines. The Checklist is not a regulatory device or a component of official policy; it is intended as a tool for use by clinicians interested in improving the safety of their operations and reducing unnecessary surgical deaths and complications.

    The Safe Surgery Saves Lives initiative was established by the World Alliance for Patient Safety as part of the World Health Organization’s efforts to reduce the number of surgical deaths across the world. The aim of this initiative is to harness political commitment and clinical will to address important safety issues, including inadequate anaesthetic safety practices, avoidable surgical infection and poor communication among team members. These have proved to be common, deadly and preventable problems in all countries and settings. To assist operating teams in reducing the number of these events, the Alliance —in consultation with surgeons, anaesthesiologists, nurses, patient safety experts and patients around the world—has identified a set of safety checks that could be performed in any operating room.

    In this manual, the “operating team” is understood to comprise the surgeons, anaesthesia professionals, nurses, technicians and other operating room personnel involved in surgery. Much as an airplane pilot must rely on the ground crew, flight personnel and air traffic controllers for a safe and successful flight, a surgeon is an essential but not solitary member of a team responsible for patient care. The operating team referred to in this manual is therefore composed of all persons involved, each of whom plays a role in ensuring the safety and success of an operation.
This manual provides suggestions for implementing the Checklist, understanding that different practice settings will adapt it to their own circumstances. Each safety check has been included based on clinical evidence or expert opinion that its inclusion will reduce the likelihood of serious, avoidable surgical harm and that adherence to it is unlikely to introduce injury or unmanageable cost.

    The Checklist was also designed for simplicity and brevity. Many of the individual steps are already accepted as routine practice in facilities around the world, though they are rarely followed in their entirety. Each surgical department must practice with the Checklist and examine how to sensibly integrate these essential safety steps into its normal operative workflow. The ultimate goal of the WHO Surgical Safety Checklist—and of this manual—is to help ensure that teams consistently follow a few critical safety steps and thereby minimize the most common and avoidable risks endangering the lives and well-being of surgical patients.

WHO Surgical Safety Checklist

    The Checklist can be modified to account for differences among facilities with respect to their processes, the culture of their operating rooms and the degree of familiarity each team member has with each other. However, removing safety steps because they cannot be accomplished in the existing environment or circumstances is strongly discouraged. The safety steps should inspire effective change that will bring an operating team to comply with each and every element of the Checklist.

    In order to ensure brevity, the WHO Surgical Safety Checklist was not intended to be comprehensive. Facilities may wish to add safety steps to the Checklist. Teams should consider adding other safety checks for specific procedures, particularly if they are part of a routine process established in the facility. Each phase should be used as an opportunity to verify that critical safety steps are consistently completed. Additional steps might include confirmation of venous thromboembolism prophylaxis by mechanical means (such as sequential compression boots and stockings) and/or medical means (such as heparin or warfarin) when indicated, the availability of essential implants (such as mesh or a prosthetic), other equipment needs or critical preoperative biopsy results, laboratory results or blood type. Each locale is encouraged to reformat, reorder or revise the Checklist to accommodate local practice while ensuring completion of the critical safety steps in an efficient manner. Facilities and individuals are cautioned, however, against making the Checklist unmanageably complex.

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Last Updated ( Wednesday, 25 June 2008 22:09 )  

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