Image:(United Nation, 2024)
WHO surgical safety checklist
Introduced in 2007 by the World Health Organisation the WHO surgical checklist intended on lowering the rate of medical errors that occurred within the operating theatre setting (Ambulkar et al. 2018).
This introduction was found to have a profound impact on patient safety within the operating theatre, however the three-step process introduced by the WHO was found to be missing to important steps a ‘briefing’ and ‘debriefing’ this lead the National patient safety agency (NPSA) to implement the Five Steps to safer surgery in 2010 (Vickers. 2011).
Image:(University of Nottingham, 2019)
Five Steps to Safer Surgery
The FIve steps to safer surgery include:
- Initial team briefing: to include information about all the patients on the list.
- Sign in: with each patient before anaesthesia.
- Time Out: The scrub practitioner and surgeon to confirm consent.
- Sign out: At the end of the procedure relevant information is to be recorded, for example the name of the procedure.
- Debrief: The list is to be discussed with the whole team to communicate any issues with the day.
Image:(WFSA, 2016)
NatSSIPs
Even with the implementation of the five steps to safer surgery, It has been identified that when things go awry it is the fault of miscommunication and lack of understanding between professionals, with McNally. (2023) suggesting that most reports on the issues, report why it has occurred and not how it can could be prevented, reinforcing a blame culture.
With these issues Identified the centre of perioperative care introduced the National Safety Standard for Invasive Procedures in 2015 and has recently published a updated version the NatSSIPs 2. This update is designed to be more customisable to the procedures being performed, identifying the risks of that specific procedure, Centre of Perioperative Care. (2023) a major addition from this new standard is the addition to the WHO, the NatSSIPs 8.
Image:(Centre for perioperative care , 2024b)
NatSSIPs 8: Sequential steps
In addition to the current five steps to safer surgery the NatSSIPs 8 adds three more requirements:
- Consent and procedural verification: This new step is for the operator, although routinely carried out, this step reinforces the need for the operator to see and involve the patient in their care prior to surgery.
- Team Brief: this step is the same as the five steps.
- Sign in: this step is the same as the five steps.
- Time out: this step is the same as the five steps.
- Implant Check (if required): This has been introduced to ensure no miscommunication in the implantation of prosthetics. All team members should stop so the surgeon and scrub practitioner can verify the implant.
- Equipment reconciliation: As scrub practitioners this new step is essential in the care we deliver, as it forces the surgeon to pause until all equipment and consumable are accounted for.
- Sign out: this step is the same as the five steps.
- Debrief: this step is the same as the five steps.
(Centre of Perioperative Care. 2023)
Image:(Centre for perioperative care , 2024a)
Why is this important in a Fem-Pop Bypass?
As a vascular scrub practitioner, you will work with several small sutures and instruments, these items can be lost easily. Ensuring a dedicated pause in surgery to account for these items is essential for patient safety and will reduce instances of never events.
Additionally, the WHO allows you and the surgeons to discuss implants such as grafts and communicate the techniques they will use to insert them reducing miscommunication during surgery and improving the overall care delivered to our patients.
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