Validation of a Norwegian version of SURgical PAtient Safety System (SURPASS) in combination with the World Health Organizations' Surgical Safety Checklist (WHO SSC)

Anette Storesund, Arvid Steinar Haugen, Hilde Valen Wæhle, Rupavathana Mahesparan, Marja A Boermeester, Monica Wammen Nortvedt, Eirik Søfteland, Anette Storesund, Arvid Steinar Haugen, Hilde Valen Wæhle, Rupavathana Mahesparan, Marja A Boermeester, Monica Wammen Nortvedt, Eirik Søfteland

Abstract

Introduction: Surgical safety checklists may contribute to reduction of complications and mortality. The WHO's Surgical Safety Checklist (WHO SSC) could prevent incidents in operating theatres, but errors also occur before and after surgery. The SURgical PAtient Safety System (SURPASS) is designed to intercept errors with use of checklists throughout the surgical pathway.

Objective: We aimed to validate a Norwegian version of the SURPASS' preoperative and postoperative checklists for use in combination with the already established Sign In, Time Out and Sign Out parts of the WHO SSC.

Methods and materials: The validation of the SURPASS checklists content followed WHOs recommended guidelines. The process consisted of six steps: forward translation; testing the content; focus groups; expert panels; back translation; and approval of the final version. Qualitative content analysis was used to identify codes and categories for adaption of the SURPASS checklist items throughout Norwegian surgical care. Content validity index (CVI) was used by expert panels to score the relevance of each checklist item. The study was carried out in a neurosurgical ward in a large tertiary teaching hospital in Norway.

Results: Testing the preoperative and postoperative SURPASS checklists was performed in 29 neurosurgical procedures. This involved all professional groups in the entire surgical patient care pathway. Eight clinical focus groups revealed two main categories: 'Adapt the wording to fit clinical practice' and 'The checklist items challenge existing workflow'. Interprofessional scoring of the content validity of the checklists reached >80% for all the SURPASS checklists.

Conclusions: The first version of the SURPASS checklists combined with the WHO SSC was validated for use in Norwegian surgical care with face validity confirmed and CVI >0.80%.

Trial registration number: NCT01872195.

Keywords: checklists; patient safety; quality improvement; surgery; transitions in care.

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Compliance to the preoperative and postoperative SURPASS checklists according to professional background when testing the content in 29 neurosurgical procedures, June–July 2012, in one Norwegian hospital. PACU, postanaesthesia care unit.
Figure 2
Figure 2
Qualitative content analyses to understand eight focus groups’ perspectives on the tested preoperative and postoperative SURPASS checklist content for neurosurgical procedures in one Norwegian hospital. OT, operating theatre; PACU, postanaesthesia care unit.

References

    1. Griffen FD, Stephens LS, Alexander JB, et al. . The American College of Surgeons' closed claims study: new insights for improving care. J Am Coll Surg 2007;204:561–9. 10.1016/j.jamcollsurg.2007.01.013
    1. Kohn LT, Corrigan JM, Donaldson MS, et al. . To err is human: building a safer healthcare system. Institute of Medicine, ed. Washington, DC: National Academy Press, 2000.
    1. Lingard L, Regehr G, Cartmill C, et al. . Evaluation of a preoperative team briefing: a new communication routine results in improved clinical practice. BMJ Qual Saf 2011;20:475–82. 10.1136/bmjqs.2009.032326
    1. Haynes AB, Weiser TG, Berry WR, et al. . A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med 2009;360:491–9. 10.1056/NEJMsa0810119
    1. de Vries EN, Prins HA, Crolla RM, et al. . Effect of a comprehensive surgical safety system on patient outcomes. N Engl J Med 2010;363:1928–37. 10.1056/NEJMsa0911535
    1. Haugen AS, Søfteland E, Almeland SK, et al. . Effect of the World Health Organization checklist on patient outcomes: a stepped wedge cluster randomized controlled trial. Ann Surg 2015;261:821–8. 10.1097/SLA.0000000000000716
    1. Manser T, Foster S, Flin R, et al. . Team communication during patient handover from the operating room: more than facts and figures. Hum Factors 2013;55:138–56. 10.1177/0018720812451594
    1. Nagpal K, Vats A, Lamb B, et al. . Information transfer and communication in surgery: a systematic review. Ann Surg 2010;252:225–39. 10.1097/SLA.0b013e3181e495c2
    1. de Vries EN, Ramrattan MA, Smorenburg SM, et al. . The incidence and nature of in-hospital adverse events: a systematic review. Qual Saf Health Care 2008;17:216–23. 10.1136/qshc.2007.023622
    1. Bochner BS, Lichtenstein LM. Anaphylaxis. N Engl J Med 1991;324:1785–90. 10.1056/NEJM199106203242506
    1. Bull AL, Russo PL, Friedman ND, et al. . Compliance with surgical antibiotic prophylaxis--reporting from a statewide surveillance programme in Victoria, Australia. J Hosp Infect 2006;63:140–7. 10.1016/j.jhin.2006.01.018
    1. Cohen AT, Tapson VF, Bergmann JF, et al. . Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE study): a multinational cross-sectional study. Lancet 2008;371:387–94. 10.1016/S0140-6736(08)60202-0
    1. de Vries EN, Hollmann MW, Smorenburg SM, et al. . Development and validation of the SURgical PAtient Safety System (SURPASS) checklist. Qual Saf Health Care 2009;18:121–6. 10.1136/qshc.2008.027524
    1. Norwegian Directorate of Health. In safe hands 24/7. 2015. (accessed 23 Jul 2018).
    1. World Health Organization. Process of translation and adaption of instruments. 2018. (accessed 23 Jul 2018).
    1. World Health Organization. WHO Surgical safety checklist. 2009. (accessed 23 Jul 2018).
    1. Haugen AS, Søfteland E, Eide GE, et al. . Impact of the World Health Organization’s Surgical Safety Checklist on safety culture in the operating theatre: a controlled intervention study. Br J Anaesth 2013;110:807–15. 10.1093/bja/aet005
    1. Norwegian Knowledge Centre for the Health Services. Sjekkliste for trygg kirurgi. 2010. (accessed 23 Jul 2018).
    1. Haugen AS, Wæhle HV, Almeland SK, et al. . Causal Analysis of World Health Organization’s Surgical Safety Checklist Implementation Quality and Impact on Care Processes and Patient Outcomes: Secondary Analysis From a Large Stepped Wedge Cluster Randomized Controlled Trial in Norway. Ann Surg 2017. [Epub ahead of print 6 Nov 2017]. 10.1097/SLA.0000000000002584
    1. Haugen AS, Bakke A, Løvøy T, et al. . Preventing complications: the preflight checklist. Eur Urol Focus 2016;2:60–2. 10.1016/j.euf.2016.01.014
    1. World Health Organization. Implementation manual - WHO surgical safety checklist. 2008. (accessed 23 July 2018).
    1. Conley DM, Singer SJ, Edmondson L, et al. . Effective surgical safety checklist implementation. J Am Coll Surg 2011;212:873–9. 10.1016/j.jamcollsurg.2011.01.052
    1. Thomassen Ø, Storesund A, Søfteland E, et al. . The effects of safety checklists in medicine: a systematic review. Acta Anaesthesiol Scand 2014;58:5–18. 10.1111/aas.12207
    1. Krueger RA, Casey MA. Focus groups: a practical guide for applied research. Los Angeles: Sage, 2015.
    1. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004;24:105–12. 10.1016/j.nedt.2003.10.001
    1. Polit DF, Beck CT. The content validity index: are you sure you know what’s being reported? Critique and recommendations. Res Nurs Health 2006;29:489–97. 10.1002/nur.20147
    1. Waltz CF OLS, Lenz ER. Measurement in nursing and health research. 3rd edn New York: Springer Publishing Company, 2005.
    1. Davis LL. Instrument review: getting the most from a panel of experts. Applied Nursing Research 1992;5:194–7. 10.1016/S0897-1897(05)80008-4
    1. Thomassen O, Brattebø G, Heltne JK, et al. . Checklists in the operating room: Help or hurdle? A qualitative study on health workers' experiences. BMC Health Serv Res 2010;10:342 10.1186/1472-6963-10-342
    1. Fourcade A, Blache JL, Grenier C, et al. . Barriers to staff adoption of a surgical safety checklist. BMJ Qual Saf 2012;21:191–7. 10.1136/bmjqs-2011-000094
    1. Russ SJ, Sevdalis N, Moorthy K, et al. . A qualitative evaluation of the barriers and facilitators toward implementation of the WHO surgical safety checklist across hospitals in England: lessons from the "Surgical Checklist Implementation Project". Ann Surg 2015;261:81–91. 10.1097/SLA.0000000000000793
    1. Borchard A, Schwappach DL, Barbir A, et al. . A systematic review of the effectiveness, compliance, and critical factors for implementation of safety checklists in surgery. Ann Surg 2012;256:925–33. 10.1097/SLA.0b013e3182682f27
    1. Leape LL. The checklist conundrum. N Engl J Med 2014;370:1063–4. 10.1056/NEJMe1315851
    1. Russ S, Rout S, Sevdalis N, et al. . Do safety checklists improve teamwork and communication in the operating room? A systematic review. Ann Surg 2013;258:856–71. 10.1097/SLA.0000000000000206
    1. Hull L, Athanasiou T, Russ S. Implementation science: a neglected opportunity to accelerate improvements in the safety and quality of surgical care. Ann Surg 2017;265:1104–12. 10.1097/SLA.0000000000002013
    1. Bergs J, Lambrechts F, Simons P, et al. . Barriers and facilitators related to the implementation of surgical safety checklists: a systematic review of the qualitative evidence. BMJ Qual Saf 2015;24:776–86. 10.1136/bmjqs-2015-004021
    1. De Bie AJR, Nan S, Vermeulen LRE, et al. . Intelligent dynamic clinical checklists improved checklist compliance in the intensive care unit. Br J Anaesth 2017;119:231–8. 10.1093/bja/aex129
    1. Gillespie BM, Marshall AP, Gardiner T, et al. . Impact of workflow on the use of the Surgical Safety Checklist: a qualitative study. ANZ J Surg 2016;86:864–7. 10.1111/ans.13433
    1. Lynn MR. Determination and quantification of content validity. Nurs Res 1986;35:382–5. 10.1097/00006199-198611000-00017
    1. Polit DF, Beck CT. Nursing Research: generating and assessing evidence for nursing practice. Philadelphia: Wolters Kluwer, 2017.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner