Citation

Acar YA, Mehta N, Rich MA, Yilmaz BK, Careskey M, Generoso J, Fidler R, Hirsch J. Prehosp. Disaster Med. 2019; 34(4): 393-400.

Affiliation

1.Department of Anesthesia and Perioperative Care, San Francisco Veterans' Affairs Medical Center,University of California San Francisco (UCSF),San Francisco, CaliforniaUSA.

Copyright

(Copyright © 2019, Cambridge University Press)

DOI

10.1017/S1049023X19004576

PMID

31389323

Abstract

INTRODUCTION: Hospital evacuations of patients with special needs are extremely challenging, and it is difficult to train hospital workers for this rare event.

Hypothesis/Problem:Researchers developed an in-situ simulation study investigating the effect of standardized checklists on the evacuation of a patient under general anesthesia from the operating room (OR) and hypothesized that checklists would improve the completion rate of critical actions and decrease evacuation time.

METHODS: A vertical evacuation of the high-fidelity manikin (SimMan3G; Laerdal Inc.; Norway) was performed and participants were asked to lead the team and evacuate the manikin to the ground floor after a mock fire alarm. Participants were randomized to two groups: one was given an evacuation checklist (checklist group [CG]) and the other was not (non-checklist group [NCG]). A total of 19 scenarios were run with 28 participants.

RESULTS: Mean scenario time, preparation phase of evacuation, and time to transport the manikin down the stairs did not differ significantly between groups (P = .369,.462, and.935, respectively). The CG group showed significantly better performance of critical actions, including securing the airway, taking additional drug supplies, and taking additional equipment supplies (P = .047,.001, and.001, respectively). In the post-evacuation surveys, 27 out of 28 participants agreed that checklists would improve the evacuation process in a real event.

CONCLUSION: Standardized checklists increase the completion rate of pre-defined critical actions in evacuations out of the OR, which likely improves patient safety. Checklist use did not have a significant effect on total evacuation time.

Language: en

Keywords

CG: checklist group; CHEST: American College of Chest Physicians; ICU: intensive care unit; IV: intravenous; NCG: non-checklist group; OR: operating room; San Francisco; UCSF: University of California; disaster planning; simulation training; transportation of patients