Every year, thousands of surgical procedures are performed in France, with one common goal: ensuring patient safety. Yet, despite strict protocols, preventable adverse events (Never Events) continue to occur. The French National Authority for Health (HAS) has implemented the "Patient Safety in the Operating Room" checklist, a tool designed to standardize procedures and improve communication between healthcare professionals. However, its application is sometimes insufficient due to routine, stress, or a lack of training among teams. An innovative program, led by Rose Prétot and the SafeTeam Academy, is revolutionizing the learning of this essential tool through an immersive educational approach. This article explores the importance of the checklist, its benefits, and recent advances in training.
Origin and objectives of the checklist
A tool inspired by aeronautical practices
The "Patient Safety in the Operating Room" checklist was inspired by aviation practices, where systematic checklists help prevent potentially fatal errors. Implemented by the HAS in 2010, this checklist aims to:
- Verify the patient's identity and the planned procedure
- Ensure the availability of necessary equipment
- Optimize communication within the surgical team
- Reduce the risks of infection, surgical site errors, and other complications
In other words, it is not a simple administrative formality, but a real dynamic safety barrier, involving all members of the operating room.
The challenges of the checklist in a hospital setting
Despite its proven effectiveness, the implementation of the checklist is not always optimal. Several obstacles have been identified:
- Routine and complacency: some healthcare professionals perceive it as a constraint rather than a tool for improvement.
- Lack of training and awareness: some professionals have not been properly trained in its use.
- Time pressure and frequent interruptions: in an operating room where every minute counts, the checklist is sometimes rushed.
For this tool to be fully effective, rigorous training is essential. It is with this in mind that an innovative educational device has been designed for IBODE (State-Certified Operating Room Nurse) students.
The central role of the IBODE in the application of the checklist
The IBODE plays a crucial role in the coordination and application of the checklist. As the safety officer in the operating room, they must:
- Initiate and coordinate the checklist with the surgical team
- Ensure that each item is correctly validated
- Encourage the verbalization of concerns and the reporting of anomalies
- Ensure compliance with protocols and good communication between stakeholders
Solid training is therefore essential to guarantee that the scrub nurse masters this tool and fully integrates it into their daily practice.
An innovative training program for scrub nurse students
Faced with the limitations of traditional teaching, Rose Prétot and the SafeTeam Academy have implemented a three-phase immersive training program for IBODE students. This program combines theoretical courses, digital simulation, and group debriefing.
The three phases of the training
- Theoretical learning
- A 3-hour lecture on the origin and importance of the checklist.
- Educational videos illustrating real-life situations in the operating room.
- Immersive simulation
- Virtual environments reproducing an operating room.
- Role-playing exercises where students must apply the checklist in realistic scenarios.
- Raising awareness of interruptions and the need to verbalize them discomforts.
- Group debriefing
- Analysis of individual and group performance.
- Identification of errors and areas for improvement.
- Exchange between students and healthcare professionals to strengthen understanding of the issues.
Results and impact of the training
The data collected after the training shows a clear progression among the students:
- Initial pre-test: 50% correct answers
- Test during the video immersion: 45% correct answers (decrease due to hesitations and questions)
- Final post-test: 87% correct answers (significant improvement in knowledge and behaviors)
These results demonstrate that immersive learning promotes better assimilation of concepts and raises awareness of the importance of the checklist in reducing surgical risks.
Perspectives and developments of the system
This program could be expanded to other operating room professionals, including:
- State-Certified Nurse Anesthetists to strengthen interdisciplinary collaboration.
- Multidisciplinary teams for better coordination in the implementation of safety procedures.
- Adapting the checklist to different surgical specialties to meet the specific needs of each discipline.
These initiatives aim to to firmly establish a shared safety culture in hospital practices.
Good practices for effective implementation
To ensure rigorous application of the checklist, here are some recommendations:
✔ Do not see the checklist as a constraint, but as an essential reflex
✔ Involve the entire team in the process and encourage open communication
✔ Anticipate the preparation of equipment to reduce mental workload
✔ Raise awareness among teams about the dangers of interruptions and distractions
✔ Dare to express doubts and report anomalies without fear
The goal is not to recite a checklist, but to integrate a genuine collective reflection on patient safety.
Conclusion
The "Patient Safety in the Operating Room" checklist is an essential tool for preventing medical errors and strengthening the safety of surgical care. However, its effectiveness depends on strong team buy-in and appropriate training.
The initiative led by Rose Prétot and the SafeTeam Academy proves that an immersive educational approach optimizes the understanding and application of this tool.
With increased awareness and innovative learning methods, it is possible to make the checklist an essential safety standard, fully integrated into the daily routine of the operating room.
