The final step in the surgical safety checklist

Implementing this checklist during the hospital stay within 30 days after surgery may reduce the incidence of complications, including death.

Used at three critical times in the operating room: Before anesthesia Before skin incision Before the patient leaves the operating room This checklist is not exhaustive and is encouraged to be added and modified to suit local medical institutions.

About this checklist This study was published by Haynes et al. on January 14, 2009, in the New England Journal of Medicine to address the issue of surgical complications. Researchers aimed to improve team communication and consistency of care by implementing a simple method of a 19-item surgical safety checklist. This is a multicenter, international, prospective study with subjects from different geographical locations and economic levels. First, prospectively collected data from 3733 consecutively enrolled patients, and then prospectively collected data from 3955 patients after implementing the surgical safety checklist. The primary endpoint was the incidence of complications (including death) during the hospital stay within 30 days after surgery. Only patients over 16 years old undergoing non-cardiac surgery were included.

Results of implementing the surgical checklist The surgical mortality rate was 1.5% in the non-use group and 0.8% in the use group (P=0.003). The incidence of in-hospital complications was 11.0% in the non-use group and 7.0% in the use group (P<0.001). The surgical site infection rate and unplanned reoperation rate were also significantly reduced in the use group (p<0.05).