Learning outcomes
• Know how to identify an SSC
• Understand how to use an SSC
What is an SSC ?
SSCs consist of a list of questions to confirm that certain steps and protocols in surgery have been followed to ensure the safety of the patient . They are used in the perianaesthetic period , including the pre-induction , preprocedure and pre-recovery stages .
SSCs were introduced by the World Health Organization ( WHO ) to improve safety in human operating theatres . They offer a standardised approach to maintain surgical safety globally [ 2 ] . Since their introduction in human medicine , there has been a significant reduction in the number of surgical-related complications , infections and deaths [ 3 ] . Following the implementation of SSCs in veterinary medicine , reductions in postoperative complications have also been observed [ 4 ] .
Why are SSCs so important ?
Human error is known to be the cause of over 50 % of fatalities in human medicine [ 5 ] , which is a significant percentage . Although mistakes are inevitable , checklists are cognitive aids that ensure preparation and minimise risks [ 6 ] . The veterinary environment is busy and fast-paced , so identifying potential hazards before they arise may prevent catastrophic events . The use of SSCs also serves as a reminder of policies and procedures that should be followed but may otherwise have been overlooked or missed .
The potential to improve patient safety should prompt the use of SSCs in every veterinary practice – in both referral and primary care – for all surgical procedures . The Royal College of Veterinary Surgeons ( RCVS ) Knowledge vetAUDIT releases statistics about the rates of complication associated with neutering for cats , dogs and rabbits each year . The results for 2023 showed that overall , 19 % of neutering procedures resulted in complications , which may have included death [ 7 ] . Neutering is considered a routine procedure , as the patient is usually fit and healthy , and so potential complications can sometimes be overlooked . However , the results of the audit clearly demonstrate the high risk of complications with these procedures , indicating the benefit of using SSCs to decrease postoperative incidents [ 3 ] .
Should a complication arise that relates to a surgical procedure , it is beneficial to have documents that display evidence-based practice in patient care . With the use of an SSC and a reduction in patient complication rates , it is likely that client satisfaction will increase [ 8 ] .
What is included in an SSC ?
An SSC consists of three stages : pre-induction , preprocedure and pre-recovery ( Table 1 ).
Pre-induction stage
The pre-induction check should be performed before the induction of anaesthesia and should be completed in the presence of all staff involved in the procedure [ 9 ] . From experience , the author has found it beneficial to perform the initial check-in with the patient present , to confirm the patient ' s identity by all parties . Questions such as ‘ Is this the correct animal for the procedure ?’, ‘ Has the owner signed the consent form ?’ and ‘ Is the anaesthetic machine check complete ?’ form a good basis for this part of the checklist .
Pre-procedure stage
The pre-procedure check should be completed following induction and before the first incision . It is advisable to complete this stage once all the surgical
Table 1 . Common features of a surgical safety checklist .
Pre-induction Pre-procedure Pre-recovery
|
Patient name and procedure
□ Patient name and procedure
□ Swab and sharp count
□
|
Consent |
Appropriate depth of
□ anaesthesia
□ All procedures complete
□
|
|
Intravenous cannula placement and patency
□ Required equipment available
□ Analgesic plan
□
|
Anaesthetic equipment checked |
□ Swab and sharp count |
Any expected postoperative
□ complications
□
|
Risks identified and intervention plan |
□ |
|
52 Veterinary Nursing Journal