555 / Procedure for safe management of the surgical pathway

ITALY
Classification of the PSP
Type of Patient Safety Practice Safe
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Surgical / Invasive procedures
Documentation There is no specified text here
Topic of the reported practice
Clinical guidelines or pathways
Aim and the benefit of the Patient Safety Practice
 
In the surgical units of the University-Teaching Hospital of Sassari there were no standard and written procedures for preparing patients to surgery and for managing the postoperative pathway. It was therefore considered necessary to work on the whole surgical pathway in terms of quality and standardization of the process.
Description of the Patient Safety Practice
 
The adverse events we aim to prevent are: wrong-site surgery, surgery on wrong patient, harm to patient due to poor maintenance of equipment, postoperative infections. A working group coordinated by the Production-Risk Management unit was created. It developed a unique perioperative card accompaying the patient during the whole pathway. The first part contains checklist of procedures necessary for the proper preparation of the patient (eg. exact indication of the surgical site the possible bowel preparation, hair is removed, the presence of all the clinical need, any antibiotic prophylaxis and / or heparin etc.), and must be signed and dated by the nurse responsible department. The second part contains the identification of the patient in the operating room, the count of the material used, which is done prior to surgery, the possible change of team and at the end of the intervention, with date and signature of the person performing the controls. The third part, which accompanies the patient in returning to the ward, contains information on the intervention, in particular, any changes from what was planned, intraoperative complications, are reported the values of important parameters, any indications of surveillance and / or therapeutic prescriptions for the doctor on call, date and signature of the submitter or prescribes. It has also been developed for each operating room records of equipment, which is completed and signed by the nurse and nurse instrumentalist.
Attachment of relevant written information and/or photos, as appropriate
There is no specified text here
There is no specified text here
There is no specified text here
There is no specified text here
Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Quantitative
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
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Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
No
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Nurses
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Yes
List of sources where public information is accessible
http://buonepratiche.agenas.it/practicesdetail.aspx
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
Yes
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
No
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
There is no specified text here
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Motivated staff
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Antonella Virdis
Country: ITALY
Organisation: UT hospital Sassari
E-mail: avirdis@aousassari.it
Phone: 3347106531
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