Abstract

BackgroundStudies have highlighted the effects the use of the WHO Surgical Safety Checklist can have on lowering mortality and surgical complications. Implementation of the checklist is not easy and several barriers have been identified. Few studies have addressed personnel’s acceptance and attitudes toward the WHO Surgical Safety Checklist. Determining personnel’s acceptance might reflect their intention to use the checklist while their awareness and knowledge of the checklist might assess the effectiveness of the training process.MethodsThrough an anonymous self- responded questionnaire, general characteristics of the respondents (age, gender, profession and years spent studying or working at the hospital), knowledge of the WHO Surgical Safety Checklist (awareness of existence, knowledge of objectives, knowledge of correct use), acceptance of the checklist and its implementation (including personal belief of benefits of using the checklist), current use, teamwork and safety climate appreciation were determined.ResultsOf the 147 surgical personnel who answered the questionnaire, 93.8% were aware of the existence of the WHO Surgical Safety Checklist and 88.8% of them reported knowing its objectives. More nurses than other personnel knew the checklist had to be used before the induction of anesthesia, skin incision, and before the patient leaves the operating room. Most personnel thought using the WHO Surgical Safety Checklist is beneficial and that its implementation was a good decision. Between 73.7% and 100% of nurses in public and private hospitals, respectively, reported the checklist had been used either always or almost always in the general elective surgeries they had participated in during the current year.ConclusionsDespite high acceptance of the checklist among personnel, gaps in knowledge about when the checklist should be used still exist. This can jeopardize effective implementation and correct use of the checklist in hospitals in Guatemala City. Efforts should aim to universal awareness and complete knowledge on why and how the checklist should be used.

Highlights

  • Studies have highlighted the effects the use of the World Health Organization (WHO) Surgical Safety Checklist can have on lowering mortality and surgical complications

  • 93.8% were aware of the existence of the WHO Surgical Safety Checklist (SSC) (89.7% of surgery residents, 97.8% of anesthesiology residents, 100% of anesthesiologists and 92.9% of nurses) and of those, 88.8% reported knowing the objectives of the checklist (80% of surgery residents, 95.5% of anesthesiology residents, 100% of anesthesiologists, and 87.8% of nurses)

  • More nurses (84.6%) and anesthesiologists (83.3%) than surgery residents (64.7%) and anesthesiology residents (69.8%) knew the checklist had to be used at the three time points: before the induction of the anesthesia, before skin incision, and before the patient leaves the operating room (OR)

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Summary

Introduction

Studies have highlighted the effects the use of the WHO Surgical Safety Checklist can have on lowering mortality and surgical complications. Major morbidity complicates 3-16% of all inpatient surgical procedures in developed countries, with death rates of about 0.4-0.8%. Due to the high volume of surgical procedures and high complication rates, the World Health Organization (WHO) launched the Save Surgery Saves Lives Initiative in 2007 [3]. The goal of this initiative was to “improve the safety of surgical care around the world by defining a core set of safety standards that can be applied in all WHO Member States” [3]. Inpatient complications decreased from 11% to 7% [4]

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