The Effectiveness of Implementation of Surgical Safety Checklist in Different Countries: A Systematic Review

Abstract

<p id="p00000"><strong>Background:</strong> The Surgical Safety Checklist (SSC) was created by the World Health Organization to improve patient safety and studies have shown that this checklist can significantly improve perioperative outcomes in surgical patients. However, some studies from developed areas have reached contradictory results. This review is intended to evaluate the different impacts of the SSC between countries with low human development index and countries with high human development index. <p id="p00005"><strong>Methods:</strong> A systematic review was performed to identify all studies on the effects of the SSC on postoperative complications, which were published from January 1, 2009 to November 30, 2018, with no language restrictions. Seven electronic databases PubMed, Embase, Cumulative Index of Nursing and Allied Health (CINAHL), the Cochrane library, Scopus, Web of Science, and China National Knowledge Infrastructure (CNKI) were searched. <p id="p00010">Data extracted and synthesized by using standard forms, two authors independently identified studies on inclusion decisions and extracted study characteristics. If two authors had different opinions on a study, a third author was asked to adjudicate. <p id="p00015"><strong>Results:</strong> Eleven articles met the inclusion criteria. Five studies were from countries with low human development index; the other six were from countries with high human development index. Results indicated that the SSC led to reduced complications (RR, 0.48; 95% CI, 0.25-0.93; P = 0.03) in countries with low human development index. <p id="p00020"><strong>Conclusion:</strong> The SSC can more effectively reduce postoperative complications in countries with low human development index. It suggests that the implementation of the SSC can help make up for the deficiencies of the medical system and improve the safety of patients undergoing surgery.