Veterinary students do not need an elephantine memory: Effectiveness of an anesthetic pre-induction checklist.

Abstract

Background: Checklists are widely recognized as safety measures in both aviation and human medicine, effectively preventing omissions caused by memory failures.

Objective: To assess whether a pre-induction safety checklist completed by veterinary students during a spay/neuter laboratory minimized the number of incomplete pre-induction tasks.

Participants and procedure: Third-year veterinary students (N = 53) managed the anesthesia of dogs and cats admitted for spay/neuter surgery under supervision. The use of a pre-induction checklist was mandatory to ensure appropriate preparation before anesthesia induction. Differences in checklist completeness between the 1st and 2nd wk of the spay/neuter laboratory were compared using Fisher's exact test.

Results: Over 2 wk, 83 anesthesia procedures were completed. Use of the pre-induction checklist identified at least 1 omitted pre-induction task in 67.5% (56/83) of anesthesia procedures. The number of incomplete pre-induction tasks identified through use of the checklist decreased significantly from the 1st (82.9%, 34/41) to the 2nd (52.4%, 22/42) wk (odds ratio: 4.4, 95% CI: 1.7 to 11; P = 0.0046). The most frequently missed item was premeasuring the endotracheal tube insertion depth (42.2%, 35/83), followed by failure to leak-test the endotracheal tube cuffs and not having gauze available (15.7%, 13/83 for each). Finally, the checklist identified closed adjustable pressure-limiting valves in 4.8% (4/83) of cases.

Conclusion and clinical relevance: The pre-induction checklist was effective in ensuring that veterinary students completed relevant pre-induction tasks during a spay/neuter laboratory. Results suggested the pre-induction checklist was a valuable tool that improved patient safety and prevented life-threatening equipment errors such as closed adjustable pressure-limiting valves.