Staff attitudes to and compliance with the use of a surgical safety checklist

OBJECTIVES

To investigate staff attitudes to the use of a surgical safety checklist in a small animal operating room and to gain insight into barriers to use.

MATERIALS AND METHODS

A questionnaire was designed and used to assess attitudes of 36 operating room personnel to the checklist. The checklist was retrospectively audited on 984 patients over an 8-month period to investigate compliance.

RESULTS

Responses were obtained from 100% of operating room personnel. Attitudes to the checklist were positive, with 83.4% agreeing that it improved teamwork and 100% agreed that the checklist improved patient safety, reduced error and was best practice. Most personnel (94%) believed that a completed checklist was used for every procedure. Several barriers were highlighted, including issues of hierarchy and team-working and lack of training. 984 checklists were used during the study period with 83 (8.4%) being fully completed.

CLINICAL SIGNIFICANCE

Surgical safety checklists have potential to improve patient safety in veterinary operating rooms. However, appropriate design and implementation are critical and surgeons should endeavour to support checklist use.

Safety culture: the Nottingham Veterinary Safety Culture Survey (NVSCS)

Safety culture is a vital concept in human healthcare because of its influence on staff behaviours in relation to patient safety. Understanding safety culture is essential to ensure the acceptance and sustainability of changes, such as the introduction of safe surgery checklists. While widely studied and assessed in human medicine, there is no tool for its assessment in veterinary medicine. This paper therefore presents initial data on such an assessment: the Nottingham Veterinary Safety Culture Survey (NVSCS). 350 pilot surveys were distributed to practising vets and nurses. The survey was also available online. 229 surveys were returned (65 per cent response rate) and 183 completed online, resulting in 412 surveys for analysis. Four domains were identified: (1) organisational safety systems and behaviours, (2) staff perceptions of management, (3) risk perceptions and (4) teamwork and communication. Initial indications of the reliability and the validity of the final survey are presented. Although early in development, the resulting 29-item NVSCS is presented as a tool for measuring safety culture in veterinary practices with implications for benchmarking, safety culture assessment and teamwork training.

A clinical trial of the efficacy and acceptability of D-fenfluramine in the treatment of neuroleptic-induced obesity

Twenty-nine overweight schizophrenic patients maintained on depot neuroleptic injections who wished to lose weight took part in a double-blind, placebo-controlled trial of 30 mg D-fenfluramine. All subjects received dietary advice. Sixteen patients completed the 12-week trial. Rate of weight loss was significantly greater in those taking D-fenfluramine. Side-effects were reported, but no deterioration in mental state was noted.