Hospital patients want pre-surgery checks done in front of them

A patient meets an emergency consultant at hospital

Hospital patients overwhelmingly prefer pre-surgical safety checklists to be completed in front of them, contrary to what is thought by doctors according to new research.

The study, by Swiss doctors examined the World Health Organisation’s checklists which were launched as part of the Safe Surgery Saves Lives Programme in 2008.

The list includes asking the patient to confirm their name, procedure and consent, and the medical team to check the anaesthesia machine and medication has been checked.

The list also checks if patients have known allergies and if antibiotics have been administered in the previous 60 minutes, as is standard with many surgeries.

Dr Sabine Nabecker, from the Department of Anaesthesiology and Pain Medicine, at Bern University Hospital, and University of Bern, led the study along with colleagues.

She said: “Anaesthesia professionals are often reluctant to use checklists in front of patients because they fear causing patients’ discomfort before anaesthesia and surgery. Yet our study shows that patients overwhelmingly prefer to see the checklist completed in front of them.”

The trial included 110 anaesthesia providers and 125 non-premedicated ear-nose-throat or face/mouth/jaw surgery patients in the Bern University Hospital from June to August 2016. Patients who signed a consent agreement to be included in the study; however those who had been premedicated, under 18 years of age, day-care only patients or those with dementia or other mental illnesses were excluded.

Participants were interviewed before the start of the procedure and on the first postoperative day, and asked to rate their agreement from 1-100 with the following statements: Anaesthesia providers should use checklists in my presence; using a checklist prior to anaesthesia induction causes discomfort for me; the use of checklists prior to induction of anaesthesia reduces the risk of errors.

Patients overwhelmingly agreed that anaesthesia providers should use checklists in front of them while anaesthesia providers were enthusiastic but less so.

Both patients and anaesthesia providers agreed using checklists had the potential to reduce errors during surgery (scores 93 for anaesthesia providers, 97 for patients before procedure and 100 for patients after procedure).

The authors say: “Anaesthesia providers estimate patient discomfort significantly higher than is actually perceived by the patients themselves. Our study suggests that although anaesthesia providers agree checklists reduce risks, they are reluctant to use them, solely based on the wrongly assumed discomfort for patients. We aimed to assess the real experience of surgical patients in the operating room.”