Implementation Of Surgical Safety Checklist Research Articles

Use of a surgical safety checklist after implementation in an academic veterinary hospital.

To determine the use and barriers to uptake of a surgical safety checklist (SSC) after implementation in a veterinary teaching hospital. Voluntary online survey and retrospective study. All personnel actively involved in the Ontario Veterinary College Health Sciences Centre small animal surgery service between October 2, 2018 and June 28, 2019. Surgical case logs and electronically initiated SSC were reviewed to calculate checklist use. The sample population was surveyed to identify factors and barriers associated with use of the SSC. Participants were allowed 1 month to respond, and five reminder emails were sent. Forth-one of 50 (82%) participants completed the survey. The SSC was used in 374 of 784 (47.7%) surgeries. Use rates declined over sequential three-month intervals (P < .0001). Twenty-six of 41 (63%) respondents overestimated checklist use. Staff attitudes were largely supportive of the SSC, with 29 of 41 respondents suggesting mandatory application. Forgetfulness, hierarchal concerns, timing issues, perceived delays in care, lack of clarity regarding roles, and inadequate training were identified as obstacles to use of the SSC. The SCC tested in this study was used in approximately half of the surgical procedures performed after its implementation. Hospital personnel were supportive of the SSC; forgetting to use the SSC was the most common barrier identified by respondents (24/41 [59%]). The SSC implementation experience and user feedback described here should be taken into consideration to improve design and implementation of future SSC.

Impact of the Norwegian National Patient Safety Program on implementation of the WHO Surgical Safety Checklist and on perioperative safety culture

ObjectivesOur primary objective was to study the impact of the Norwegian National Patient Safety Campaign and Program on Surgical Safety Checklist (SSC) implementation and on safety culture. Secondary objective was...

Implementation Strategies and the Uptake of the World Health Organization Surgical Safety Checklist in Low and Middle Income Countries: A Systematic Review and Meta-analysis.

To identify the implementation strategies used in World Health Organization Surgical Safety Checklist (SSC) uptake in low- and middle-income countries (LMICs); examine any association of implementation strategies with implementation effectiveness; and to assess the clinical impact. The SSC is associated with improved surgical outcomes but effective implementation strategies are poorly understood. We searched the Cochrane library, MEDLINE, EMBASE and PsycINFO from June 2008 to February 2019 and included primary studies on SSC use in LMICs. Coprimary objectives were identification of implementation strategies used and evaluation of associations between strategies and implementation effectiveness. To assess the clinical impact of the SSC, we estimated overall pooled relative risks for mortality and morbidity. The study was registered on PROSPERO (CRD42018100034). We screened 1562 citations and included 47 papers. Median number of discrete implementation strategies used per study was 4 (IQR: 1-14, range 0-28). No strategies were identified in 12 studies. SSC implementation occurred with high penetration (81%, SD 20%) and fidelity (85%, SD 13%), but we did not detect an association between implementation strategies and implementation outcomes. SSC use was associated with a reduction in mortality (RR 0.77; 95% CI 0.67-0.89), all complications (RR 0.56; 95% CI 0.45-0.71) and infectious complications (RR 0.44; 95% CI 0.37-0.52). The SSC is used with high fidelity and penetration is associated with improved clinical outcomes in LMICs. Implementation appears well supported by a small number of tailored strategies. Further application of implementation science methodology is required among the global surgical community.

The DIFFERENCE OF OBEDIENCE SURGICAL TEAM IN THE IMPLEMENTATION OF SURGICAL SAFETY BETWEEN ELECTIVE AND EMERGENCY SURGERY PATIENTS IN KARSA HUSADA HOSPITAL BATU

Patient safety with surgery becomes the main focus in medical action, as it involves invasive procedure. The surgical team’s obedience is very important to reduce the risk at the surgery procedure. At 2007, WHO has released a method for keep the patient safety in Surgical Safety Checklist (SSC) form, to reduce the patient’s mortality. The purpose from this research is to know the difference of surgical team’s obedience in implementation of surgical safety between elective and emergency surgical patient at Karsa Husada Hospital’s operating room. The research design that used is comparative design with cross-sectional approach, with the amount of sample is 22 person and used the purposive sampling according to the both inclusion and exclusion criteria. The method of collecting data implemented by non-participative observation to the surgical team that conducting the operation each 15 times to both the elective dan emergency surgery patient. The research instrument that used was SSC observation form and it was customized by hospital’s form. The tabulating data that used was analytic comparative technic with Chi Square test. The research’s result show the surgical team’s obedience in surgical safety checklist implementation at elective surgical patient is 80% was scored obey, meanwhile at emergency surgical patient is only 7% was scored obey, and the significance score is 0,000, that means there is a difference of surgical team’s obedience in the implementation of surgical safety between elective and emergency surgery patient. The recommendation given to the surgical team is the team is expected to carry out the surgical safety maximally and don’t missed some of the SSC’s point especially at the both of time out and sign out phase.&#x0D; Keywords: Obedience, surgical team, surgical safety, elective, emergency

How does the WHO Surgical Safety Checklist fit with existing perioperative risk management strategies? An ethnographic study across surgical specialties

BackgroundThe World Health Organization (WHO) Surgical Safety Checklist (SSC) has demonstrated beneficial impacts on a range of patient- and team outcomes, though variation in SSC implementation and staffʼs perception of it remain challenging. Precisely how frontline personnel integrate the SSC with pre-existing perioperative clinical risk management remains underexplored – yet likely an impactful factor on how SSC is being used and its potential to improve clinical safety. This study aimed to explore how members of the multidisciplinary perioperative team integrate the SSC within their risk management strategies.MethodsAn ethnographic case study including observations (40 h) in operating theatres and in-depth interviews of 17 perioperative team members was carried out at two hospitals in 2016. Data were analysed using content analysis.ResultsWe identified three themes reflecting the integration of the SSC in daily surgical practice: 1) Perceived usefullness; implying an intuitive advantage assessment of the SSCʼs practical utility in relation to relevant work; 2) Modification of implementation; reflecting performance variability of SSC on confirmation of items due to precence of team members; barriers of performance; and definition of SSC as performance indicator, and 3) Communication outside of the checklist; including formal- and informal micro-team formations where detailed, specific risk communication unfolded.ConclusionWhen the SSC is not integrated within existing risk management strategies, but perceived as an “add on”, its fidelity is compromised, hence limiting its potential clinical effectiveness. Implementation strategies for the SSC should thus integrate it as a risk-management tool and include it as part of risk-management education and training. This can improve team learning around risk comunication, foster mutual understanding of safety perspectives and enhance SSC implementation.

Using the Knowledge to Action Framework to Describe a Nationwide Implementation of the WHO Surgical Safety Checklist in Cameroon

BACKGROUND:Surgical safety has advanced rapidly with evidence of improved patient outcomes through structural and process interventions. However, knowledge of how to apply these interventions successfully and sustainably at scale is often lacking. The 2019 Global Ministerial Patient Safety Summit called for a focus on implementation strategies to maintain momentum in patient safety improvements, especially in low- and middle-income settings. This study uses an implementation framework, knowledge to action, to examine a model of nationwide World Health Organization (WHO) Surgical Safety Checklist implementation in Cameroon. Cameroon is a lower-middle-income country, and based on data from high- and low-income countries, we hypothesized that more than 50% of participants would be using the checklist (penetration) in the correct manner (fidelity) 4 months postintervention.METHODS:A collaboration of 3 stakeholders (Ministry of Health, academic institution, and nongovernmental organization) used a prospective observational design. Based on knowledge to action, there were 3 phases to the study implementation: problem identification (lack of routine checklist use in Cameroonian hospitals), multifaceted implementation strategy (3-day multidisciplinary training course, coaching, facilitated leadership engagement, and support networks), and outcome evaluation 4 months postintervention. Validated implementation outcomes were assessed. Primary outcomes were checklist use (penetration) and fidelity; secondary outcomes were perioperative teams’ reactions, learning and behavior change; and tertiary outcomes were perioperative teams’ acceptability of the checklist.RESULTS:Three hundred and fifty-one operating room staff members from 25 hospitals received training. Median time to evaluation was 4.5 months (interquartile range [IQR]: 4.5–5.5, range 3–7); checklist use (penetration) increased from 20% (95% confidence interval [CI], 16–25) to 56% (95% CI, 49–63); fidelity for adherence to 6 basic safety processes was high: verification of patient identification was 91% (95% CI, 87–95); risk assessment for difficult intubation was 79% (95% CI, 73–85): risk assessment for blood loss was 88% (95% CI, 83–93) use of pulse oximetry was 93% (95% CI, 90–97); antibiotic administration was 95% (95% CI, 91–98); surgical counting was 89% (95% CI, 84–93); and fidelity for nontechnical skills measured by the WHO Behaviorally Anchored Rating Scale was 4.5 of 7 (95% CI, 3.5–5.4). Median scores for all secondary outcomes were 10/10, and 7 acceptability measures were consistently more than 70%.CONCLUSIONS:This study shows that a multifaceted implementation strategy is associated with successful checklist implementation in a lower-middle-income country such as Cameroon, and suggests that a theoretical framework can be used to practically drive nationwide scale-up of checklist use.

User related factors in implementation of WHO surgical safety checklist (SSC)

Introduction: WHO Surgical Safety Checklist (SSC) was introduced to address the well-recognized global problem of lack of surgical safety. Although proper implementation of SSC reduces common adverse events occurring during surgical procedures, the practical implementation in some cases has been found to be less than optimal. Objective: To assess the user related factors in the implementation of the SSC at District General Hospital (DGH), Matara . Methods: A descriptive cross-sectional study was carried out at DGH, Matara using a self-administered questionnaire among 76 doctors and 116 nurses who worked in operating theatres of DGH, Matara. A questionnaire based on the SSC and its implementation was used to assess the knowledge, attitudes and practices of doctors and nurses. Results: On the average, the seniority and experience in working in the operating theatres of DGH, Matara had a significant association with the awareness of the SSC. Nurses were more familiar about the SSC compared to doctors. Even when the user of the checklist had good knowledge, favorable attitudes and interest for proper implementation of the SSC, only a minority (8.7%) was trained in SSC. Discussion: The complexity, uncertainty of the definition of the responsibility and frequent unavailability of checklists were the main perceived barriers. It is recommended to simplify and reformat the checklist to make more user friendly and designating a checklist coordinator, training and monitoring implementation for better compliance.

A Team-Based Approach to Introduce and Sustain the Use of the WHO Surgical Safety Checklist in Tanzania.

Millions of patients worldwide suffer disability and death due to complications related to surgery. Many of these complications can be reduced by the use of the World Health Organization (WHO) Surgical Safety Checklist (SSC), a simple tool that can enhance teamwork and communication and improve patient safety. Despite the evidence on benefits of its use, introducing and sustaining the use of the checklist are challenging. We present a team-based approach employed in a low-resource setting in Tanzania, which resulted in high checklist utilization and compliance rates. We reviewed reported data from facility registers supplemented by direct observation data by mentors to evaluate the use of the WHO SSC across 40 health facilities in two regions of Tanzania between January and December 2018. We analyzed the self-reported monthly data on total number of major surgeries performed and proportion of surgeries where the checklist was used. We also analyzed the use of the SSC during direct observation by external mentors and completion rates of the SSC in a random selection of patient files during two mentorship visits between June and December 2018. During the review period, the average self-reported checklist utilization rate was 79.3% (11,564 out of 14,580 major surgeries). SSC utilization increased from 0% at baseline in January 2018 to 98% in December 2018. The proportion of checklists that were completely and correctly filled out increased between the two mentor visits from 82.1 to 92.8%, but the gain was significantly greater at health centers than at hospitals (p < 0.05). Health centers (which had one or two surgical teams) self-reported a higher checklist utilization rate than hospitals (which had multiple surgical teams), i.e., 99.4% vs 68.8% (p < 0.05). Our findings suggest that Surgical Safety Checklist implementation is feasible even in lower-resource settings. The self-reported SSC utilization rate is higher than reported in other similar settings. We attribute this finding to the team-based approach employed and the ongoing regular mentorship. We recommend use of this approach to scale-up checklist use in other regions in the country as recommended in the Ministry of Health of Tanzania's National Surgical, Obstetric, and Anesthesia Plan (NSOAP).

Review of “Causal Analysis of World Health Organization's Surgical Safety Checklist Implementation Quality and Impact on Care Processes and Patient Outcomes: Secondary Analysis From a Large Stepped Wedge Cluster Randomized Controlled Trial in Norway” by Haugen AS in Ann Surg 269:283–290, 2017

Review of “Causal Analysis of World Health Organization's Surgical Safety Checklist Implementation Quality and Impact on Care Processes and Patient Outcomes: Secondary Analysis From a Large Stepped Wedge Cluster Randomized Controlled Trial in Norway” by Haugen AS in Ann Surg 269:283–290, 2017

A survey of the ten-year implementation of WHO surgical safety checklist in China

Objective To investigate the current status of the ten-year implementation of the World Health Organization (WHO) surgical safety checklist (SSC) in China. Methods A questionnaire was designed based on the three phases described by the checklist — the period before induction of anaesthesia, the period before skin incision, and the period before patient leaves operating room, taking into account some hotspots and disputes.The questionnaire was sent to the members of the Chinese-based online New Youth Anesthesia Forum through the WeChat platform.Answers were completed by mobile phones or desktop computers.Each WeChat ID number allowed only one answer for each individual participant. Results A total of 3 943 members red the questionnaire invitation, of which 2 121 members completed the questionnaire with an overall completion rate of 53.79%.For checks completed before induction of anesthesia, the percentage of members who routinely practiced checks before induction of anesthesia was 93.35%, the percentage of members who completed each and every element of the checklist was 60.16%, and the percentage of members who selected the element of the checklist the surgeon was not involved in the check was 14.05%.For checks practiced before skin incision, the percentage of members who routinely completed checks before skin incision was 78.22%, the percentage of members who completed each and every element of the checklist was 51.91%, and the percentage of members who selected the element of the checklist surgeons and anesthesiologists routinely stated their own professional key information was 18.24% and 18.81%, respectively.For checks practiced before the patient leaved the operating room, the percentage of members who routinely completed checks before removing the patient from the operating room was 64.26%, and the percentage of members who completed each and every element of the checklist was 44.18%.The percentage of members who was really serious about practicing the checklist was 56.20%.The percentage of members who believed that surgeons should participated in checks practiced before induction of anesthesia was 81.47%.If the member himself or a member of his family needed a surgery, the percentage of members who hoped to implement the checklist was 98.35%.The percentage of members who believed that practicing WHO SSC could reduce the complications of surgery and improve the anesthetic safety of patients was 94.34%. Conclusion The implementing rate of checks practiced before induction of anesthesia is high, while the implementing rates of checks completed before skin incision and before patient leaves operating room are sequentially reduced in China.Although there are some problems with the implementation of WHO SSC, most respondents believe that implementing SSC can improve the anesthetic safety of patients undergoing surgery. Key words: Anesthesia; Surgical safety checklist

Impacts of the surgical safety checklist on postoperative clinical outcomes in gastrointestinal tumor patients: A single-center cohort study.

A 19-item surgical safety checklist (SSC) was published by the World Health Organization in 2008 and was proved to reduce postoperative complications. To date, however, the impacts of SSC implementation in China have not been evaluated clearly. The study was performed to evaluate the impacts of the SSC on postoperative clinical outcomes in gastrointestinal tumor patients.Between April 2007 and March 2013, 7209 patients with gastrointestinal tumor who underwent elective surgery at the Affiliated Hospital of Qingdao University were studied. Data on the clinical records and outcomes of 3238 consecutive surgeries prior to SSC implementation were retrospectively collected; data on another 3971 consecutive surgeries performed after SSC implementation were prospectively collected. The clinical outcomes (including mortality, morbidity, readmission, reoperation, unplanned intervention and postoperative hospital stay) within postoperative 30 days were compared between the two groups. Univariate and multivariate logistic regression analysis were performed to identify independent factors for postoperative complications.The rates of morbidity and in-hospital mortality before and after SSC implementation were 16.43% vs 14.33% (P = .018), 0.46% vs 0.18% (P = .028), respectively. Median of postoperative hospital stay in post-implementation group was shorter than that in pre-implementation group (8 vs 9 days, P < .001). Multivariable analysis demonstrated that the SSC was an independent factor influencing postoperative complications (odds ratio = 0.860; 95% CI, 0.750–0.988).Implementation of the SSC could improve the clinical outcomes in gastrointestinal tumor patients undergoing elective surgery in China.

Effect of surgical safety checklist on colorectal surgical site infection rates in 2 countries: Brazil and Canada

The effectiveness of the surgical safety checklist (SSC) in countries with different socioeconomic backgrounds is uncertain. To evaluate the effect of the SSC in 2 different socioeconomic settings, we compared surgical site infection (SSI) rates before and after its implementation in colorectal procedures. An epidemiological retrospective study was conducted in the university hospitals in Ottawa, Canada, and Belo Horizonte, Brazil. Data were collected through chart review from the period before and after the SSC implementation. The SSI rate decreased from 27.7%-25.9% (P = .625) and from 17.0%-14.4% in Canada and Brazil, respectively (P = .448) after the SSC implementation. In Canada, there was no SSI in incomplete SSC, and in Brazil, SSI was 20.0% (P = .026). Despite high and regular completion of the SSC in the Canadian and Brazilian hospitals, respectively, there was no significant reduction of SSI after the SSC implementation in any setting. However, in Brazil, the association between incomplete SSC and higher SSI rates demonstrated the potential impact of the SSC in developing countries. The effect of the SSC on SSI may be greater in developing countries due to minor investment and consolidation of policies in SSI prevention.

RELATIONSHIP BETWEEN NURSE WORK STRESS AND NURSE COMPLIANCE IN THE IMPLEMENTATION OF SURGICAL SAFETY CHECKLIST (SSC)

Work stress negatively impacts if one's ability to deal with stress is low. Excessive stress leads to a decrease in performance. One of the performance of nurse surgical room is the implementation of SSC. The purpose of this study is to determine the relationship of nurses work stress with nurse obedience in the implementation of SSC in the surgery room Mardi Waluyo Blitar Hospital. This research uses correlational research design with cross-sectional approach. The population is all nurses in the surgery room of RSUD Mardi Waluyo Blitar number of 23 people, by using purposive sampling technique got sample as much 16 person (circular nurse). The instrument used is a questionnaire about work stress and an observation sheet about SSC. The result of univariate analysis was found that most of surgical nurses of Mardi Waluyo Blitar Hospital experienced mild stress, 13 people (81%). Then, most of surgical nurses Mardi Waluyo Blitar RSUD did not obey the whole point in the SSC that is 10 people (63%). The result of bivariate analysis using Spearman correlation test obtained p = 0,039, it means there is relation between nurses work stress with nurse compliance in SSC implementation in RSUD Mardi Waluyo Blitar surgery room. The recommendation of the results of this study is that you can find factors that may affect patients in the surgical safety checklist (SSC) aside from occupational stress factors.

Role and impact of WHO Surgical safety checklist implementation on patient safety, in a tertiary level health care center

Background: With over more than 200 million operations performed per year worldwide, there seems to be an urgent need for a checklist to ensure an errorless surgical procedure. WHO surgical safety checklist(SSC) is one, which can help in minimising intraoperative and post-operative errors. In addition, it can also serve as a tool to encourage teamwork and communication among the hospital staff members. Methods: This 1 yearlong study was conducted in 2 parts, in the first held pre checklist implementation phase, complications and mortalities were recorded retrospectively and compared with post checklist implementation phase data. Total of 244 patients participated in the first phase and 236 patients were enrolled in the post checklist implementation phase. Compliance and compatibility with the checklist was tested by a questionnaire given to staff members. Results: Marked reduction in both intraoperative and post-operative complications was documented after checklist implementation. Intraoperative complications went down from 6.14% to 2.12% and post-operative from 6.56% to 3.38%. Similarly, intraoperative mortality rate scrolled down from 3.87% to 0.85% after checklist implementation. Regarding the compliance of the study, 95.3% of our hospital staff was in favour of introducing the WHO SSC as a routine practice in our hospital. Conclusion: WHO SSC is the need of the hour in order to reduce the intraoperative and post-operative complications. Incorporating WHO SSC in health care setup will not only result in improved health care quality but will surely reduce the cost burden in health sector.

Role of Perioperative Surgical Safety Checklist in Reducing Morbidity and Mortality among Patients: An Observational Study.

Background:Safe Surgery Saves Lives. Patient safety is a fundamental of good quality health care, and complications due to the health-care system are well-documented and constitute an important public health problem. Implementation of the checklist in medicine and surgery can help to decrease the risk of adverse events thus can improve patient safety.Materials and Methods:After the Institutional Ethical Committee clearance, a total of 500 patients were enrolled and divided into two equal groups. In Group 1 (n = 250), patients underwent surgery before regular implementation of the World Health Organization (WHO) surgical safety checklist (SSC), whereas in Group 2 (n = 250), patients underwent surgery after the WHO SSC was regularly implemented. All the patients were followed up after the surgery, and patients were looked for and compared for the postoperative complications.Results:We found that 27 patients (10.8%) in Group 1 and 13 patients (5.2%) in Group 2 developed major wound disruption (P < 0.05). There were 73 patients (29.2%) in Group 1 and 34 patients (13.6%) in the Group 2 who developed an infection of the surgical site (P < 0.05). There were five patients (2%) in Group 1 while none of the patients in Group 2 developed sepsis during the study (P < 0.05).Conclusions:We found that implementation of the WHO SSC significantly reduces surgical site infections, major disruptions of the wound, and sepsis.

Surgical safety checklist implementation and its impact on patient safety

Background: Surgery has become an integral part of global health care, with an estimated 234 million operations performed yearly. Surgical complications are common and often preventable. Although surgical and anesthetic caregivers seek to deliver optimal quality in peri-operative service, surgery still carries considerable risk for the patient. WHO surgical safety checklist outlines essential standards of surgical care and has been shown to reduce complications and death associated with surgery.Methods: Pre-intervention and post-intervention study. The effect on patient outcomes and documentation of WHO surgical safety checklist was examined. After an education programme, the checklist implementation and patient safety outcome indicators were studied.Results: Checklist compliance increased over time. The median number of items documented was 16. After implementation of the checklist, mortality decreased from 3.13% to 2.85%. Most causes of death did not significantly differ between the implementation periods, except for multiorgan failure and major bleeding. Adjustment of the association between implementation period and outcome for all variables revealed a decreased mortality after checklist implementation.Conclusions: Implementation of the checklist showed improved outcomes. Use of the WHO surgical safety checklist in urgent operations is feasible and should be considered. Implementation proved neither costly nor lengthy. Further research is needed to confirm these findings and reveal additional factors supportive of checklist implementation.

Implementation of surgical safety checklist in Mukalla hospitals; Yemen

Background: The use of WHO surgical safety checklist results in striking improvements in surgical outcomes and decreases effectively the adverse events; accordingly, it necessitates rapid adoption worldwide. We are going to assess the extent of application of such checklist in our surgical setting. Methods: we surveyed all six hospitals in Mukalla city in three months period (aug- oct 2016), Observations and interviews were conducted using already prepared forms. The data was analyzed by SPSS version 20. Results: Atotal of six hospitals performed 110 procedures during the three months period. The private hospitals implementing the WHO surgical safety checklist more than government hospitals 87.10 % vs 79.39%. (Sign out) part of the checklist was the most applied 86.75% followed by (sign in) and (Time out) 86.37%, 81.08% respectively. The overall application of the standards of the checklist in Mukalla hospitals was 81.77%. Conclusion: The surgical safety checklist of WHO was partially applied in our hospitals. The checklist is a simple tool, which can downloaded freely from the WHO. Adaptation of the checklist to suit local conditions is encouraged.

Evaluation Of Team Compliance To Apply WHO Surgical Safety Checklist On Major Surgical Operation In Surgical Department Of PKU Muhammadiyah Bantul Hospital

Background: Procedure of major surgery at PKU Muhammadiyah Bantul Hospital already has a standard from medical committee in surgical department, but there is no evaluation to assess safety related to surgical procedure. Aim: To assess surgical team compliance to apply surgical safety checklist, especially part of sign in, time out, and sign out phase at major surgery and to find strategy to minimize obstacles about implementation of surgical safety checklist in operating room of PKU Muhammadiyah Bantul Hospial. Method: This study using sequential explanatory design. The subjects were all staffs who were work in the operating room, then nurse and doctor were assessed about surgical safety checklist including sign in, time out and sign out. Data collection was done gradually for 7 days in the surgery instalation of PKU Muhammadiyah Bantul Hospital. Instrument: This study used WHO surgical safety checklist which was divided into three phases: before induction (Sign In), before the skin incision (Time Out), and before the patient leaves the operating room (Sign Out). If the procedure is not completely done then the point is 0 and if completely done the point is 1. Result: There were 30 surgery sessions in urology surgery 7 (23,33%), obgyn 6 (20%), orthopedic 2 (6,67%), oncology 3 (10%), digestive 6 (20%), and other operations 6 (20%). The lowest compliance to filling the checklis was the time of sign in 4 (13.3%) of 30 operating sessions. The lowest compliance during time out was filling the time that was only filled as much as 3 (10%), and insertion of radiology imaging that was just as much as 5 (16,7%). The lowest compliance when signed out was the time of sign out (10,0%) and post op diagnosis (16,7%). Conclusion: Surgical Safety Checklist filling either Sign In, Time Out, or Sign Out at Surgery Instalation PKU Muhammadiyah Bantul Hospital was included in less obedient criteria.

HUBUNGAN PELAKSANAAN SURGICAL SAFETY CHECKLIST DAN KEJADIAN INFEKSI POST OPERASI MAYOR

Background: wound postoperative infection (ILO) are infections caused by pathogenic microorganisms that contaminate the wound area during surgery or after surgery. The data from survey by World Health Organization (WHO) found that about ILO cuased infection as 5% - 34% of total nosocomial infections. The data from Centers for Disease Control and Prevention cited that annually there was 500,000 surgical site infections (SSI) and that caused 3% surgical mortality, prolonged length of stay in hospital, and increased medical costs. Objective: to know the correlation of Surgical Safety Checlist Implementation and post operative infection. Research method: the method was quantitative method with cohort analytic survey design. The population were all patients with major surgery at Public Hospital of Tugurejo Semarang periode December 2016 - January 2017 as many as 99 patients. &#x0D; Result:the result of this study were major surgery mostly have implementation of surgical safety checklist either 81 respondent (81,8%) and have no infection incidence were 84 responden (84,8%). There was no significant correlation between surgical safety checklist implementation and postoperative infection.

An exploration of surgical team perceptions toward implementation of surgical safety checklists in a non-native English-speaking country

In-depth information on the success and failure of implementing the World Health Organization surgical safety checklist (SSC) has been questioned in non-native English-speaking countries. This study explored the experiences of SSC implementation and documented barriers and strategies to improve SSC implementation. A qualitative study was performed in 33 Thai hospitals. The information from focus group discussions with 39 nurses and face-to-face, in-depth interviews with 50 surgical personnel was analyzed using content analysis. Major barriers were an unclear policy, inadequate personnel, refusals and resistance from the surgical team, English/electronic SSC, and foreign patients. The key strategies to improve SSC implementation were found to be policy management, training using role-play and station-based deconstruction, adapting SSC implementation suitable for the hospital's context, building self-awareness, and patient involvement. The barriers of SSC were related to infrastructure and patients. Effective policy management, teamwork and individual improvement, and patient involvement may be the keys to successful SSC implementation.