Construction and Application Research of a Perioperative Inspection Checklist for Acute Upper Gastrointestinal Bleeding.

Abstract

Purpose: To enhance patient safety and improve communication and response times during the perioperative management of patients with acute upper gastrointestinal bleeding, a checklist was developed, tested for psychometric properties, and implemented in clinical practice.

Design: This is a methodological study.

Methods: A perioperative checklist for acute upper gastrointestinal bleeding was developed using a literature review and the Delphi method. The psychometric properties of the checklist were assessed through reliability and validity testing, including Cronbach's α coefficient, split-half reliability, content validity, and construct validity. A pre-and-post intervention study was conducted to evaluate the checklist's practical impact on clinical outcomes. Data were collected on safety indicators, efficiency metrics (including response times), and satisfaction levels.

Findings: The final checklist comprises 19 items across 3 domains: preoperative, intraoperative, and postoperative management. The Cronbach's α coefficient was 0.775, indicating good internal consistency. Split-half reliability was 0.701. The scale-content validity index/average for the 3 domains was 0.987, 0.971, and 0.904, respectively, while the item-content validity index ranged from 0.857 to 1.000, demonstrating excellent content validity. Factor loadings for each item exceeded 0.5, and 6 latent factors explained 83.874% of the total variance, confirming the checklist's strong factor structure. In the clinical application, 210 cases were analyzed-101 before and 105 after checklist implementation. The response time for emergency endoscopy improved significantly (t = -2.556, P < 0.05). Additionally, satisfaction with team collaboration showed significant improvement (χ² = 8.56, P < 0.05), highlighting the checklist's effectiveness in enhancing clinical outcomes and coordination among the health care team.

Conclusions: The perioperative checklist for acute upper gastrointestinal bleeding demonstrates strong reliability, validity, and practical utility. Its application improves response times, patient safety, and teamwork, making it an effective tool for perioperative management in patients with acute upper gastrointestinal bleeding.