Development of the scoliosis research society spinal deformity surgery safety checklist.

IF 1.6 Q3 CLINICAL NEUROLOGY Spine deformity Pub Date : 2024-10-23 DOI:10.1007/s43390-024-00973-1
Rafael De la Garza Ramos, Justin K Scheer, Nabil Matmati, Lloyd A Hey, Douglas C Burton, Marinus de Kleuver, Christopher P Ames, Vijay Yanamadala
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Abstract

Purpose: Spine deformity surgery is a complex multi-step procedure that has a relatively high complication rate. The use of surgical safety checklists has been shown to reduce perioperative adverse events, but existing lists are varied and non-specific for spinal deformity surgery. Thus, the purpose of this study was to develop a comprehensive surgical checklist for complex spinal corrective surgery.

Methods: An electronic survey consisting of 187 surgical checklist items that had been developed and used by a group of SRS members over a 5-year period was distributed to the Scoliosis Research Society Safety and Value Committee membership. The survey sections included: (1) pre-operative area, (2) initial operating room visit, (3) before turning, (4) positioning, (5) prepare and drape, (6) pre-incision timeout, (7) intraoperative, (8) finishing implant placement and confirming imaging, (9) final rods and locking, (10) prior to closure, (11) closure, (12) turn to supine, and (13) checkout/debriefing. Respondents graded each item on a five-point Likert scale based on their perceived importance and feasibility for inclusion in the checklist. Features graded as "moderately important" or "very important" to include by at least 70% of respondents were considered to meet the cutoff for inclusion-based standard Delphi practices. Study data were collated using REDCap.

Results: A total of 25 surgeons completed the survey in its entirety. The overall checklist "package" was shortened to 9 individual checklist modules, with 2 to 16 items per checklist. In terms of individual checklist items, 40% of items (74 of 187) met the cutoff for inclusion; 17 of these items were graded as "very important," which included verifying the presence of implantable devices, reviewing the surgical plan and positioning with the surgical staff, securing the endotracheal tube, bite block confirmation, prone and lateral positioning, neuromonitoring baseline readings, double-checking that the implant screw caps were locked prior to closure, and confirming that the patient was moving bilateral lower extremities before leaving the operating room when possible.

Conclusion: This study has led to the development of a specific spinal deformity surgical checklist of 74 (many specific to spine surgery) items that were considered important for inclusion; 17 were considered "very important".

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脊柱侧凸研究学会脊柱畸形手术安全清单的开发。
目的:脊柱畸形手术是一种复杂的多步骤手术,并发症发生率相对较高。手术安全清单的使用已被证明可以减少围手术期的不良事件,但现有的清单五花八门,且不针对脊柱畸形手术。因此,本研究旨在为复杂的脊柱矫正手术制定一份全面的手术清单:方法:向脊柱侧弯研究学会安全与价值委员会成员分发了一份电子调查表,其中包含 187 个手术核对表项目,这些项目是由一组脊柱侧弯研究学会成员在 5 年内开发和使用的。调查内容包括(1)术前区域,(2)手术室初诊,(3)翻身前,(4)定位,(5)准备和铺巾,(6)切口前超时,(7)术中,(8)完成植入物置入并确认成像,(9)最终杆和锁定,(10)关闭前,(11)关闭,(12)转为仰卧,以及(13)结账/简报。受访者根据其认为纳入核对表的重要性和可行性,用五点李克特量表对每个项目进行评分。被至少 70% 的受访者评为 "适度重要 "或 "非常重要 "的特征被认为符合基于标准德尔菲实践的纳入临界值。研究数据使用 REDCap 进行整理:共有 25 名外科医生完成了整个调查。整个核对表 "包 "缩短为 9 个单独的核对表模块,每个核对表包含 2 到 16 个项目。就单个核对表项目而言,40%的项目(187 项中的 74 项)达到了纳入的临界值;其中 17 项被评为 "非常重要",包括核实是否存在植入装置、与手术人员一起审查手术计划和定位、固定气管插管、咬合阻滞确认、俯卧位和侧卧位、神经监测基线读数、在关闭手术室前仔细检查植入物螺帽是否锁定,以及在可能的情况下,确认患者在离开手术室前活动了双侧下肢:通过这项研究,我们制定了一份专门的脊柱畸形手术核对表,其中包含 74 个被认为重要的项目(许多项目专门针对脊柱手术);17 个项目被认为 "非常重要"。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.20
自引率
18.80%
发文量
167
期刊介绍: Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.
期刊最新文献
18th International Congress on Early Onset Scoliosis and the Growing Spine : November 13-15, 2024 Scottsdale, Arizona, USA. A team approach to improve outcomes in pediatric scoliosis surgery: a review of the current literature. Research trends of biomechanics in scoliosis from 1999 to 2023: a bibliometric analysis. Is the information provided by large language models valid in educating patients about adolescent idiopathic scoliosis? An evaluation of content, clarity, and empathy : The perspective of the European Spine Study Group. What imaging does my AIS patient need? A multi-group survey of provider preferences.
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