ABSTRACT
BACKGROUND: The purpose of this study was to examine the outcomes of checklist-driven preoperative briefings and postoperative debriefings during the Veterans Health Administration (VHA) medical team training program. METHODS: A briefing score (1, never started; 2, started then discontinued; 3, maintained on original targeted cases; 4, expanded to other services; 5, briefing all cases, all services) was established at 10.1 ± .3 months after introduction of the checklist. Outcomes included antibiotic and deep venous thrombosis prophylaxis compliance rates before and after use of the checklist. RESULTS: Antibiotic (97.0% ± .1% vs 92.1% ± 1.5%; P = .01) and deep venous thrombosis (95.7% ± .8% vs 85.1% ± 4.6%; P = .05) prophylaxis compliance rates were higher after initiation of a surgical checklist. CONCLUSIONS: Checklist-driven preoperative briefings and postoperative debriefings are associated with improvements in patient safety for surgical patients.
Subject(s)
Checklist , Education, Medical, Continuing/organization & administration , Operating Rooms/organization & administration , Patient Care Team/organization & administration , Postoperative Period , Preoperative Period , United States Department of Veterans Affairs/organization & administration , Hospitals, Veterans , Humans , Operating Room Technicians/education , Program Development , Surgical Procedures, Operative/standards , United States , Veterans Health , WorkforceABSTRACT
Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging cause of skin and soft-tissue infections among athletes. To determine statewide incidence among high school athletes, we surveyed all 312 Nebraska high schools regarding sport programs offered, program-specific participation numbers, number of athletes with physician-diagnosed MRSA infections, and athlete's sport at infection onset. Among 271 (86.9%) schools responding, MRSA infections were reported among one or more athletes by 4.4% (12/270) and 14.4% (39/271) during school years 2006-2007 and 2007-2008, respectively. From 2006-2007 to 2007-2008, MRSA incidence per 10,000 wrestlers increased from 19.6 to 60.1, and incidence per 10,000 football players increased from 5.0 to 25.1. We did not identify differences in distribution of MRSA infections on the basis of grade, school enrollment, location, or number of participants per team. Incidence of reported MRSA infections among football players and wrestlers was substantially higher during 2007-2008, compared with 2006-2007.
