Abstract
Purpose
The World Health Organisation (WHO) identified patient safety in surgery as an important public health matter and advised the adoption of a universal peri-operative surgical checklist. An adapted version of the WHO checklist has been mandatory in the National Health Service since 2010. Wrong intraocular lens (IOL) implantation is a particular safety concern in ophthalmology. The Royal College of Ophthalmologists launched a bespoke checklist for cataract surgery in 2010 to reduce the likelihood of preventable errors. We sought to ascertain the use of checklists in cataract surgery in 2012.
Patients and methods
A survey of members of the Royal College of Ophthalmologists seeking views on the use of checklists in cataract surgery. Four hundred and sixty-nine completed responses were received (18% response rate).
Results
Respondents worked in England (75%), Scotland (11%), Wales (5%), Northern Ireland (2%), the Republic of Ireland (1%), and overseas (6%). Ninety-four per cent of respondents support the use of a checklist for cataract surgery and 85% say that they always use a checklist before cataract surgery. Sixty-seven per cent of cataract surgeons stated they undertake a pre-operative team brief. Thirty-six per cent use a cataract surgery checklist developed locally, 18% use the college’s bespoke cataract surgery checklist, 39% use a generic surgical checklist, and 4% reported that they do not use a checklist.
Conclusion
Ninety-three per cent of cataract surgeons responding to the questionnaire report using a surgical checklist and 67% use a team brief. However, only 54% use a checklist, which addresses the selection of the correct intraocular implant. We recommend wider adoption of checklists, which address risks relevant to cataract surgery, in particular the possibility of selection of an incorrect IOL.
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Acknowledgements
We thank the College members who responded to this survey. We thank Miss Beth Barnes of the College for her help with the survey.
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SPK and SR declare they were involved, unpaid, in drafting the College’s cataract surgery checklist. All other authors declare no conflict of interest.
Additional information
Presented, in part, at the 2012 and 2013 Annual Congress of the Royal College of Ophthalmologists
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Kelly, S., Steeples, L., Smith, R. et al. Surgical checklist for cataract surgery: progress with the initiative by the Royal College of Ophthalmologists to improve patient safety. Eye 27, 878–882 (2013). https://doi.org/10.1038/eye.2013.101
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DOI: https://doi.org/10.1038/eye.2013.101
