Adherence to the cardiac surgery checklist decreased mortality at a teaching hospital: A retrospective cohort study

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Citações na Scopus
3
Tipo de produção
article
Data de publicação
2022
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ELSEVIER ESPANA
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CLINICS, v.77, article ID 100048, 6p, 2022
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Resumo
Objective: To evaluate the impact of adherence to the cardiac surgical checklist on mortality at the teaching hospital. Methods: A retrospective cohort study after the implementation of the cardiac surgical safety checklist in a reference hospital in Latin America. All patients undergoing coronary artery bypass surgery and/or heart valve surgery from 2013 to 2019 were analyzed. After the implementation of the project InCor-Checklist ???Five steps to safe cardiac surgery??? in 2015, the correlation between adherence and completeness of this instrument with surgical mortality was assessed. The EuroSCORE II was used as a reference to assess the risk of expected mortality for patients. Cross-sectional questionnaires were during the implementation of the InCor-Checklist. To perform the correlation, Pearson???s coefficient was calculated using R software. Results: Since 2013, data from 8139 patients have been analyzed. The average annual mortality was 5.98%. In 2015, the instrument was used in only 58% of patients; in contrast, it was used in 100% of patients in 2019. There was a decrease in surgical mortality from 8.22% to 3.13% for the same group of procedures. The results indicate that the greater the checklist use, the lower the surgical mortality (r = 88.9%). In addition, the greater the InCor-Checklist completeness, the lower the surgical mortality (r = 94.1%). Conclusion: In the formation of the surgical patient safety culture, the implementation and adherence to the InCorChecklist ???Five steps to safe cardiac surgery??? was associated with decreased mortality after cardiac surgery.
Palavras-chave
Checklists, Quality improvement, Cardiac surgery, Mortality
Referências
  1. Bock M, 2016, JAMA SURG, V151, P639, DOI 10.1001/jamasurg.2015.5490
  2. Clancy CM, 2009, AM J MED QUAL, V24, P525, DOI 10.1177/1062860609349728
  3. Clark SC, 2012, EUR J CARDIO-THORAC, V41, P993, DOI 10.1093/ejcts/ezs009
  4. de Jager E, 2019, WORLD J SURG, V43, P117, DOI 10.1007/s00268-018-4703-x
  5. de Leval MR, 2000, J THORAC CARDIOV SUR, V119, P661, DOI 10.1016/S0022-5223(00)70006-7
  6. de Vries EN, 2008, QUAL SAF HEALTH CARE, V17, P216, DOI 10.1136/qshc.2007.023622
  7. de Vries EN, 2010, NEW ENGL J MED, V363, P1928, DOI 10.1056/NEJMsa0911535
  8. Flin R, 2009, BMJ-BRIT MED J, V339, P984
  9. Gawande A., CHECKLIST MANIFESTO, V1st, P215
  10. Haynes AB, 2017, ANN SURG, V266, P923, DOI 10.1097/SLA.0000000000002249
  11. Haynes AB, 2011, BMJ QUAL SAF, V20, P102, DOI 10.1136/bmjqs.2009.040022
  12. Haynes AB, 2009, NEW ENGL J MED, V360, P491, DOI 10.1056/NEJMsa0810119
  13. Hill MR, 2015, BRIT J ANAESTH, V114, P958, DOI 10.1093/bja/aev063
  14. Kawano T, 2014, J ANESTH, V28, P467, DOI 10.1007/s00540-013-1737-y
  15. Kohn LT, 2000, ERR IS HUMAN, V1st, P312
  16. Lingard L, 2004, QUAL SAF HEALTH CARE, V13, P330, DOI 10.1136/qshc.2003.008425
  17. Lingard L, 2008, ARCH SURG-CHICAGO, V143, P12, DOI 10.1001/archsurg.2007.21
  18. Lingard L, 2011, BMJ QUAL SAF, V20, P475, DOI 10.1136/bmjqs.2009.032326
  19. Marsteller JA, 2015, ANN THORAC SURG, V100, P2182, DOI 10.1016/j.athoracsur.2015.05.109
  20. Mayer EK, 2016, ANN SURG, V263, P58, DOI 10.1097/SLA.0000000000001185
  21. Mejia OAV, 2020, ARQ BRAS CARDIOL, V114, P603, DOI 10.36660/abc.20190736
  22. Neily J, 2010, JAMA-J AM MED ASSOC, V304, P1693, DOI 10.1001/jama.2010.1506
  23. Ogrinc G, 2008, QUAL SAF HEALTH CARE, V17, P13, DOI 10.1136/qshc.2008.029058
  24. Organization WH, WHO GUID SAF SURG 20, V08
  25. Papaspyros SC, 2010, INTERACT CARDIOV TH, V10, P43, DOI 10.1510/icvts.2009.217356
  26. Ramsay G, 2019, BRIT J SURG, V106, P1005, DOI 10.1002/bjs.11151
  27. Russ S, 2013, ANN SURG, V258, P856, DOI 10.1097/SLA.0000000000000206
  28. Sanchez JA, 2016, ANN THORAC SURG, V101, P426, DOI 10.1016/j.athoracsur.2015.12.034
  29. Singer SJ, 2016, J AM COLL SURGEONS, V223, P568, DOI 10.1016/j.jamcollsurg.2016.07.006
  30. Spanjersberg AJ, 2020, J THORAC CARDIOV SUR, V159, P1882, DOI 10.1016/j.jtcvs.2019.07.094
  31. Urbach DR, 2014, NEW ENGL J MED, V370, P1029, DOI 10.1056/NEJMsa1308261
  32. Wahr JA, 2013, CIRCULATION, V128, P1139, DOI 10.1161/CIR.0b013e3182a38efa
  33. Weiser TG, 2008, LANCET, V372, P139, DOI 10.1016/S0140-6736(08)60878-8
  34. Weiser TG, 2010, INT J QUAL HEALTH C, V22, P365, DOI 10.1093/intqhc/mzq039
  35. Ziewacz JE, 2011, J AM COLL SURGEONS, V213, P212, DOI 10.1016/j.jamcollsurg.2011.04.031