basic language and a logical flow [ 8 ] . The template created by the AVA consists solely of tick-box questions , to enable quick responses to minimise time . The author suggests that one way to reduce user forgetfulness is to store the checklist alongside the general anaesthetic ( GA ) forms . This way , every time a GA form is collected or printed , an SSC form is used alongside it .
An SSC can help inexperienced staff members , such as SVNs , to prepare adequately for procedures [ 8 ] . Similar checklists can be used in all areas of the hospital , both clinical and non-clinical , to support staff members . A study conducted by Down and Vivian [ 18 ] reported that only 7 % of SVNs were involved in the completion of anaesthetic-related checklists , compared with 79 % of RVNs . The use of an SSC also supports the requirements of the RCVS Day One skills and competences ( Table 2 ) [ 19 ] . It is beneficial for all training practices and clinical coaches to be familiar with the use of SSCs to support SVNs to achieve these requirements as part of their training .
Table 2 . Day One skills that may be linked to the use of surgical safety checklists .
Section
Day One skills
2 : Communication 2.1 : Communicate effectively using a variety of different methods
2.2 : Create accurate and legible written communications / documentation according to practice policy
9 : Theatre practice 9.3 : Prepare the theatre for use based on patient , equipment and procedure
9.4 : Position patients appropriately on the operating table in accordance with the planned procedure considering patient condition
9.5 : Prepare the surgical site appropriately for the procedure in accordance with practice protocol
9.8 : Prepare for surgical assistance wearing appropriate attire in accordance with practice protocol
10 : Anaesthesia 10.1 : Assess the patient and identify the patient ' s anaesthetic risks
10.2 : Prepare equipment for anaesthesia
Implementing SSCs in practice
Implementation of an SSC may pose some challenges , due to the barriers previously discussed . Discussion and support from senior team members , such as the practice manager , surgical team and / or lead VS , is advised before bringing in a new practice policy . Overall agreement and cooperation from the entire team will be required to ensure success .
The involvement of the whole team during the introduction of a new policy will not only ensure that everyone ' s opinions and concerns are sought and recognised , but a collaborative approach will also empower the team and allow everyone to feel heard . Collaboration is something that is widely embedded within veterinary education to promote ongoing learning and professional development [ 20 ] .
Staff training and standard operating procedures will be required to ensure a new SSC is clearly understood and used correctly . However , training is likely to be minimal and should not incur any cost , as SSCs are self-explanatory and user-friendly . RCVS Knowledge provides free continuing professional development that can help with the development and implementation of checklists , if required .
Feedback throughout the use of SSCs is necessary to ensure they remain relevant and up to date . Changes to staff dynamics will influence the requirements of the SSC , so periodic auditing of their suitability will be required [ 13 ] . This contributes towards reflective practice and improving clinical governance , to which all RVNs and VSs must adhere [ 13 ] .
‘ Clinical governance ’, ‘ auditing ’ or ‘ quality improvement ’ are all terms that are used when reflecting on and evaluating protocols to improve and develop evidence-based veterinary medicine . Again , it is advantageous to include the entire team in quality improvement , to reduce barriers and improve communication and transparency [ 21 ] . Clinical audits are not in place to target individual team members , but to recognise areas of concern . Audits can be performed on all aspects of the veterinary practice for both clinical and non-clinical procedures [ 21 ] .
Checklists could also be used to develop SVN training and meet the requirements of the Nursing Progress Log ( section 2 , skill 10 ).
Conclusions
The use of SSCs has had a significant and positive impact within human medicine , reducing surgeryrelated complications and fatalities . SSCs should be used in all veterinary practices – and in all procedures , even if they are deemed routine – to promote patient safety and identify any potential risks .
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