The effect of a surgical safety checklist on complication rates associated with permanent transvenous pacemaker implantation in dogs.

INTRODUCTION: To determine whether use of a surgical safety checklist (SSC) would reduce the rate of major complications after permanent transvenous pacemaker implantation in dogs. ANIMALS: The study included one hundred ninety-nine dogs undergoing pacemaker implantation for bradyarrhythmias at an academic teaching hospital. METHODS: A service-specific SSC was developed and implemented for cardiac catheterization procedures in 2015. Medical records were reviewed to extract relevant clinical and procedural data for cases with (SSC [+]) and without (SSC [-]) a checklist. Owners or referring veterinarians were contacted for outcome and survival data. RESULTS: Major complications occurred in 25/199 (12.6%) dogs. Incidence of major complications was significantly lower in SSC [+] dogs compared with SSC [-] dogs (1/45 procedures vs 24/144 procedures; p = 0.019). Dogs with SSCs were more likely to receive antibiotics within 5 min of the first incision (p = 0.0082) and to receive antibiotics every 90 min throughout the procedure as prescribed (p = 0.001) compared with dogs without SSCs. Incidence of cardiac death was lower in SSC [+] dogs compared with SSC [-] dogs (p = 0.0012), but checklist use was not associated with increased survival time (all-cause or cardiac). On average, 91% of checklist components were completed for each SSC; minor changes in record-keeping protocols could increase compliance. CONCLUSIONS: Use of an SSC was associated with a decrease in the major complication rate and an increase in compliance with antibiotic protocols during pacemaker implantation. Results of this study support the use of an SSC in veterinary cardiology procedures.

Effects of social support and relapse prevention training as adjuncts to a televised smoking-cessation intervention.

Smokers registering for a televised cessation program who also expressed interest in joining a support group and who had a nonsmoking buddy were randomly assigned to 3 conditions: no-contact control, discussion, and social support. All Ss received a self-help manual and were encouraged to watch the daily TV program. Ss in the discussion and social support conditions were scheduled to attend 3 group meetings (one with a buddy). Social support Ss and buddies received training in support and relapse prevention. A 4th analysis group was composed of Ss who failed to attend any of the scheduled meetings (no shows). There were strong group effects at the end of treatment. Abstinence rates were highest in the social support group, followed, in order, by the discussion group, no shows, and no-contact controls. The social support group improved outcome by increasing both the level of support and program material use (reading the manual and watching TV).