Abstract
Background
Adult surgical patient safety literature is plentiful; however, there is a disproportionate paucity of published safety work in the children's surgical literature. We sought to systematically evaluate the nature and quality of patient safety evidence pertaining to pediatric surgical practice.
Methods
Systematic search of MEDLINE and EMBASE databases and grey literature identified 1399 articles. Data pertaining to demographics, methodology, interventions, and outcomes were extracted. Study quality was assessed utilizing formal criteria.
Results
20 studies were included. 14 (70%) comprised peer-reviewed articles. 18 (90%) were published in the last 4 years. 13 (65%) described a novel intervention, 7 (35%) described a modification of an existing intervention. Median patient sample size was 79 (29-1210). A large number (n = 55) and variety (n = 35) of measures were employed to evaluate the effect of interventions on patient safety. 15 (75%) studies utilized a checklist tool as a component of their intervention. 9 (45%) studies [comprising handoff tools (n = 7); checklists (n = 1) and multi-dimension quality improvement initiatives (n = 1)] reported a positive effect on patient safety. Quality assessment was undertaken on 14 studies. Quantitative studies had significantly higher quality scores than qualitative studies (61 [0-89] vs 44 [11-78], p = 0.03).
Conclusions
Pediatric surgical patient safety evidence is in its early stages. Successful interventions we identified were typically handoff tools. There now ought to be an onus on pediatric surgeons to develop and apply bespoke pediatric surgical safety interventions and generate an evidence base to parallel the adult literature.
Adult surgical patient safety literature is plentiful; however, there is a disproportionate paucity of published safety work in the children's surgical literature. We sought to systematically evaluate the nature and quality of patient safety evidence pertaining to pediatric surgical practice.
Methods
Systematic search of MEDLINE and EMBASE databases and grey literature identified 1399 articles. Data pertaining to demographics, methodology, interventions, and outcomes were extracted. Study quality was assessed utilizing formal criteria.
Results
20 studies were included. 14 (70%) comprised peer-reviewed articles. 18 (90%) were published in the last 4 years. 13 (65%) described a novel intervention, 7 (35%) described a modification of an existing intervention. Median patient sample size was 79 (29-1210). A large number (n = 55) and variety (n = 35) of measures were employed to evaluate the effect of interventions on patient safety. 15 (75%) studies utilized a checklist tool as a component of their intervention. 9 (45%) studies [comprising handoff tools (n = 7); checklists (n = 1) and multi-dimension quality improvement initiatives (n = 1)] reported a positive effect on patient safety. Quality assessment was undertaken on 14 studies. Quantitative studies had significantly higher quality scores than qualitative studies (61 [0-89] vs 44 [11-78], p = 0.03).
Conclusions
Pediatric surgical patient safety evidence is in its early stages. Successful interventions we identified were typically handoff tools. There now ought to be an onus on pediatric surgeons to develop and apply bespoke pediatric surgical safety interventions and generate an evidence base to parallel the adult literature.
| Original language | English |
|---|---|
| Journal | Journal of Pediatric Surgery |
| Early online date | 24 Sept 2016 |
| DOIs | |
| Publication status | E-pub ahead of print - 24 Sept 2016 |