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Surgery. 2018 Aug;164(2):344-349. doi: 10.1016/j.surg.2018.04.007. Epub 2018 May 24.

Adherence to the Pediatric Preinduction Checklist Is Improved When Parents Are Engaged in Performing the Checklist.

Author information

1
Center for Surgical Trials and Evidence-based Practices (C-STEP), The University of Texas Health Sciences Center at Houston, TX, USA; Children's Memorial Hermann Hospital, Houston, TX, USA; Department of Pediatric Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, TX, USA.
2
Children's Memorial Hermann Hospital, Houston, TX, USA; Department of Pediatric Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, TX, USA.
3
Center for Surgical Trials and Evidence-based Practices (C-STEP), The University of Texas Health Sciences Center at Houston, TX, USA; Children's Memorial Hermann Hospital, Houston, TX, USA; Department of Pediatric Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, TX, USA. Electronic address: kuojen.tsao@uth.tmc.edu.

Abstract

BACKGROUND:

The World Health Organization recommends including the parents in completion of the pediatric surgical safety checklist. At our hospital, the preinduction surgical safety checklist is conducted in the preoperative holding with anesthesia, nursing, and often with the parents of children undergoing an operative procedure. We hypothesized that adherence to the preinduction checklist is better when parents are engaged in surgical safety checklist performance.

METHODS:

An observational study of adherence to the preinduction checklist for nonemergent pediatric operations was performed (2016-2017). Adherence was defined as verbalization of checkpoints. Only checkpoints (patient identification, procedure, site marking, weight, allergies, and NPO status) relevant to parental knowledge were evaluated. Parental engagement was based on: positive body language, eye contact, lack of distractions, and understanding of checkpoints.

RESULTS:

484 preinduction surgical safety checklists were observed (interrater reliability >0.7). Partial completion occurred in 55% cases; only 41% checklists were fully completed. Parents were present for 81% of checklists, and more checkpoints were performed when parents were present (5, IQR 4-6) versus absent (2, IQR 1-3, P < .001). Increased preinduction adherence was associated with increased parent engagement by linear regression analysis (1.20, 95%CI 1.05-1.33). Staff confirmed more checkpoints with engaged parents (28-78%) versus when parents were not engaged (1-9%, P < .001 for all checkpoints).

CONCLUSION:

Overall preinduction surgical safety checklist performance was poor (less than half of checklists fully completed). In contrast, checklist adherence improved with parental presence and engagement during performance of the checklist.

PMID:
29803562
DOI:
10.1016/j.surg.2018.04.007
[Indexed for MEDLINE]

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