423 / 492
11:20 - 11:25
ESPUN S6-2
(PP)
REDUCING THE OPERATING ROOM RISKS: THE EXPERIENCE ON BLADDER
EXSTROPHY-EPISPADIAS SURGERY
Valentina CILLO
1
, Federica RICCI
1
, Sofia CESTRA
1
, Laura SERAFINI
1
, Fabio FERRARI
1
, Simona GEROCARNI NAPPO
1
and
Paolo CAIONE
2
1) Bambino Gesù Children's Hospital, Emergency Medicine and Critical Care, Rome, ITALY - 2) Bambino Gesù Children's
Hospital, Paediatric Urology, Rome, ITALY
PURPOSE
Our Pediatric Hospital is accredited by Joint Commission International (JCI) since 2006.
We report our experience on adopting the new JCI procedures during reconstructive surgery for the Exstrophy-
Epispadias Complex (EEC) repair, to increase safety.
MATERIAL AND METHODS
The “sign in-time out - sign out” procedure was adopted in the Urology Operating Room during surgery for EEC repair
(study group) during 2014 year. The method included nurses-surgeons pre-operative briefing, sign-in before starting
the surgical procedure, time-out at anesthesia induction, sign-out at patient wake-up. Adverse events, sentinel events
and near-miss events were recorded, comparing with the patients who received surgery for EEC repair, during the
previous 12 months (control group). The EEC primary repair required a 2-stage technique in male patients.
RESULTS
A total of 13 patients underwent surgical repair, 6 bladder closure and 7 epispadias (study group). Eleven patients, 4
exstrophic bladder closure and 7 epispadias repair were the control group. Both groups of patients received the same
reconstructive surgical technique.
No adverse events were recorded in the study group whereas 2 adverse events were observed in the control group (red
cell transfusion not ready at surgery starting, delay of X-ray check of CVC). The difference was significant.
CONCLUSIONS
Both the two stages of the EEC repair are considered as major surgery that required specific preparation and attention
of the Nurses/Anesthesiologist/Urologist team in the operating room. Adopting the JCI procedures allowed a significant
reduction of the adverse events, increasing the safety of the surgery.