Posts Tagged ‘checklist’

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Checklist, Please!

June 28, 2010

Christine Moffa, MS, RN, AJN clinical editor

It’s embarrassing to admit how many times I’ve either locked myself out of my apartment or arrived at work and realized I’d left either my wallet or cell phone at home. That is, until someone very close to me taught me to say, “wallet, keys, cell phone, Metrocard” before walking out the door. Little did he know he was using a very powerful tool, the checklist.

As part of my money-saving strategies this year, I’ve resorted to using the New York Public Library to support my reading habit, instead of going to the various megabookstores in my neighborhood (I always fall for the “buy-two-get-one-free” deal!). That’s why I’m late to the party for The Checklist Manifesto, by Atul Gawande. After three months on hold, my turn finally came up—and boy was it worth the wait. There are so many great anecdotes about success stories (and some failures) of checklists—including patients surviving accidents and surgeries against all odds, averted airplane crashes, and well-orchestrated rock concerts—that it makes me want to start implementing checklists in every aspect of my life (including some at AJN). In fact, if I’d had a checklist for packing my bag for this weekend, I’d have remembered my flat iron, amongst other necessities. Now I’m forced to go the next 48 hours with serious frizz! 

My favorite part of the book, though, is that Gawande gives credit to nurses for being the originators of checklist usage in hospitals, citing vital sign charts, medication administration records (MARs), and care plans.

Checklists, it turns out, foster communication, which in turn leads to teamwork. Who knew? In this world of ever increasing complexity, there are so many details to focus on it’s easy for errors to happen. Often you have to focus on your own responsibilities and trust that your colleagues are taking care of theirs. The checklist brings us all back to the same page; if nobody can proceed until it’s confirmed that a particular task has been performed, we’re forced to check in with each other.

If you’d like to make a checklist of your own, you can visit Gawande’s  Web site and download a “Checklist for Checklists,” or see some examples of those used in the medical and aviation industries.

Do you have a favorite checklist that you find helpful either in your personal or professional life? Let us know about it.

Atul Gawande's "Checklist for Checklists"

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The Checklist – Taking Finger-Pointing Out of the Equation

February 5, 2010

By Peggy McDaniel, BSN, RN

Ok, I will admit right off that I am a huge fan of Atul Gawande’s writing. I have read his books Better and Complications, and I think much of his work should be required reading for all health care students. I haven’t read his newest book, The Checklist Manifesto: How to Get Things Right. I plan to soon, but it’s the 3rd book down in the pile on my bedside stand.

That confession aside, there has been some recent news around the use of checklists that bears some attention. Dr. Gawande helped develop a two-minute checklist that is to be done prior to surgery. 

Dr. Peter Pronovost was involved in the development of a similar checklist related to the insertion of central lines. 

Airlines and airplane manufacturers, such as Boeing, use checklists constantly to ensure consistent, high quality outcomes. 

I did a quick Google search for “checklists and nursing” and found various references to skills and competency checklists. As a nurse, my skills have been observed and validated with checklists over the years. I have also been party to filling out checklists on myself and my peers. Come to think of it, much of our charting has been done by filling out checklists. 

I guess I am a bit surprised that the use of checklists to validate competencies and keep track of specific processes and actions by doctors and multidisciplinary teams has been so long in coming.  Read the rest of this entry ?

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