Adherence to the cardiac surgery checklist decreased mortality at a teaching hospital: A retrospective cohort study

Abstract Objectives To evaluate the impact of adherence to the cardiac surgical checklist on mortality at the teaching hospital. Methods A retrospective cohort study after the implementation of the cardiac surgical safety checklist in a reference hospital in Latin America. All patients undergoing coronary artery bypass surgery and/or heart valve surgery from 2013 to 2019 were analyzed. After the implementation of the project InCor-Checklist "Five steps to safe cardiac surgery" in 2015, the correlation between adherence and completeness of this instrument with surgical mortality was assessed. The EuroSCORE II was used as a reference to assess the risk of expected mortality for patients. Cross-sectional questionnaires were during the implementation of the InCor-Checklist. To perform the correlation, Pearson's coefficient was calculated using R software. Results Since 2013, data from 8139 patients have been analyzed. The average annual mortality was 5.98%. In 2015, the instrument was used in only 58% of patients; in contrast, it was used in 100% of patients in 2019. There was a decrease in surgical mortality from 8.22% to 3.13% for the same group of procedures. The results indicate that the greater the checklist use, the lower the surgical mortality (r = 88.9%). In addition, the greater the InCor-Checklist completeness, the lower the surgical mortality (r = 94.1%). Conclusion In the formation of the surgical patient safety culture, the implementation and adherence to the InCor-Checklist "Five steps to safe cardiac surgery" was associated with decreased mortality after cardiac surgery. HIGHLIGHTS Checklists avoid human errors and are commonly used in high-reliability industries. The "InCor Checklist" was associated with decreased mortality over time. Adherence, completeness, and sustainability within public policies are necessary.

Mediastinite no Hospital de Base do Distrito Federal: incidência em seis anos / Incidence of mediastinits at the Hospital de Base do Distrito Federal in six years of study

Realizada análise dos prontuários de pacientes adultos submetidos à operação cardíaca com esternotomia no Hospital de Base do Distrito Federal no período de seis anos. Determinou?se incidência de mediastinite em 15 (1,09por cento) pacientes, dentre 1388 operações cardíacas consecutivas com esternotomia, realizadas no período de janeiro de 1995 e março de 2001. Diversas variáveis foram consideradas, como sexo, idade, tipo de operação, tempo de permanência em respirador, tempo de permanência em Unidade de Terapia Intensiva, uso de antibióticos e germes isolados em culturas de ferida operatória