Informatizzazione della checklist per la sicurezza in sala operatoria e i risultati raggiunti presso l'Istituto Ortopedico Rizzoli di Bologna

[Computerization of the checklist in the operating room safety and the results achieved at the Rizzoli Orthopaedic Institute in Bologna] Since 2010, the Rizzoli Orthopaedic Institute in Bologna has joined the project of the Emilia-Romagna «Project SOS.net: Network operating theaters safe», adopting the surgical safety checklist regional in hard copy from three surgical units.Over the years, the adoption of the checklist has been extended to all surgical units, thanks to the computerization of the same: at the Institute had in fact been initiated a process of computerization of operating rooms, which also included the introduction/editing tools for the management of clinical risk in the operating room. This change has allowed not only to integrate computationally the moment of verification, by means of the surgical safety checklist regional, with the detection of deviations from the expected standard but also to be able to have specific reporting in real time.These implementations have been accompanied by appropriate training and organizational interventions, bringing the level of adherence to the instrument until it reaches almost 100%.

The Impact of the Second Wave of COVID-19 on Outcomes in Hip Fracture Patients: An Observational Study

The aim of this work was to measure the healthcare outcomes for patients undergoing surgery for femur fractures during the second wave of the COVID-19 pandemic within a context of orthopaedic surgery units and living with the pandemic and compare them with pre-pandemic outcomes. A retrospective observational study was conducted. The incidence of pressure ulcers and deambulation recovery time were the main outcome. The pre-pandemic group consisted of 108 patients and the second wave pandemic group included 194 patients. The incidence of pressure ulcers increased from 10% in the pre-pandemic period to 21% in the second wave (p = 0.016) and the crude relative risk (RR) was 2.06 (p = 0.023). The recovery of deambulation showed no significant difference in the recovery time in terms of days needed to walk the first time (3 days vs. 2 days; p = 0.44). During the second wave of COVID-19, the risk of pressure ulcers for patients undergoing femur fracture surgery increased significantly. This variation could be explained by the absence of a caregiver for these patients and the increased average complexity of the patients managed in the orthopaedic setting. The hospital management should take into account these aspects when restoring the hospital’s normal surgical activities