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Utilization of checklists in the clinical setting to improve patient safety

Posted by on August 23rd, 2017

The use of checklists have been proven to increase patient safety within the clinical setting. Notable studies have shown that when clinicians utilize checklists, central line infections are dramatically decreased and surgical morbidity and mortality is reduced. [1] Types of checklist include laundry lists, iterative checklists, diagnostic checklists and more.[2]  Clinicians use these tools to verify that procedures have been completed during the patient care process.

Examples of a surgical checklist can be found at the Association of Perioperative Registered Nurses. The checklist denoted on this site ‘includes key safety checks as outlined in the World Health Organization (WHO) Surgical Safety Checklist and The Joint Commission Universal Protocol. It is designed for use in all types of facilities (eg, hospital ORs, ambulatory surgery settings, physician offices).’ [3]

Checklists have also been used in the medical school setting to increase student diagnostic skills. Students at Maastricht University in the Netherlands were provided a checklist to aid in interpreting chest radiographs. Kok et al. reported that students found the use of a checklist helpful when attempting to detect multiple abnormalities within a chest X-Ray. [4]

While checklists are widely utilized within hospitals, and by many clinical specialties, a recent study by Boyd et al. suggests the quality of many randomized controlled trials on the impact of checklists in patient safety could be improved. [5] She analyzed 9 research studies and stated the methodological quality of the studies she reviewed were of moderate quality.

The ongoing development and use of checklists has been a key tool utilized to increase patent safety and clinical quality. Research studies continue to analyze the effectiveness of these tools and more information on the efficacy of these checklists may be found by searching the PubMed.gov biomedical literature database.

[1] Patient Safety Primer. Checklists. [Internet]. Rockville (MD): Patient Safety Network. Agency for Healthcare Research & Quality; [cited 2017 Aug 20]. Available from: https://psnet.ahrq.gov/primers/primer/14/checklists

[2] AHA/HRET Guides: Checklists to improve patient safety [Internet]. Chicago (IL): Health Research & Educational Trust; [cited 2017 Aug 20]. Available from: www.hpoe.org/resources/aharet-guides/1398.

[3] AORN Comprehensive surgical checklist [Internet]. Denver (CO): Association of Perioperative Registered Nurses; [cited 2017 Aug 20]. Available from:  https://www.aorn.org/guidelines/clinical-resources/tool-kits/correct-site-surgery-tool-kit/aorn-comprehensive-surgical-checklist.

[4] Kok EM, Abdelrazek A, Robben S. Does the use of a checklist help medical students in the detection of abnormalities on a chest radiograph? Journal of Digital Imaging 2017 May 30: 1-6.

[5] Boyd JM, Wu G, Stelfox HT. The Impact of checklists on inpatient safety outcomes: a systematic review of randomized controlled trials. J Hosp. Med 2017; 8:675-682.

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