Safe Surgery and Consent- January 2013

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Safe Surgery and Consent


Listed below is the high level evidence on Safe Surgery and Consent produced by NICE, SIGN and NHS based organisations. Also included are the European Society guidelines where available. This list is produced and maintained by HEFT Library Services to support VITAL 4 Medics core skills programme developed in the Trust.


HEFT Local Policies

Could not find any on the Intranet (Policies section) to highlight in this section


Map of Medicine

Map of Medicine (MoM)

Use HEFT Athens ID to login to Map of Medicine.

Map of Medicine is a visual representation of evidence-based, practice –informed pathways on various conditions and treatment options. Care of patients in the perioperative period (analgesia, fluid therapy) forms part of the pathways and the evidence links to national guidelines and guidelines from professional bodies related to that specific condition or therapies.


National Guidelines & Non-UK Guidelines (includes Professional Bodies/Associations)


PBritish Consensus Guidelines on Intravenous Fluid Therapy for Adult Surgical Patients Giftasup

Jeremy Powell-Tuck et al. On behalf of BAPEN Medical 2011


PThe management of inadvertent perioperative hypothermia in adults

NICE, 2008


PACC / AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery : executive summary. A report of the American College of Cardiology / American Heart Association Task Force on Practice Guidelines

American College of Cardiology; American Heart Association, 2007


PRaising the Standard: a compendium of audit recipes

Royal College of Anaesthetists, 2nd ed, 2006.


PPostoperative Management in Adults: a practical guide to postoperative care for clinical staff

Scottish Intercollegiate Guidelines Network, 2004

PPost Operative Pain Management Best Practice Statement

NHS Quality Improvement Scotland, 2004


PPreoperative Tests: The use of routine preoperative tests for elective surgery

NICE, 2003


PAnaesthesia and Peri-Operative Care of the Elderly

The Association of Anaesthetists of Great Britain and Ireland, 2001


PSurgical site infection: prevention and treatment of surgical site infection

NICE, 2008


PGood Practice in Postoperative and Procedural Pain

Association of Paediatric Anaesthetists, 2008


The WHO Surgical Safety Checklist: to reduce harm by consistent use of best practice Document TypeNPSA, 2011

The effective implementation of the Five Steps to Safer Surgery reduces harm to surgical patients and increases efficiency in operating theatres, resulting in substantial savings for NHS trusts.


How to guide to the five steps to safer surgery, NPSA, 2010


WHO Surgical Safety checklist, NPSA, 2009


WHO surgical safety checklist and implementation manual; World Alliance for Patient Safety, 2008


Safe Surgery Saves Lives, WHO

This page on WHO website provides access to the actual checklist in different languages, tools and resources required to implement it in an organisation.


WHO surgical safety checklist: for maternity cases only; NPSA, 2010


WHO Surgical Safety Checklist: for cataract surgery only; NPSA, 2010


Systematic Reviews – Cochrane Library

PHypertonic saline for peri-operative fluid management

Vivian McAlister1,*, Karen EA Burns2, Tammy Znajda3, Brian Church4

Editorial Group: Cochrane Anaesthesia Group

Published Online: 20 JAN 2010

Full text available from here


NHS Evidence

Safe Surgery

This website provides a list of health organisations around the world including UK who have modified the WHO Surgical Checklist and using it within their institutions.


New scientific evidence supports WHO findings: a surgical safety checklist could save hundreds of thousands of lives

At least half a million deaths per year would be preventable with effective implementation of the WHO Surgical Safety Checklist worldwide. These results, obtained in the World Health Organization's 2007-2008 pilot study of its Surgical Safety Checklist have now been confirmed by new studies: the use of checklists significantly reduces surgical morbidity and mortality.

Read the statement


The article it refers to is

de Vries EN, Prins HA, Crolla RMPH, et al. Effect of a comprehensive surgical safety system on patient outcomes. N Engl J Med 2010;363:1928-37


Title: Re: effect of a comprehensive surgical safety system on patient outcomes.

Citation: Journal of Urology, April 2011, vol./is. 185/4(1329-30), 0022-5347;1527-3792 (2011 Apr)

Author(s): Babayan RK

Full Text: Available in fulltext at Elsevier; Note: You will need to register (free of charge) with Science Direct the first time you use it.

Title: Effect of a comprehensive surgical safety system on patient outcomes.

Citation: New England Journal of Medicine, November 2010, vol./is. 363/20(1928-37), 0028-4793;1533-4406 (2010 Nov 11)

Author(s): de Vries EN, Prins HA, Crolla RM, den Outer AJ, van Andel G, van Helden SH, Schlack WS, van Putten MA, Gouma DJ, Dijkgraaf MG, Smorenburg SM, Boermeester MA, SURPASS Collaborative Group

Abstract: BACKGROUND: Adverse events in patients who have undergone surgery constitute a large proportion of iatrogenic illnesses. Most surgical safety interventions have focused on the operating room. Since more than half of all surgical errors occur outside the operating room, it is likely that a more substantial improvement in outcomes can be achieved by targeting the entire surgical pathway.METHODS: We examined the effects on patient outcomes of a comprehensive, multidisciplinary surgical safety checklist, including items such as medication, marking of the operative side, and use of postoperative instructions. The checklist was implemented in six hospitals with high standards of care. All complications occurring during admission were documented prospectively. We compared the rate of complications during a baseline period of 3 months with the rate during a 3-month period after implementation of the checklist, while accounting for potential confounders. Similar data were collected from a control group of five hospitals.RESULTS: In a comparison of 3760 patients observed before implementation of the checklist with 3820 patients observed after implementation, the total number of complications per 100 patients decreased from 27.3 (95% confidence interval [CI], 25.9 to 28.7) to 16.7 (95% CI, 15.6 to 17.9), for an absolute risk reduction of 10.6 (95% CI, 8.7 to 12.4). The proportion of patients with one or more complications decreased from 15.4% to 10.6% (P<0.001). In-hospital mortality decreased from 1.5% (95% CI, 1.2 to 2.0) to 0.8% (95% CI, 0.6 to 1.1), for an absolute risk reduction of 0.7 percentage points (95% CI, 0.2 to 1.2). Outcomes did not change in the control hospitals.CONCLUSIONS: Implementation of this comprehensive checklist was associated with a reduction in surgical complications and mortality in hospitals with a high standard of care. (Netherlands Trial Register number, NTR1943.).

Full Text: Available in fulltext at EBSCOhost