EVALUATION OF A CHECKLIST FOR ANESTHETIC EQUIPMENT BEFORE USE

Objective: To describe and to assess the use of a checklist for anaest hetic equipment, the effects on the quality of care, as well as the di fficulty to obtain a complete and permanent compliance of anaesthesia staff to the use of the checklist, in comparison with the practice pat terns in other countries and of the recommendations by the French soci ety of anaesthesia and intensive care for the anaesthetic machine chec king. Study design: Prospective quality assurance study with two subse quent phases. Methods: Both a detailed and a simplified checklist were initially tested over a 57-day- period to evaluate the incidence and severity of recognized abnormalities and to assess the compliance of t he staff with this new procedure. Four months later, the same evaluati on was performed again. The detailed checklist was used before the fir st anaesthetic in the morning and called <<Theater opening form>>. The simplified list was used before the subsequent anaesthetics and calle d <<Checking before induction form>>. Results: During phase I, the det ailed and simplified forms of the checklist were only used in 54% and 32% of cases respectively. They were more often completed in scheduled (93%) than in emergency cases (31%). The detailed checklist detected 5/165 potentially severe abnormalities in the breathing system that co uld be amended before use. After formal discussion with all members of the department, the simplified checklist was abandoned, as it did not detect any significant abnormality and was considered too time-consum ing. During the phase II of the study, as the staff checked the anaest hetic machine more often in emergency cases (52%), the overall complia nce increased (73%) but remained insufficient. However, no critical in cident could be detected during the second evaluation period. Discussi on: This study demonstrated the safety benefits associated with the pr ocedure of checking anaesthetic equipment, but also pointed out the di fficulty to obtain a full participation of the staff in quality-assura nce programmes.