Each year, thousands of surgical procedures are performed in France, with a common goal: to ensure patient safety. However, despite strict protocols, preventable adverse events (Never Events) continue to occur.
The Haute Autorité de Santé (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 sometimes remains insufficient due to routine, stress or lack of team training.
An innovative program run by Rose Prétot and the SafeTeam Academy is revolutionizing the learning of this essential tool, thanks to an immersive teaching approach. This article explores the importance of the checklist, its benefits and recent advances in training.
Origins 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 patient identity and planned procedure
- Ensure availability of necessary equipment
- Optimize communication within the surgical team
- Reduce the risk of infections, surgical site errors and other complications
In other words, it is not a mere administrative formality, but a real dynamic safety barrier, involving all members of the operating room.
The stakes of the checklist in the hospital environment
Despite its proven effectiveness, 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. With this in mind, an innovative educational program has been designed for IBODE (State-Certified Operating Room Nurses) students.
The central role of the scrub nurse in applying the checklist
The Operating Room Nurse plays a crucial role in coordinating and implementing the checklist. As the safety reference within the operating room, they must:
- Initiate and coordinate the checklist with the surgical team
- Ensure that each point is properly validated
- Encourage the verbalization of concerns and the reporting of anomalies
- Ensure compliance with protocols and good communication between players
Solid training is therefore essential to ensure that IBODEs master this tool and integrate it fully into their daily practice.
An innovative training program for IBODE students
Faced with the limitations of traditional teaching, Rose Prétot and the SafeTeam Academy have implemented an immersive three-phase training program for scrub nurse students. This program combines theoretical courses, digital simulation, and collective debriefing.
The three phases of 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 replicating an operating room.
- Scenario where students must apply the checklist in realistic scenarios.
- Awareness of interruptions and the need to verbalize discomfort.
- Collective debriefing
- Analysis of individual and collective performance.
- Identification of errors and areas for improvement.
- Exchange between students and healthcare professionals to enhance understanding of the issues.
Training results and impact
Data collected after the training shows a clear progression of the students:
- Initial pre-test 50% correct answers
- Test during 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 checklists in reducing surgical risks.
Perspectives and evolutions of the system
This program could be extended to other operating room staff, including:
- 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 permanently anchor a culture of shared safety in hospital practices.
Best practices for effective implementation
To ensure rigorous application of the checklist, here are some recommendations:
✔ Don't see the checklist as a constraint, but as an essential reflex
✔ Involve the whole team in the process and encourage open communication
✔ Anticipate material preparation to lighten the mental load
✔ Make teams aware of the dangers of interruptions and distractions
✔ Dare to express doubts and report anomalies without fear
The objective 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 indispensable tool for preventing medical errors and strengthening the safety of surgical care. However, its effectiveness relies on strong team buy-in and appropriate training.
The initiative led by Rose Prétot and the SafeTeam Academy proves that an immersive pedagogical approach optimizes the understanding and application of this tool.
With better 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.
