“Time out:” A Strategy for Reducing Errors In Regional Anesthesia

Abstract

Use of regional anesthetic blocks is becoming more prevalent as new techniques such as ultrasound and nerve stimulation provide better pain control for surgical patients post-operatively. However, adding additional procedures increases the risk of harm as well. Breakdown in communication and collaboration can compromise patient safety and lead to harm.

The purpose of this project is to enhance patient safety through the implementation of a brief pause for safety checklist review prior to any regional anesthetic procedure performed, referred to as a “time-out.” The population for this project are pediatric patients receiving regional anesthetics within a pediatric specialty hospital located in the Southern United States. The use of a time-out is necessary for any invasive procedure, including regional anesthetic block placement. Utilizing a checklist for this process ensures accurate completion, without the exclusion of relevant information. An extensive literature review on this topic was performed, and applied to recommendations for practice. This includes the creation of a regional safety checklist, participation of all team members in a pre-procedural time out, and a pause for debriefing at the conclusion of the regional block.

Keywords: Regional time-out, pediatric regional anesthesia, safety checklist, anesthetic block safety, wrong-site procedure