Link the problem in  PICOT question:In patients undergoing elective surgery does the implementation of a comprehensive ​preoperative checklist compared to standard care reduce the rate of postoperative ​
complications within 30 days of surgery?

Evaluate the evidence discovered the following 5 articles to the picot question above: 

• 1) Increasing Completion Rate and Benefits of Checklists: Prospective Evaluation of Surgical Safety Checklists With Smart Glasses-https://mhealth.jmir.org/2019/4/e13447/ 
• 2)Patients’ and healthcare workers’ recommendations for a surgical patient safety checklist – a qualitative study-https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-4888-1
• 3)Role of perioperative surgical safety checklist in reducing morbidity and mortality among patients: An observational study-https://pubmed.ncbi.nlm.nih.gov/31579376/
• 4)Surgical Teams’ Attitudes About Surgical Safety and the Surgical Safety Checklist at 10 Years-https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9770110/
• 5)How does the WHO Surgical Safety Checklist fit with existing perioperative risk management strategies? An ethnographic study across surgical specialties- https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-4965-5

Now briefly discuss the hierarchy of evidence for each article utilized and suggest a potential nursing practice change.

ANSWER

Hierarchy of Evidence and Nursing Practice Change in Preoperative Checklists

The hierarchy of evidence in evidence-based practice assists in evaluating the reliability and relevance of research findings. Applying this framework to the five articles relevant to the PICOT question – whether implementing a comprehensive preoperative checklist reduces postoperative complications – provides insights into their strength and potential impact on nursing practice.

Increasing Completion Rate and Benefits of Checklists: Prospective Evaluation of Surgical Safety Checklists With Smart Glasses
This study, utilizing smart glasses for checklist completion, falls within the hierarchy as a randomized controlled trial (RCT). RCTs are considered high-level evidence due to their controlled nature and strong ability to establish causal relationships. The findings suggest that the use of smart glasses enhances checklist completion and benefits. A potential nursing practice change could involve exploring the integration of technology to improve checklist adherence and efficiency.

Patients’ and Healthcare Workers’ Recommendations for a Surgical Patient Safety Checklist – A Qualitative Study
A qualitative study falls lower in the hierarchy, yet it provides valuable insights into patient and healthcare worker perspectives. Qualitative research helps understand complex phenomena. In this case, it offers recommendations for checklist improvement from those directly involved. Nursing practice might benefit from incorporating patient and healthcare worker feedback to tailor the checklist to their needs.

Role of Perioperative Surgical Safety Checklist in Reducing Morbidity and Mortality Among Patients: An Observational Study
This observational study occupies a mid-tier position on the hierarchy. While not as rigorous as RCTs, observational studies can provide valuable real-world insights. The findings here suggest that the perioperative surgical safety checklist is associated with reduced morbidity and mortality. Nursing practice might involve emphasizing the consistent use of the checklist in perioperative care.

Surgical Teams’ Attitudes About Surgical Safety and the Surgical Safety Checklist at 10 Years
This study employs mixed-methods research, combining surveys and interviews. Mixed-methods research holds a place in the hierarchy due to its comprehensive approach. The study explores surgical teams’ attitudes towards the checklist, uncovering their perspectives after a decade of its use. Nursing practice may involve fostering open dialogue about the checklist’s impact and addressing any concerns or challenges raised.

How Does the WHO Surgical Safety Checklist Fit with Existing Perioperative Risk Management Strategies? An Ethnographic Study Across Surgical Specialties
This ethnographic study is situated at a mid-level within the hierarchy. Ethnographic studies provide in-depth insights into social phenomena within their context. This particular study delves into how the surgical safety checklist aligns with existing risk management strategies. Nursing practice could integrate findings to enhance risk management approaches through checklist utilization.

Conclusion

Each article contributes to the understanding of the impact of comprehensive preoperative checklists on postoperative complications. The hierarchy of evidence helps prioritize research findings based on their rigor and relevance. Nursing practice can benefit from this synthesis by considering technological enhancements, patient and healthcare worker input, consistent checklist usage, addressing attitudes, and optimizing risk management strategies to reduce postoperative complications effectively.