Abstract
BackgroundAccording to the World Health Organization, the WHO surgical safety checklist can prevent complications, improve communication and contribute to postsurgical safety culture; hence, there is a need to investigate the attitudes and opinions of surgical teams regarding safety utilizing the WHO instrument. The aim of this study was to assess the attitudes and opinions towards surgical safety among operating room professionals in three public hospitals in the Brazilian Federal District.MethodsA cross-sectional study was conducted with the use of a checklist based on the safety attitudes questionnaire-operating room, sent out during the pre- and post-intervention surveys of the WHO surgical safety checklist (period I and period II) between 2012 and 2014.ResultsAbout 470 professionals, mostly nurse technicians, responded to the questionnaire in both periods. Regarding the perception of safety and agreement about the collaboration of the operating team, a significant statistical improvement of the nursing staff and anesthesiologists was observed in the operating room after the checklist was implemented. After utilizing the checklist before each surgical procedure, concerns about patient safety and compliance with standards as well as rules and hand-washing practices in the operating room statistically improved after the post-intervention, especially by the nursing staff. The checklist was considered easy and quick to use by most respondents. They also believed that the checklist inclusion improved communication, reflecting significant differences. At least 90.0 % of respondents from each team agreed that the checklist helps prevent errors in the operating room.ConclusionsThe study results showed progress in relation to the attitudes and opinions regarding surgical safety from operating teams in relation to the checklist response in the surveyed units. However, difficulties in its implementation are experienced, especially in relation to checklist use acceptance by the surgeons. New studies are needed to verify the sustainability of the surgical teams’ changes in attitudes in the hospitals studied.
Highlights
According to the World Health Organization, the WHO surgical safety checklist can prevent complications, improve communication and contribute to postsurgical safety culture; there is a need to investigate the attitudes and opinions of surgical teams regarding safety utilizing the WHO instrument
Several studies show that the WHO surgical safety checklist can modify personal attitudes of professionals working in operating room (OR) [10, 27, 28] and is seen as a tool that improves patient safety [29]
Given the difficulties found in the implementation of the checklist, especially as it relates to the acceptance of the referred instrument by surgeons, it is urgent that health planners draw up new strategies to deal with the problem, in an attempt to make surgeons understand that this is a work procedure, without a hierarchy in which some professionals are dominant over others, with the empowerment of all team members and where care is centered on the patient
Summary
According to the World Health Organization, the WHO surgical safety checklist can prevent complications, improve communication and contribute to postsurgical safety culture; there is a need to investigate the attitudes and opinions of surgical teams regarding safety utilizing the WHO instrument. The WHO safe surgery saves lives program addresses the prevention of adverse events (AEs), which includes surgical site infection (SSI) prevention, safe surgical teams, safe anesthesia and surgical services [5]. This initiative, besides the administrative and managerial aspects of health care, prioritizes safety attitudes of surgical teams, given the complexities of the operating room (OR). Complications and deaths were low in both periods [8] These findings may have contributed to the prevention of safety incidents and minimize risks during the implementation of the checklist in these services
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