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 for Doctors core skills programme developed in the Trust.
HEFT Local Policies
Director of Operations-Surgery, January 2009. Next review date: September 2009
Senior Investigations Manager, January 2011. Next review date: January 2014
Senior Investigations Manager, October 2011. Next review date: October 2013
NICE Guidelines and Pathways
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.
Other National (includes Professional Bodies/Associations) and non-UK Guidelines (with EU)
Standards for Children’s Surgery Royal College of Surgeons, 2013
Guidance for Fellows in implementing surgical safety checklists for radiological procedures Royal College of Radiologists, April 2013
Raising the Standard: a compendium of audit recipes Royal College of Anaesthetists, 3rd edition 2012.
British Consensus Guidelines on Intravenous Fluid Therapy for Adult Surgical Patients Giftasup Jeremy Powell-Tuck et al. On behalf of BAPEN Medical 2011
WHO Surgical Safety checklist NPSA, 2009
Surgery in safe hands: priorities and policies 2010 Royal College of Surgeons, September 2009
Reducing harm in perioperative care Patient Safety First Campaign, 2009
Good Practice in Postoperative and Procedural Pain Association of Paediatric Anaesthetists, 2008
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.
Correct Site Surgery Royal College of Surgeons and NPSA, 2005
Postoperative Management in Adults: a practical guide to postoperative care for clinical staff Scottish Intercollegiate Guidelines Network, 2004
Post Operative Pain Management Best Practice Statement NHS Quality Improvement Scotland, 2004
Anaesthesia and Peri-Operative Care of the Elderly The Association of Anaesthetists of Great Britain and Ireland, 2001
Good practice in consent implementation guide: consent to examination or treatment Department of Health, 2001
Patient Safety Resources – Surgery This NPSA site highlights guidance on improving patient safety during surgery.
Systematic Reviews – Cochrane Library
Vivian McAlister1,*, Karen EA Burns2, Tammy Znajda3, Brian Church4
Editorial Group: Cochrane Anaesthesia Group Published Online: 20 JAN 2010
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.
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.
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
The following sources have been searched for evidence published in the previous 12 months: HEFT Policies, NHS Evidence, NICE, SIGN, NPSA, Patient Safety First Campaigns, Cochrane Library, Royal College of Surgeons and World Health Organisation. Please contact [email protected] for any further information.
For more information on how to make the most use of the HEFT Library Services, visit www.heftlibrary.nhs.uk
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