Modifications of the World Health Organization’s Surgical Safety Checklist—Ways Forward to Ensure Sustainable Implementation

Haugen, Arvid Steinar

doi:10.1001/jamanetworkopen.2023.17100

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…Despite the overall success of the checklist's application, indicated by its use in 94% of all surgical procedures, our study reveals gaps in compliance, particularly in emergency settings. This nding is important for re ning and targeting WHO SSC modi cations to effectively address current surgical challenges (37). Our ndings of lower use of the WHO Surgical Safety Checklist (SSC) during emergency procedures, especially caesarean sections, emphasizes the need for increased attention to compliance with checklists during such interventions.…”

Section: Discussionmentioning

confidence: 99%

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The associations of intra-operative risk factors on Surgical Site Infections: a retrospective cohort study in a Norwegian University Hospital

Aanes,

Pfeffer,

Eide

et al. 2024

Preprint

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Objective: This study aimed to evaluate associations of intra-operative risk factors and the WHO Surgical Safety Checklist with the incidence of surgical site infections (SSIs) following abdominal surgery up to 30 days post-surgery. Background: SSIs pose a significant challenge in healthcare, particularly after major abdominal surgery. Implementing the Surgical Safety Checklist is considered a strategy to mitigate the risk of SSIs. Evidence on intra-operative risk factors contributing to post-discharge SSIs, especially in abdominal surgery patients, is limited. Method: A retrospective observational, cohort study was conducted over 5 years at a Norwegian university hospital, and included adult patients undergoing colon resection, cholecystectomy, and caesarean sections. Standardised anaesthetic techniques were applied, and core body temperatures were routinely recorded at the start and end of surgery. Data were collected from an administrative operation planning system and SSIs register. SSIs were monitored according to the Norwegian national surveillance system on Surgical Site Infections (NOIS) and The Healthcare-Associated Infections Surveillance Network (HAI-Net), with additional patient and physician-reported data on wound infections. The probability of SSIs was analysed using multiple logistic regression. Results: A total of 11.2% (463/4142) of patients developed SSIs, of which 4.6% (189/4142) developed SSIs after discharge from hospital. Age, gender, forced air warming blankets, fluid warmer, volume of intravenous fluids, and the Surgical Safety Checklist use were not associated with the total number of SSIs. Perioperative temperature, duration of surgery, open surgical access, type of surgery, regional anaesthesia, and higher comorbidity were observed as risk factors. A significant association was found between omitting use of the WHO SSC Time-Out component and post-discharge SSIs, with a fully adjusted odds ratio of 1.95. The incidence of SSIs after discharge was also associated with factors such as perioperative temperature. Conclusion: The WHO SSC may predominantly impact the incidence of SSIs after discharge. Moreover, intra-operative work processes such as shorter duration of surgery and maintaining perioperative normothermia may protect against SSIs. Clinical Trial Identifier:NCT03112317

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Section: Discussionmentioning

confidence: 99%

“…This can be considered a success and shows a sustainable use of the checklist. However, focusing on modi cations of the WHO SSC is vital for addressing contemporary surgical issues (38), and to ensure that it is targeted and performed with quality (37).…”

Section: Discussionmentioning

confidence: 99%

The associations of intra-operative risk factors on Surgical Site Infections: a retrospective cohort study in a Norwegian University Hospital

Aanes,

Pfeffer,

Eide

et al. 2024

Preprint

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Obstacles to using the safe surgery checklist: Perspectives of first-line personnel

Palm,

Braut

2024

SAGE Open Medicine

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Objectives: The safe surgery checklist, presented by the World Health Organization in 2008, is an aid to performing surgical interventions safely. Research indicates that the use of checklists in clinical activities leads to a reduced number of adverse events. However, research suggests that the use of checklists differs between different institutions and even between units in the same organisation. The intention of this study is to identify factors regarded by the health personnel in ‘the sharp end’ as obstacles to using the checklist. Methods: The study has a qualitative, case-based design. It is performed by the Hazard Identification method, which is a method for revealing safety hazards based on workers’ experiences. Results: Obstacles were identified related to the content of the list, areas of use, distribution of responsibilities connected with the use of the list, and finally the organisation and management of safety efforts related to clinical activities. The use of checklists must be part of a system’s perspective, and deviations from checklists must be discussed in the organisation. The informants also claimed that checklists should be implemented for interventions located outside the operating theatres and for emergency treatments. Conclusions: Even though the majority of employees believe that checklists are necessary, many surrounding factors are perceived as obstacles to their use. Not least, site-specific factors may be revealed by use of the Hazard Identification method.

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Modifications of the World Health Organization’s Surgical Safety Checklist—Ways Forward to Ensure Sustainable Implementation

Cited by 2 publications

References 6 publications

The associations of intra-operative risk factors on Surgical Site Infections: a retrospective cohort study in a Norwegian University Hospital

The associations of intra-operative risk factors on Surgical Site Infections: a retrospective cohort study in a Norwegian University Hospital

Obstacles to using the safe surgery checklist: Perspectives of first-line personnel

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