NatSSIPS

NatSSIPs (National Safety Standards for Invasive Procedures) cover all invasive procedures, which can be defined as a procedure that requires piercing the skin to gain access to the inside of a patient’s body (e.g. inserting a tube in to a blood vessel), or gaining access to a body cavity without cutting into the body (bronchoscopy) or using electromagnetic radiation (laser eye treatments).

LocSSIPs

LocSSIPs (Local Safety Standards for Invasive Procedures) have arisen from a framework document produced by NHS England’s Patient Safety Domain and the NatSSIPs group to promote safe practice locally. The aim is to build on the positive aspects of the WHO Safer Surgery Checklist acknowledging that checklists alone are not enough to ensure patient safety; a team trained in this area with safe practice at the forefront of their thinking would reinforce best practice and improve patient safety.

The NatSSIP guidelines outline the key elements for the development of LocSSIPs including: governance, documentation, handovers, briefing, procedural verification, and sign in and out. As each institution will have their own approach to invasive procedures, an overarching, inflexible, centrally driven dictat was not appropriate.

In 2017, the Faculty of Intensive Care Medicine and the Intensive Care Society, in collaboration with Ged Smith at the Walton Centre in Liverpool first produced a series of checklists focused on procedures commonly performed in Critical Care Units. 

These have been revised, taking into account learning from reported patient safety incidents, some of which have been associated with considerable morbidity and mortality. The publication of NatSIPs 2 has been acknowledged during the update. These updated checklists include: 

• bronchoscopy
• central venous catheter insertion
• intercostal chest drain insertion
• intubation
• tracheostomy insertion

The checklists have been designed to enable departments to use and adapt to make them unit specific. They will require relevant educational and clinical governance procedures to accompany them, to fit into local working practices.