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Clinical risk management in outpatient ocular surgery

Poster Details

First Author: M.De Maria ITALY

Co Author(s):    L. Campi   M. Forlini   L. Chiesi   G. Cavallini     

Abstract Details



Purpose:

To test a new model of surgical safety checklist for eye surgery in the outpatient operating room, especially for cataract surgery and intravitreal anti-VEGF injections. The first outcome is the analysis of risks that may occur during these procedures to obtain the best safety for the patient.

Setting:

Institute of Ophthalmology, University of Modena and Reggio Emilia

Methods:

The Surgical Safety Checklist (SSC) by WHO was analyzed and changed to fit to ocular surgery. The new SSC was used in the outpatient operating room during a period of 4 months. All cataract surgery and intravitreal anti-VEGF injections were included in the study. The percentage of answer to each safety checks was calculated to obtain an esteem of adherence to our new checklist.

Results:

849 procedures (390 cataract, 452 anti-VEGF injections, 7 combined surgery) were analyzed. The study has shown high level of adherence to the most part of safety checks in the checklist. Differences have been identify in consent confirmation (correct confirmation in 99.76%), surgical site marking (correct marking in 99.29%), patient cooperation during operation (95.17% of patient was cooperative), adherence to antibiotic prophylaxis (correct prophylaxis in 93.17%), critical situation during surgical procedures (no critical situation in 91.76%) and a number need to treat (NNT) of 1/12. The dioptric power of the IOL to implant in the eye of the patient was confirmed, according with ecobiometric values, in 100% of cataract operations.

Conclusions:

The new SSC allowed us to avoid errors that could have severe welfare consequences and to increase equipe cooperation. The study has shown an high level of adherence to all the safety checks of the new SSC. A surgical safety checklist could improve the management of an eye surgery operating room, ensuring a better quality of procedures and a reduction of complications and consequently a better safety for the patient. FINANCIAL DISCLOSURE?: No

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