Every year, thousands of surgical procedures are performed in France, all with the same 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 among healthcare professionals. However, its implementation is sometimes inadequate 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 aviation 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 that the necessary equipment is available
- Optimize communication within the surgical team
- Reduce the risk of infection, surgical site errors, and other complications
In other words, it is not merely an administrative formality, but a genuine, active safety measure that involves everyone in the operating room.
The Challenges of Using Checklists 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 view it as a hindrance rather than a tool for improvement.
- Lack of training and awareness: some professionals have not received adequate training in its use.
- Time pressure and frequent interruptions: in an operating room where every minute counts, the checklist is sometimes rushed through.
For this tool to be fully effective, rigorous training is essential. With this in mind, an innovative educational device has been designed for IBODE (State-Certified Operating Room Nurse) students.
The central role of the IBODE in the implementation of the checklist
The IBODE plays a crucial role in coordinating and implementing the checklist. As the safety officer in the operating room, they must:
- Initiate and coordinate the checklist with the surgical team
- Make sure each item is properly validated
- Encourage the expression of concerns and the reporting of irregularities
- Ensure compliance with protocols and effective communication among stakeholders
Thorough training is therefore essential to ensure that scrub nurses are proficient in using this tool and fully incorporate 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 that simulate an operating room.
- Role-playing exercises in which students must apply the checklist in realistic scenarios.
- Raising awareness of interruptions and the need to express the discomfort they cause.
- Group debriefing
- Analysis of individual and group performance.
- Identification of errors and areas for improvement.
- Exchange between students and healthcare professionals to deepen understanding of the issues.
Results and impact of the training
The data collected after the training shows clear improvement among the students:
- Initial pre-test: 50% correct answers
- Test during the video immersion: 45% correct answers (a decrease due to hesitations and questions)
- Final post-test: 87% correct answers (significant improvement in knowledge and behavior)
These results demonstrate that immersive learning promotes better understanding of concepts and raises awareness of the importance of checklists in reducing surgical risks.
Outlook and developments of the system
This program could be expanded to include other operating room professionals, such as:
- State-certified nurse anesthetists to strengthen interdisciplinary collaboration.
- Multidisciplinary teams to improve 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 firmly establish a shared safety culture in hospital practices.
Best practices for effective implementation
To ensure that the checklist is applied rigorously, here are some recommendations:
✔ Don’t view the checklist as a constraint, but as an essential reflex
✔ Involve the entire team in the process and encourage open communication
✔ Plan ahead for equipment preparation to reduce mental workload
✔ Raise awareness among teams about the dangers of interruptions and distractions
✔ Don’t be afraid to voice concerns and report issues
The goal is not to simply go through a checklist, but to foster a genuine collective discussion about patient safety.
Conclusion
The "Patient Safety in the Operating Room" checklist is an essential tool for preventing medical errors and improving 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 demonstrates that an immersive educational approach enhances 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.
