Transcript Webinar 4: Checklist Modification/Customization

Surgical Site Infections:
The Impact of Culture, Teamwork, and
Communication
Our Last Call Together
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Purpose of This Portion of the Call Series
History of Infection Prevention Techniques
Prophylactic Antibiotic Administration
Weight-Based Dosing
Re-Dosing
Discontinuing Antibiotics
Todays Topics
• Three problems that sit at the core of
surgical site infections
• The South Carolina Surgical Safety
Checklist as a Drug
Three Problems
Doing reliably
what we know
needs to be
done
Teamwork
and
Communication
Always being
vigilant about
keeping the
patient safe
The Checklist As A Drug:
Doing Reliably What We Know Needs
To Be Done
 Risk of hypothermia – operation > 1h
- Warmer in place
Make sure that appropriate
warming precautions are taken
when necessary
 Has antibiotic prophylaxis been given within the last
60 minutes?
Plan for re-dosing discussed
• Anesthesia professional
discusses if antibiotics are
completely infused
• If needed, plan for re-dosing is
discussed
Practical Tip For Re-Dosing:
Use a timer to help remind the team to
re-dose antibiotics
 Sterility, including indicator results
Confirmation that all of the
instruments are sterile
The Checklist As A Drug:
Teamwork and Communication
Communication and
Teamwork
Better Communication and
Pre-Operative Briefings
Can Reduce OR Traffic
The Checklist As A Drug:
Vigilance
Surgical Conscience
When individuals . . .
– promote patient safety all of the time
– hold themselves accountable for making sure
the patient is safe and don’t hesitate to admit
when the patient may be at risk
– do not take shortcuts when it may put the
patient at risk
Surgical Conscience in
Everyday Life in the OR
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Scrubbing
Gowning
Gloving
Instrument Sterility
Defending the Sterile Field
The Majority of Us Go Into the
OR With the Intention of
Doing What is Best For Our
Patients
The reality of the OR:
– Pressure to move quickly
– Individuals have to feel comfortable and safe
to voice concerns
Realities of Speaking Up
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“I’m afraid”
“I’m embarrassed”
“I’m stupid”
“They might yell at me”
“I might be wrong”
“The surgeon is mean”
“They won’t listen anyway”
“It is not that important”
 Please state your name and role
• Activates team members
• If someone says
something at the
beginning of the case
they are more likely to
speak up if they see
something that may not
be right
Surgeon says:
“Does anybody have any concerns? If you see something that
concerns you during this case, please speak up.”
• Sets the tone that anybody
can say something during
the case if they see
something
• Invites people to speak up
Take Home Messages
• Preventing SSI’s is technical and cultural
• A well used checklist can help:
– us reliably do what we know needs to be done
for every patient
– improve teamwork and communication, which
sit at the core of surgical site infections and
complications
– us create a culture where everyone feels
empowered to speak up if they feel that
something isn’t right
Questions
Upcoming Calls
Thursday, May 30th 2:00-2:45
Preventing SSI’s When Preparing Our
Patients for Surgery
Thursday, June 13th 2:00-2:45
Other Ways of Preventing Venous
Thromboembolism
Office Hours:
Wednesday 2:00-3:00
Resources
Website:
www.safesurgery2015.org
Email:
[email protected]