Key result
Observing the use of pre-induction checklists caused far less discomfort in patients than anaesthesia providers expected, with patients highly valuing the potential safety benefits.
Why the study?
Anaesthesia professionals are often reluctant to use pre-induction checklists in front of patients out of fear of causing patient discomfort.
Does the use of pre-induction checklists cause less patient discomfort than estimated by anaesthesia providers in surgical patients?
Observational (n=235)
No
Does the use of pre-induction checklists cause less patient discomfort than estimated by anaesthesia providers in surgical patients?
Patients experience significantly less discomfort observing pre-induction checklists than anaesthesia providers expect, supporting their routine implementation in the operating room.
May alleviate provider concerns over checklist discomfort; leaves open safety impact pending randomized trials.
BACKGROUND: Since the WHO release of the Safe Surgery Saves Lives Program in 2008, peri-operative checklists minimise errors and improve patient safety worldwide. Anaesthesia professionals are often reluctant to use these checklists in front of patients because they fear causing patients' discomfort before anaesthesia and surgery. OBJECTIVE: To assess and compare the subjective level of patient discomfort caused by the use of pre-induction checklists with the patient discomfort estimated by anaesthesia providers. DESIGN: Prospective observational study. SETTING: The current single-centre trial included 110 anaesthesia providers and 125 nonpremedicated ear, nose and throat or maxillofacial surgery patients in Switzerland from June to August 2016. Inclusion criterion: signed general research consent. EXCLUSION CRITERIA: received premedication, less than 18 years old, day-care patients, dementia or other mental illnesses. INTERVENTIONS: Anaesthesia healthcare providers and patients before surgery and on the first postoperative day were asked to rate three statements: MAIN OUTCOME MEASURES: All statements were rated on a 100-mm visual analogue scale, where 0 meant no agreement and 100 meant total agreement. RESULTS: Patients overwhelmingly agreed that anaesthesia providers should use checklists in front of them. Anaesthesia providers rated the patient discomfort much higher than actually perceived by patients. Both, patients and anaesthesia providers rated the possibility of reducing the risk of errors high. CONCLUSION: Patients experience far less discomfort observing the use of pre-induction checklists than anaesthesia providers expect. Patients value the potential safety benefit significantly higher than anaesthesia providers. These results further support the implementation of peri-operative checklists in the operating room environment. TRIAL REGISTRATION: The current observational study had no intervention, therefore, was not registered.
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Nabecker et al. (2019) conducted an observational in Ear, nose and throat or maxillofacial surgery (n=235). Pre-induction checklists vs. Anaesthesia providers' estimation was evaluated on Subjective level of patient discomfort on a 100-mm visual analogue scale. Observing the use of pre-induction checklists caused far less discomfort in patients than anaesthesia providers expected, with patients highly valuing the potential safety benefits.
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