Summary of WHO Surgical Safety Checklist - MRCOG Part 2 & 3 Tasks

Summary of the Video: WHO Surgical Safety Checklist - MRCOG Part 2 & 3 Tasks

This video provides a comprehensive overview of the WHO Surgical Safety Checklist, focusing on its relevance for MRCOG Part 2 and Part 3 candidates. The checklist is emphasized as a crucial clinical tool for ensuring patient safety during surgery, beyond its exam importance.

Main Ideas and Concepts

• Importance of WHO Surgical Safety Checklist
  • A global safety tool developed by WHO in 2008 to reduce surgical morbidity and mortality.
  • Promotes a culture of safety, reduces errors and adverse events, improves teamwork and communication during surgery.
  • Used worldwide as an international standard in surgical care.
• Structure of the Checklist
  The checklist is divided into three main sections with a total of 19 questions to be answered by the surgical team:
  1. Sign In (Briefing) – Before induction of anesthesia
     • Confirm patient identity (using triple identification if names are similar)
     • Confirm procedure, site, and consent
     • Mark surgical site
     • Check anesthesia machine and medications
     • Confirm presence and function of monitoring equipment
     • Identify allergies, airway difficulties, aspiration risk
     • Assess risk of blood loss and plan accordingly (e.g., IV access)
  2. Time Out – Before skin incision
     • Team introductions (name and role)
     • Confirm patient identity, procedure, incision site
     • Confirm antibiotic prophylaxis within 60 minutes
     • Discuss anticipated critical events with surgeon, anesthetist, nurse
     • Confirm sterility and any concerns about equipment
     • Confirm any necessary imaging is displayed
  3. Sign Out (Debriefing) – Before patient leaves operating room
     • Confirm procedure performed (including any changes)
     • Confirm instrument, sponge, needle counts
     • Confirm specimen labeling
     • Address any equipment problems
     • Discuss recovery concerns
• Integration of the Checklist in Healthcare Units
  • Review and understand evidence on patient impact
  • Present evidence to medical staff and mandate use
  • Conduct internal audits to monitor usage
  • Analyze impact of checklist use vs. non-use
  • Discuss findings with staff to ensure continuous use
• Adapting the Checklist for Specific Environments (e.g., Maternity Unit)
  • Focused: Include only critical and previously unchecked safety points
  • Brief: Each section should take no more than one minute (3 minutes total)
  • Actionable: Each item should have a clear, specific action linked to it
  • Verbal: Should be performed as a team communication exercise
  • Collaborative: Involve nurses, anesthetists, surgeons, and other relevant staff
  • Testing and simulation practice are essential before full integration.
• Mandatory Items That Should Never Be Removed
  • Team introductions (name and role)
  • Patient identity confirmation
  • Procedure and treatment plan discussion
• Specific Additions for Maternity/Cesarean Section Checklist
  • Sign In: Add cesarean section category (emergency levels 1-4), readiness of resuscitation equipment, and neonatal team notification
  • Time Out: Add Obstetrician concerns about placental site, Midwife checks (cord blood sampling, urinary catheter drainage, fetal scalp electrode removal), VTE prophylaxis assessment
  • Sign Out: Add Midwife checks for baby labeling, cord blood collection and gas analysis
• Exam Preparation Tips for Candidates
  • Understand the timing, personnel, and questions for each checklist section
  • Demonstrate leadership and communication skills during the structured discussion
  • Address all three domains: communication, patient safety, and applied clinical knowledge
  • Be aware of the checklist’s aims, structure, and integration steps
  • Know how to adapt the checklist for specific units like maternity
• Common Candidate Pitfalls
  • Some candidates know the checklist but fail to understand the question or miss key points
  • Importance of knowing non-technical skills (NOTSS) including communication and teamwork

Detailed Bullet Points: WHO Surgical Safety Checklist Overview

Sections and Questions

• Sign In (Before anesthesia induction) – 7 items:
  • Patient identity (triple ID if needed)
  • Procedure and site confirmation
  • Consent check and site marking
  • Anesthesia machine and medication readiness
  • Monitoring equipment check (e.g., pulse oximeter)
  • Allergy, airway, aspiration risk assessment
  • Blood loss risk and IV access plan
• Time Out (Before skin incision) – 7 items:
  • Team introductions (name and role)

Notable Quotes

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Category

Educational

Video