Attitude and beliefs about surgical safety checklist in a North Indian tertiary care hospital, a decade later of World Health Organisation checklist

Abstract

Background: Avoidable surgical complications account for a large proportion of preventable medical injuries and deaths globally. Surgical safety checklist (SSCL) is evidence‑based, internationally accepted valid instrument, which has been found to reduce postoperative morbidity and mortality; the benefits of which are most striking in low and middle‑income countries (LMICs) Despite implementation in many hospitals throughout the country, there is still lack of awareness and concern in many LMICS health care facilities towards SSCL and its use, even after a decade of World Health Organisation (WHO) checklist. Methods: This was a single centre e-survey to assess the knowledge, attitudes and beliefs about the WHO‑surgical checklist, in which 65.4% (138) surgeons, 25.1% (53) anaesthetists and 9.5% (20) nurses participated. Results: Majority believed that the use of SSCL improves the safety of procedures, improves communication amongst theatre staff and will result in a reduction in errors in theatre, yet there was no commitment for the use of SSCL. Although all theatre personnel support implementation and use of SSCL; however, hierarchical issues, lack of administrative support, lack of training, logistics and timing, high patient volume and overburdened residents, lack of co‑ordinator or leadership role and shortage of workforce can be impediment to effective use. Discussion: Nurses and junior doctors play a crucial role. Commitment rather than compliance and teamwork will be the key, ably supported by education and training which should be mandatory for all operation theatre stakeholders. Therefore, any measure that can potentially improve patient safety should be embraced and benefits of SSCL be told to motivate them and enhance participation for patient safety. Committed leadership, knowledge sharing and periodic trainings, interdisciplinary communication, feedback and regular audits can define and determine effective implementation process.