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Impact of a daily safety checklist in an obstetric high dependency unit
Abstract Number: 52
Abstract Type: Original Research
Introduction: Care bundles and daily safety checks as developed by the Institute of Healthcare Improvement have been shown to improve patient safety in the general critical care setting (1,2). We introduced a similar daily safety checklist to our obstetric high dependency unit (HDU) with the aim of improving patient safety. The checklist ensures ward round review of drug kardex, thromboprophylaxis, fluid regime and integrity of invasive lines. The impact of the daily checklist on the adequacy of information documented in the case notes following HDU admission
Methods: A retrospective case note review of mothers admitted to HDU prior to the checklist introduction was performed and documentation of information requested on the new daily checklist assessed. A program of education emphasising the practicalities associated with its use and
importance of completion accompanied the introduction of the new checklist. The audit was then repeated prospectively using solely checklist for information collection.
Results: The case notes of 20 parturients were reviewed prior to introduction and 10 after. The results are summarised in the table below. Percentages for central venous and arterial access refer to only those patients who had such a line in situ.
Discussion: The daily safety checklist was successfully incorporated into obstetric high dependency ward rounds. Documentation standards prior to its introduction were unsatisfactory with review of the drug kardex particularly poorly documented. Compliance with standards of documentation has been observed to improve significantly. Future audit will aim to refine the checklist and assess the impact on clinical incidents.
1. Institute for Healthcare Improvement: Bundle Up for Safety. http://www.ihi.org/IHI/Topics/CriticalCare/IntensiveCare/ImprovementStories
2. Provonost P, Berenholtz S, Dorman T et al. Improving communication in the ICU using daliy goals. J of Crit Care 2003;18: 71-75.