Surgical Safety Checklist in Obstetrics and Gynaecology

OBJECTIVE: To provide guidance on the implementation of a surgical safety checklist in the practice of obstetrics and gynaecology. OUTCOMES: OUTCOMES evaluated include the impact of the surgical safety checklist on surgical morbidity and mortality. EVIDENCE: Medline databases were searched for articles on subjects related to "surgical safety checklist" published in English from January 2001 to January 2011. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Searches were updated on a regular basis and incorporated in the guideline to January 2012. VALUES: The quality of evidence was rated with use of the criteria described by the Canadian Task Force on Preventive Health Care. Recommendations for practice were ranked according to the method described by the Task Force (Table). BENEFITS, HARMS, AND COSTS: Implementation of the guideline recommendations will improve the health and well-being of women undergoing obstetrical or gynaecologic surgery. Summary Statements and Recommendations Summary Statements 1. Surgery may account for up to 40% of all hospital adverse events. (II-2) 2. Good communication is essential for safer surgical care, as communication failure is common in the operating room. (III) 3. The concept of a surgical safety checklist has been studied globally, and there have been decreases in complications and mortality when the checklist has been implemented. (II-1) 4. Emergency cases such as a "crash" Caesarean section will require a modified approach that is centre- and situation-dependent. (III) 5. The SOGC endorses the adoption of the surgical safety checklist in obstetrics and gynaecology. (III) Recommendations 1. The surgical safety checklist should be adopted by all surgical care providers and their respective institutions to improve patient safety. (II-1A) 2. Surgeons should be familiar with, advocate for the use of, and participate in all 3 parts of the surgical safety checklist. (II-1A) 3. The surgical safety checklist may be modified and adapted for use in surgical obstetrics cases. (II-2A).