IADR Abstract Archives
Safety Checklist for Restorative Dentistry: Development and Validation
Objectives: Safety checklists have been proved to successfully decrease the prevalence of adverse events (AE) caused by health providers’ negligence. Implementing the World Health Organization (WHO) “Surgical Safety Checklist” resulted in significant decrease in deaths and in-hospital complications. Unfortunately, dentistry is far behind in patient safety practices. Therefore, we aimed to develop a restorative dentistry checklist to minimize AEs in undergraduate clinic following the principles used to develop WHO Surgical Safety Checklist.
Methods: This study was performed in three phases: first, identifying the most common AEs in restorative dentistry and their causative errors, second; developing the checklist, and third; validating it. To identify the most common AEs, dental records of McGill undergraduate clinic were searched for cases of refunded patients from 2012-2014. Errors in those cases were identified and classified by two specialists. Based on the most frequent errors, the checklist was drafted. The checklist was validated by assessing the dentists’ perception of the importance of each checklist item for restorative dentistry practice. Finally, undergraduate students (n=48) were surveyed after clinical sessions to assess whether students forget to address any of the checklist items during the sessions.
Results: Fifty-four errors were identified in 46 cases of refunded patients. Pre-operative errors were the most prevalent (54%), followed by intra-operative errors (33%). Based on these errors, the checklist was drafted into three parts; a treatment planning part, a during-treatment part to be used before starting a dental procedure and a post-treatment part to be used before dismissing the patient. The checklist was validated by the positive perception of the checklist items expressed by dentists (n=11). Thirteen out of the 48 students surveyed (27%) forgot at least one checklist item, associated with adverse event, during clinical sessions, which indicate the potential importance of the validated checklist.
Conclusions: Adverse events in dentistry are mostly caused by preventable errors. Checklist can be produced to address those errors. In about 27% of clinical interventions, students forgot to address at least one of the checklist items which indicates the potential importance of its implementation.
Methods: This study was performed in three phases: first, identifying the most common AEs in restorative dentistry and their causative errors, second; developing the checklist, and third; validating it. To identify the most common AEs, dental records of McGill undergraduate clinic were searched for cases of refunded patients from 2012-2014. Errors in those cases were identified and classified by two specialists. Based on the most frequent errors, the checklist was drafted. The checklist was validated by assessing the dentists’ perception of the importance of each checklist item for restorative dentistry practice. Finally, undergraduate students (n=48) were surveyed after clinical sessions to assess whether students forget to address any of the checklist items during the sessions.
Results: Fifty-four errors were identified in 46 cases of refunded patients. Pre-operative errors were the most prevalent (54%), followed by intra-operative errors (33%). Based on these errors, the checklist was drafted into three parts; a treatment planning part, a during-treatment part to be used before starting a dental procedure and a post-treatment part to be used before dismissing the patient. The checklist was validated by the positive perception of the checklist items expressed by dentists (n=11). Thirteen out of the 48 students surveyed (27%) forgot at least one checklist item, associated with adverse event, during clinical sessions, which indicate the potential importance of the validated checklist.
Conclusions: Adverse events in dentistry are mostly caused by preventable errors. Checklist can be produced to address those errors. In about 27% of clinical interventions, students forgot to address at least one of the checklist items which indicates the potential importance of its implementation.