- Surgical security checklists CSCs to reduce complications
- Introduction
- Background and current research results
- How do surgical security checklists work?
- Advantages of using CSCs
- Challenges and obstacles
- Tips for successful implementation of CSCs
- What are surgical security checklists?
- Why are you important?
- Tips for implementation
- Conclusion
- Frequently asked questions (FAQs) about CSCs
- Summary Chururgical security checklists
Surgical security checklists CSCs to reduce complications
Introduction
Surgical interventions are commonplace in veterinary medicine, but they always raise a certain risk of complications and mistakes. In order to minimize these risks, surgical security checklists (Surgical Safety Checklists, SSCs or German: CSCs) have proven to be valuable tools. They offer a structured process that enables surgical teams to consistently carry out safety -related measures. These checklists are already widespread in human medicine and have been shown to reduce the complication rate and mortality.
This article illuminates the importance of CSCs in veterinary medicine, presents current research results and gives practical tips for implementation.
Here is a translation of the RCV Handbook with various examples of CSCs: https://tierzar-karlsruhe-durlach.de/wp-content/uploads/2025/02/cScs.pdf
Background and current research results
In veterinary surgery, mistakes are common and can have serious consequences for the patients. Studies show that a significant proportion of complications through better communication and structured security protocols could be avoided.
A current study by Davidow et al. (2023) examined the level of knowledge and the use of CSCs in various areas of veterinary medicine. For this purpose, an online survey was carried out under 1,235 small animal surgeons in the USA and Canada. The most important findings of the study were:
- Low use of CSCs : The majority of the veterinarians surveyed stated not to use CSCs.
- Positive effects in use : 66 % of those who used a CSC believed that they had prevented at least one medical error or a complication.
- Differences between the practical types : In university clinics and special practices, the checklist was used more often than in general practices. However, only 52 % of those surveyed stated in these specialized facilities to consistently use CSCs.
- A lack of awareness : Many of those who did not use CSC simply didn't know that they exist.
The study authors came to the conclusion that CSCs can reduce complications and mortality in any kind of veterinary interior. In addition, their use hardly incurred any additional costs.
How do surgical security checklists work?
Most CSCs consist of three main phases:
- PREACE CHECK : Before initiating anesthesia, the team checks the patient identity, the planned operation and any necessary medication (e.g. antibiotics).
- Preinzision check : Before the first cut, the team confirms the operating area again, clarifies critical points of the procedure and ensures that all the required materials are available.
- Postoperative check : After completing the intervention, it is checked whether all instruments have been counted correctly, the postoperative instructions are clear and the patient is transferred to a stable state.
The checklists can be led in paper form or as a digital version. Another effective method is the visualization of the checklist on a clearly visible wall table in the operating room.
Advantages of using CSCs
The advantages of CSCs are numerous and concern both patients and the surgical team:
- Reduction of errors : A structured checklist helps to minimize sources of error such as incorrect medication, confusion or forgotten materials.
- Better communication in the OR team : By going through the checklist together, it ensures that all team members are informed about critical aspects of the intervention.
- Higher patient safety : Studies from human medicine show that CSCs significantly reduce the complication rate and mortality.
- Improvement of teamwork : A structured approach increases the sense of responsibility of the parties involved and promotes a joint working atmosphere.
- Low implementation costs : CSCs do not require expensive additional equipment and can easily be integrated into existing processes.
Challenges and obstacles
Despite the obvious advantages, there are some obstacles that make the comprehensive use of CSCs difficult:
- A lack of awareness : Many veterinarians are not aware that CSCs exist or what benefits they have.
- Time required : Some teams fear that the use of a checklist will cost additional time. However, studies show that it can even increase efficiency.
- Resistance to changes : Established work processes are difficult to change. Successful implementation requires the active integration of the entire team.
- Missing training courses : Without sufficient training, the use of CSCs can remain ineffective.
Tips for successful implementation of CSCs
In order for CSCs to be successfully integrated into veterinary surgery, the following aspects should be observed:
- Include employees : The team's active participation in the development and implementation of the checklist promotes acceptance.
- Define clear responsibilities : A team member should take on the task of consistently using the checklist and ensuring that it is carried out fully.
- Offer training and training courses : Regular training helps to raise awareness of the importance of the checklist.
- Place the checklist visibly : A large-format version of the CSC on an operation wall can make it easier to use.
- Obtain and adapt feedback : CSCs should be checked regularly and adapted to the needs of the team.
Use and implementation of surgical security checklists
What are surgical security checklists?
Surgical security checklists (SSC) are structured guidelines that lead the entire surgical team step by step through all critical phases of a surgical intervention. This ensures that essential points such as patient identity, planned procedures and available instruments are not overlooked. The aim is to reduce the risk of complications and to promote open communication.
Why are you important?
With the help of SSCs, it is uniformly ensured that all team members - from surgeons to anesthesia care - are up to date. Errors that arise in a hurry or communication gaps can be prevented more effectively. In the long term, applied checklists consistently lead to higher patient safety and can significantly reduce the mortality and complication rates.
Before the operation (pre-op)
Checking the patient identity, relevant laboratory values and the planned surgical procedure. Make sure that all the required instruments and medication are available.
Introduction and team presentation
Presentation of all team members and confirmation of the roles. Clear definition of who takes on which tasks, including emergency scenarios.
Before the first cut
Last control of the patient, review of the operating room and any allergies. Discussion of special features and critical points.
During the operation
Continuous monitoring of the vital parameters, timely communication of changes and documentation of incidents.
After the operation (post-op)
Control of the number of instruments and association materials. Coordination with the entire team whether all steps were carried out properly.
Debriefing and documentation
Common reflect on the procedure so that future processes can be further optimized. Careful documentation in the patient data system.
Tips for implementation
1. Integrating the team: Include all team members in the planning phase to create acceptance.
2. Adjust the checklist: Every practice or clinic has its own processes. Adjust the template to your individual needs.
3. Name those responsible: Determine a person who consistently ensures the use of the checklist to avoid gaps.
4. Regular schools: Keep the team up to date. For new employees, spa training is worthwhile directly to the start.
5. Receive feedback: Collect regular feedback to evaluate the benefits of the checklist and, if necessary, adjust.
Conclusion
Surgical security checklists are a simple and effective way to increase patient safety and improve cooperation in the operating room. With clear agreements, a structured documentation and a responsible team, postoperative complications can be significantly reduced. Take the opportunity to offer your patients optimal care - and your team a reliable system for stressful everyday life.
Frequently asked questions (FAQs) about CSCs
Why are surgical security checklists in veterinary medicine not yet widespread?
Many veterinarians are not aware of the existence and use of CSCs. There are also concerns about the time required, which is often compensated for by the improved efficiency of the OP team. Resistance to new work processes and missing training are other factors that stand in the way of a nationwide introduction.
What specific mistakes can be avoided by using a CSC?
Typical errors that can be avoided are wrong medication, confusion of patients or interventions, forgotten instruments in the operating room area and not recognized anesthesier risks. The structured checklist ensures that each team member informs and remains attentive.
Is there scientific evidence of the effectiveness of CSCs?
Yes, numerous studies in human medicine show that CSCs reduce complication rates and hospital mortality. Initial studies in veterinary medicine also indicate a significant improvement in patient safety.
How can the implementation of CSCs be facilitated in a clinic or practice?
Successful implementation requires active integration of the team. Regular training, the definition of clear responsibilities and attaching a clearly visible checklist in the operating room are helpful measures. In addition, the team should be encouraged to give feedback and to adapt the checklist to them as required.
What costs are associated with the introduction of a CSC?
The costs are minimal, since CSCs usually only require a printed checklist or a digital version. Additional training or meetings can initially take some time, but pay out in the long term due to more efficient processes and fewer complications.
Summary Chururgical security checklists
The use of surgical security checklists is a simple, inexpensive and effective method to reduce complications and errors in veterinary medicine. Although their use has so far not been widespread, scientific knowledge shows that they can significantly improve patient safety.
With a targeted implementation and the active integration of the entire team, many hurdles can be overcome. A structured procedure can not only increase the safety of the patients, but also improve efficiency and satisfaction in the operating room.
In view of the minimal costs and the high benefit, the integration of CSCs into everyday veterinary life should be actively promoted.
CSCs are a valuable instrument in veterinary medicine to reduce errors, since surgical security checklists both increase patient safety and improve teamwork. Surgical security checklists manage to comply with standardized processes, and CSCs help you not to overlook important steps.
Various studies show that surgical security checklists lead to a significant reduction in complication rates because CSCs provide a clear structure for every intervention. In the run-up to surgery, surgical security checklists enable the patient's clear identification, and CSCs promote open communication in the operating room. Especially in the case of complex interventions, surgical security checklists can help reduce the risk of loss of instruments, while surgical security checklists at the same time clarify the role of every team member.
Since every step is documented, CSCs create confidence in the treatment process; Surgical security checklists also support clear documentation of all relevant data. Many practices face the challenge of raising enough time for logging, but surgical security checklists reduce the time required in the long term, since surgical security checklists also minimize the risk of errors.
Last but not least, CSCs motivate the staff to actively contribute, because surgical security checklists convey a common sense of responsibility for patient safety.
Although many veterinarians have recognized the benefits, not all surgical security checklists have yet consistently used, which is why surgical security checklists should continue to be extensively advertised. A clearly structured process by surgical security checklists facilitates the familiarization of new employees because CSCs summarize the essential steps.
Surgical security checklists are considered effective tools both in university clinics and in small animal practices, especially since surgical security checklists require few resources. In many cases, a simple wall table or a digital template is sufficient so that surgical security checklists are implemented, and CSCs can be adapted to practical requirements at any time.
One crucial advantage is that CSC's misunderstandings reduce, while surgical security checklists also strengthen the self-confidence of all involved. Cooperation becomes more intensive if surgical security checklists are used, since surgical security checklists clearly specify all relevant points and promote open communication. In the long term, surgical security checklists can increase patient satisfaction, because surgical security checklists bring more security and transparency into every step of the operational process.
In the end, surgical security checklists are a central part of modern veterinary standards, and surgical security checklists should not be missing in any clinic in view of their versatile benefits.
Another aspect that promotes the use of surgical security checklists is its versatility: they are not only suitable for standard procedures, but can also be adapted to special operations. By surgical security checklists in the case briefing, veterinarians ensure that all the necessary materials are available and that each team member knows about the individual needs of the patient.
Especially in highly specialized clinics, in which complex interventions are common, surgical security checklists ensure that communication between the surgeon, anesthetist and surgical care staff merges seamlessly. In this way, stressful situations can be defused because surgical security checklists prevent important points in the zeal of the battle.
Another plus is that surgical security checklists can improve the entire clinic organization in the long term. When teams regularly surgical security checklists , they develop a finer feel for processes and possible risk factors. This often leads to a more open culture of conversation in which concerns or uncertainties are given before they develop into serious problems.
Furthermore, surgical security checklists be used in the follow-up of an operation to systematically analyze success and possible sources of error. In this way, important insights can be drawn from every operation for future cases, and surgical security checklists form the structured framework in which such debriefing is carried out. In this way, surgical security checklists contribute to continuously improving practices and clinics and keeping the quality of the supply at a high level.
Here you will find a good manual for CSCs in English: https://knowledge.rcvs.org.uk/document-library/surgical-safety-checklist-manual/