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Safe preoperative regional nerve blocks

BACKGROUND: Procedural time-outs and checklists are proven to be an effective means of improving teamwork and preventing wrong-sided procedures. The main objective of this study was to ensure that all regional nerve blocks being performed in the preoperative area at our hospital were executed with a...

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Autores principales: Arbizo, Joseph Christopher, Dalal, Kajal, Lao, Veronia, Rosinia, Frank, Adejuyigbe, Temiloluwa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8753394/
https://www.ncbi.nlm.nih.gov/pubmed/35012932
http://dx.doi.org/10.1136/bmjoq-2021-001370
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author Arbizo, Joseph Christopher
Dalal, Kajal
Lao, Veronia
Rosinia, Frank
Adejuyigbe, Temiloluwa
author_facet Arbizo, Joseph Christopher
Dalal, Kajal
Lao, Veronia
Rosinia, Frank
Adejuyigbe, Temiloluwa
author_sort Arbizo, Joseph Christopher
collection PubMed
description BACKGROUND: Procedural time-outs and checklists are proven to be an effective means of improving teamwork and preventing wrong-sided procedures. The main objective of this study was to ensure that all regional nerve blocks being performed in the preoperative area at our hospital were executed with a proper time-out. The goal of this project was to increase integration of a safe preoperative block process including a time-out checklist to ensure; complete consents, correct patient and laterality were marked prior to each procedure. We focused on recognising events that took place before, during and after the nerve block including non-compliance with the checklist and deviations from protocol. METHODS: A safe preoperative block process current and future state flowchart, revised time-out checklist and action/implementation plan as part of our Plan–Do–Study–Act model was constructed using a multidisciplinary approach. Pre-implementation and post- implementation data were collected by medical students acting anonymously via direct observation noting the presence of an anaesthesiologist, resident, nurse, time-out for procedure, checklist completed and procedure start and sedation time representing a complete time-out. RESULTS: The direct observations in the pre-implementation group showed a 20% (3/15) compliance with a correct time-out. The direct observations in the post implementation group showed 85% (12/14) compliance. This revealed a 65% increase in all portions of the time-out checklist completed. Comparative analysis confirmed decrease in non-compliance and deviations from protocol as displayed by 65% increase in all portions of time-out checklist completed. CONCLUSION: We aimed to improve safety, communication and compliance for preoperative nerve blocks through development and implementation of a safe preoperative block process using a multidisciplinary model. We conclude that creation of a safe nerve block was achieved by integration of a preoperative nerve block process which included increased compliance to the time-out checklist, verifying patients and laterality with marking of patient prior to each procedure, identifying proper consents were completed and ensuring each regional nerve block was executed with a proper time-out.
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spelling pubmed-87533942022-01-26 Safe preoperative regional nerve blocks Arbizo, Joseph Christopher Dalal, Kajal Lao, Veronia Rosinia, Frank Adejuyigbe, Temiloluwa BMJ Open Qual Quality Improvement Report BACKGROUND: Procedural time-outs and checklists are proven to be an effective means of improving teamwork and preventing wrong-sided procedures. The main objective of this study was to ensure that all regional nerve blocks being performed in the preoperative area at our hospital were executed with a proper time-out. The goal of this project was to increase integration of a safe preoperative block process including a time-out checklist to ensure; complete consents, correct patient and laterality were marked prior to each procedure. We focused on recognising events that took place before, during and after the nerve block including non-compliance with the checklist and deviations from protocol. METHODS: A safe preoperative block process current and future state flowchart, revised time-out checklist and action/implementation plan as part of our Plan–Do–Study–Act model was constructed using a multidisciplinary approach. Pre-implementation and post- implementation data were collected by medical students acting anonymously via direct observation noting the presence of an anaesthesiologist, resident, nurse, time-out for procedure, checklist completed and procedure start and sedation time representing a complete time-out. RESULTS: The direct observations in the pre-implementation group showed a 20% (3/15) compliance with a correct time-out. The direct observations in the post implementation group showed 85% (12/14) compliance. This revealed a 65% increase in all portions of the time-out checklist completed. Comparative analysis confirmed decrease in non-compliance and deviations from protocol as displayed by 65% increase in all portions of time-out checklist completed. CONCLUSION: We aimed to improve safety, communication and compliance for preoperative nerve blocks through development and implementation of a safe preoperative block process using a multidisciplinary model. We conclude that creation of a safe nerve block was achieved by integration of a preoperative nerve block process which included increased compliance to the time-out checklist, verifying patients and laterality with marking of patient prior to each procedure, identifying proper consents were completed and ensuring each regional nerve block was executed with a proper time-out. BMJ Publishing Group 2022-01-10 /pmc/articles/PMC8753394/ /pubmed/35012932 http://dx.doi.org/10.1136/bmjoq-2021-001370 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Quality Improvement Report
Arbizo, Joseph Christopher
Dalal, Kajal
Lao, Veronia
Rosinia, Frank
Adejuyigbe, Temiloluwa
Safe preoperative regional nerve blocks
title Safe preoperative regional nerve blocks
title_full Safe preoperative regional nerve blocks
title_fullStr Safe preoperative regional nerve blocks
title_full_unstemmed Safe preoperative regional nerve blocks
title_short Safe preoperative regional nerve blocks
title_sort safe preoperative regional nerve blocks
topic Quality Improvement Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8753394/
https://www.ncbi.nlm.nih.gov/pubmed/35012932
http://dx.doi.org/10.1136/bmjoq-2021-001370
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