Manuale per la sicurezza in sala operatoria - Azienda Sanitaria ...

Raccomandazioni per la sicurezza in sala operatoria - Ottobre 2009A SUP.OICAL SAFETlf CHECK LISTidentity of die patient, thè operative site, and thèprocedure to be perfbrmed; and compdttioo ofa spenge count at thè end of thè procedale, ifan Incitò» was made. We lecorded whether aliax of these safèty measures were taken for eachpatient.ITKTIITICAL ANALTSISStatistial aaaljnes were peribrmed wìth die useof thè SAS statistica! software package, vernai 9.1(SAS Insalate). To minjmjze thè efiect of dìfièrenceslo die nambers ofpatìems at each site, wettandardìied thè rates of various end poma toreflect thè proportioa of patients ftom cadi àte.These Handardìged rates were used to computetfeefiequenctes of performance of spetified safétymeasures, major complJcations, and deadi ateach site befbce and afte* ìmplemeatatian of thèchecldjst1* We used logìstk-regrwsian analysisto calcola» wo-sKted P values far each cooipar}-son, wfeh she as a fixed efiècL We used genetalteeoVestìmatiDg^uatkmmethods to test fbr aayefièct of dustering according to site,We perfbtmed additìonal analyses to test thècobusmess of otti fmdings, iododìag logisticcegressionaoaljrses in which thè presene? or abaeaceof a data coflectot m thè operating toomand thè case mix were added as rariaUes. Wedanì6ed caaes as orthopedìc, thccacìc, nonobstaricabdomioopeWc,obttetoc,Tasculai; endoscopic,or othet. To detennìnc whether tìie effect ofthè cheddist at any one she dominated thè resolts,we perfocmed cros*-vaUdatìc» by sequentìaìlyretnoving each site from thè analjrèis. Ftnally,we djsaggregated thè shes on thè baais ofwhether they were Iccated in high-income or kwormiddle-income owntries and repeated ouranaJysis of prìmary end poìntt. Ali reportedP vahiefi are two-sided, and oo adJustmeDts weremade fbr multiple compansoos.B.ESULTSWe enrolled 3733 patìents duriag thè baseUoeperiod and 3955 pittóncs afta implementatjonofthè cheddist. Table 4 ] jsts charactenstìcs of thèpadeots and theit distributkn among thè sìtes;there were no sgnificant dififeimces between thèpatìents in thè mo phases of thè swdjr.The rate of any complicatimi at ali àtesdropped fìnm 11.0% at baseUoe to 7Sfk aftaiatroductìoo of thè cheddist (P to0^% (P=0.003) (TaUe 5), The orerall rates ofsur^ica-l-fiit£ ìnfèctiao and onplaitoed reopermonalso dedined s^ùfkantty (P 0,0 49.1 55.921,9 05 OJZ 97.5 94J46.7*175 56J S7.6 22.3 23J 9.9 9.4 Tifi 7730.63 0.21 0-2fi 0.40 o.aRw-mviui vilues ire meim &SD. Uient cases were those in whicti lurgery wfthin 24 houn was deened neos«wr by thè dìnkal team,Outprtent procedurec were ihose for whkk ifischarge from thè hotpittl ocaimd on thè une diy M thè operalion. P viluw tre >hown forthè oomptmon of thè totd vtlue dtw eheditrt impìémentiboo with thè total vilue before implementitioaScurezza dei parenti54