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PROCEDURAL COMPLICATION CHECKLIST

📍 Located in D17 – Paperwork Tower (next to EPIC/Flow Nurse desk)

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PROCEDURAL COMPLICATION CHECKLIST

WHEN TO USE IT

Use this checklist when a complication occurs with potential for lasting harm

✅ Arterial puncture during IV or nerve block

✅ Pneumothorax after central line insertion

✅ Nerve injury during a procedure

❌ Not needed for:

– Missed IVs

– Sedation events (laryngospasm) that resolve without harm

👥 Anyone involved can complete this – not just the proceduralist

✅ Nurses, RMOs, SMOs – all encouraged to use it

This is for complications with potential for harm, whether that’s obvious now or might become a problem later. It’s especially important for procedures like cannulation, nerve blocks, chest drains, or central lines.

“You don’t need to use it for minor events with no lasting consequence — like a missed IV or a brief sedation hiccup that fully settles — but if you’re unsure, use it anyway.”

“And it doesn’t need to be the person who did the procedure — anyone involved can use this form to kick off the documentation and follow-up process.”

📝 If asked where this came from:

“This came from a case review and was supported by Greg & Liz. A staff survey showed that even experienced clinicians were missing key steps like documenting open disclosure, completing ACC45s, or debriefing after the event. This checklist helps cover that.”

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PROCEDURAL COMPLICATION CHECKLIST

WHAT TO DO

✅ Ensure patient safety

✅ Inform senior staff (SMO or NIC)

✅ Provide open disclosure to patient/whānau:

• What happened

• What was done about it

✅ Safety netting advice + handover if admitted/discharged

📋 Complete:

– ACC45 Treatment Injury Form

– DATIX

– Consider M&M referral

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PROCEDURAL COMPLICATION CHECKLIST

📍 Located in D17 – Paperwork Tower (EPIC/Flow Nurse desk)

WHEN TO USE IT

Use this checklist when a complication occurs with potential for harm

🟡 Not sure? Use it anyway – It’s there to help, not penalise

WHAT TO DO

✅ Ensure patient safety

✅ Document and refer

✅ Inform the patient, whanau, and team

🤝 Debrief if needed – peer support is available

This is OPTIONAL not mandatory, but strongly encouraged to make sure nothing is missed