Background Infants requiring surgical intervention are at high risk of complications. Peri-operative checklists have demonstrated reduction in morbidity and mortality in many patient groups by maintaining high standards of care provided.
Objectives We audited compliance with current perioperative protocols on a surgical neonatal intensive care unit at King’s College Hospital, London, UK and identified deficits in documentation and clinical practices. A perioperative checklist was then formulated as a quality improvement activity to standardize care which was re-audited to demonstrate significant improvisation of deficiencies.
Various new variables were introduced with the implementation of peri-operative check list to provide an extended and comprehensive health care package to infants undergoing surgical interventions. These included post-operative examination, IV antibiotics, replacement of ongoing fluid losses, identity bands and COVID swabs results prior to theatres.
Methods Review of case notes were undertaken pre and postoperatively. Documentation of clinical examination, laboratory investigations, imaging, ventilation plan, consent, communication, prescriptions of fluids, antibiotics and analgesia were assessed.
Results The case records of 48 infants (birth weight 460 – 4600 grams) with gestational ages ranging from 23–41 weeks were analysed (shown in table 1) both pre and post introduction of peri-operative checklist (shown in figure 1). The surgical interventions included laparotomy (32), neurosurgery (10), thoracotomy (4) and central venous line insertion (2).
Conclusions Introduction of a structured peri-operative checklist as a standard practice, significantly improved the compliance with most protocol recommendations and optimized safety during surgical care of infants.
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