Abstract
Objective:To assess World Health Organization (WHO) Surgical Safety Checklist (SSC), compliance and its effectiveness in reducing complications and final outcome of patients.Methods:This was a prospective study done in Department of General Surgery (Ward 02), Jinnah Postgraduate Medical Centre (JPMC), Karachi. The study included Total 3638 patients who underwent surgical procedure in elective theatre in four years from November 2011 to October 2015 since the SSC was included as part of history sheets in ward. Files were checked to confirm the compliance with regards to filling the three stage checklist properly and complications were noted.Results:In 1st year, out of 840 surgical procedures, SSC was properly marked in 172 (20.4%) cases. In 2nd year, out of 857 surgical procedures 303 (35.3%) cases were marked which increased in 3rd year out of 935 surgical procedures 757 (80.9%) cases and in 4th year out of 932 surgical procedures 838 (89.9%) cases were marked. No significant change in site and side (left or right) complications were noted in all four years. Surgical Site Infection (SSI) was noted in 59 (7.50%), 52 (6.47%), 44 (4.70%) and 20 (2.12%) cases in 1st, 2nd, 3rd and 4th year respectively. SSI in laparoscopic cholecystectomies was 41 (20.8 %), 45 (13%), 20 (5.68%) and 4 (1.12%) in 1st, 2nd, 3rd and 4th year respectively. No significant change in chest complications were noted in all four years. Mortality rate also remained same in all four years.Conclusion:WHO SSC is an effective tool in reducing in-hospital complications thus producing a favorable outcome. Realization its efficacy would improve compliance.
Highlights
Hospitals are not as safe as generally believed.[1]
The incidence of in-hospital adverse events is about 10 per cent, of which three-quarters are related to surgery
Surgical Site Infection (SSI) was noted in 59 (7.50%), 52 (6.47%) in the first year which reduced to 20(2.12%) in the fourth year
Summary
Hospitals are not as safe as generally believed.[1] Surgical morbidity and mortality are rightly considered public health concerns. It has been estimated that more than 200 hundred million major surgical procedures are performed annually worldwide.[2] Overall, the incidence of in-hospital adverse events is about 10 per cent, of which three-quarters are related to surgery. At least half of these adverse events are considered preventable within the current standards of care.[35]. Substantial improvements can be achieved by reducing variation in the reliability of surgical care processes.[6] Briefings in the operating room improve team cooperation, motivation, discipline, and outcomes.[7]
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