Surgical team perceptions of the surgical safety checklist in a tertiary hospital in Jordan: a descriptive qualitative study

Abstract

PurposeThe purpose of this paper is to explore the perceptions of operating room staff towards the use of the World Health Organization Surgical Safety Checklist in a tertiary hospital in Jordan.Design/methodology/approachThis was a qualitative descriptive study. Semi-structured interviews were conducted with a purposeful sample of 21 healthcare staff employed in the operating room (nurses, residents, surgeons and anaesthesiologists). The interviews were conducted in the period from October to December 2021. Thematic analysis was used to analyse the data.FindingsThree main themes emerged from data analysis namely compliance with the surgical safety checklist, the impact of surgical safety checklist, and barriers and facilitators to the use of the surgical safety checklist. The use of the checklist was seen as enabling staff to communicate effectively and thus to accomplish patient safety and positive outcomes. The perceived barriers to compliance included excessive workload, congestion and lack of training and awareness. Enhanced training and education were thought to improve the utilization of the surgical safety checklist, and help enhance awareness about its importance.Originality/valueWhile steps to utilize the surgical safety checklist by the operation room personnel may seem simple, the quality of its administration is not necessarily robust. There are several challenges for consistent, complete and effective administration of the surgical safety checklist by the surgical team members. Healthcare managers must employ interventions to eliminate barriers to and offer facilitators of adherence to the application of the surgical safety checklist, therefore promoting quality healthcare and patient safety.

Barriers and facilitators associated with the implementation of surgical safety checklists: A qualitative systematic review

“…Of the 1912 publications retrieved from the database searches, a total of 34 studies were included (Figure 1) (Page et al, 2021). The studies were conducted in a range of countries: Jordon 1 (Albsoul et al, 2022), Turkey 1 (Aydin Akbuga et al, 2023), Brazil 1 (De Oliveira Junior & De Magalhães, 2017), France 1 (Fourcade et al, 2012), Cyprus 1 (Georgiou et al, 2018), Thailand 1 (Kasatpibal et al, 2018), Sweden 3 (Krupic et al, 2020; Nordström & Wihlborg, 2019; Rönnberg & Nilsson, 2015), Saudi Arabia 1 (Manamela et al, 2022), Zambia 1 (Munthali et al, 2022), Spain 1 (Peñataro‐Pintado et al, 2021), Switzerland 1 (Schwendimann et al, 2019), New Zealand 1 (Weller et al, 2018) and Madagascar 1 (White et al, 2018), USA 2 (Alidina et al, 2017; Conley et al, 2011), multiple countries 2 (Aveling et al, 2013; Elam et al, 2022), Norway 3 (Haugen et al, 2015; Høyland et al, 2014; Wæhle et al, 2012), UK 3 (O'brien et al, 2017; Robertson‐Smith, 2016; Russ et al, 2015), Australia 4 (Braaf et al, 2013; Gillespie, Marshall, et al, 2016; Gillespie, Withers, et al, 2016; Rogers et al, 2020) and Canada 6 (Dharampal et al, 2016; Gagliardi et al, 2014; Mahmood et al, 2019; Mobilio et al, 2022; Spence et al, 2011; Ziman et al, 2018). The sample sizes ranged from 8 to 196 participants and represented the total number of all members of the perioperative MDT: surgeons, anaesthesiologists, operating room nurses, medical students, nurse anaesthetists, surgical trainees, theatre support workers, radiographers, nursing students, administrative staff, management and consumers (see Table 1).…”

“…Resistance, attitudes and understanding, surgeon participation, patient anxiety and individual non‐technical skills were identified as individual barriers to the implementation of the WHO Surgical Safety Checklist. Across the studies, the main barrier to successful implementation was the behaviours and attitudes of senior medical staff, and in particularly the lead surgeon (Albsoul et al, 2022; Alidina et al, 2017; Aveling et al, 2013; Braaf et al, 2013; De Oliveira Junior & De Magalhães, 2017; Dharampal et al, 2016; Fourcade et al, 2012; Gagliardi et al, 2014; Georgiou et al, 2018; Kasatpibal et al, 2018; Manamela et al, 2022; Mobilio et al, 2022; Nordström & Wihlborg, 2019; Robertson‐Smith, 2016; Rönnberg & Nilsson, 2015; Russ et al, 2015; White et al, 2018; Ziman et al, 2018).…”

“…Workload, time pressures, competing tasks, emergency procedures and distractions were key environmental factors that created barriers to the successful use of the checklist. In particular, time pressures because of extended surgical patient lists, high patient turnover rates and brief non‐complex procedures were significant environmental barriers (Albsoul et al, 2022; Alidina et al, 2017; Aydin Akbuga et al, 2023; Braaf et al, 2013; De Oliveira Junior & De Magalhães, 2017; Fourcade et al, 2012; Gagliardi et al, 2014; Georgiou et al, 2018; Gillespie, Marshall, et al, 2016; Gillespie, Withers, et al, 2016; Haugen et al, 2015; Munthali et al, 2022; Peñataro‐Pintado et al, 2021; Robertson‐Smith, 2016; Schwendimann et al, 2019). Furthermore, the impact of increased staff workloads and disruption to the perioperative workflow created perceived delays which compounded suboptimal checklist compliance rates (Aveling et al, 2013; Fourcade et al, 2012; Gagliardi et al, 2014; Mahmood et al, 2019; O'brien et al, 2017; Rönnberg & Nilsson, 2015; Russ et al, 2015; Wæhle et al, 2012; Ziman et al, 2018).…”

Factors influencing patient safety culture in operating room in a teaching hospital in Jordan: a qualitative descriptive study

“…Cancellation of scheduled operations has a significant influence on patients’ health, quality of health care and resources (Al Talalwah and McIltrot, 2019). It is important to verify that patients are sufficiently prepared preoperatively to be able to recognize any issue which is contraindicated for surgery (Albsoul et al. , 2022).…”

“…Cancellation of scheduled operations has a significant influence on patients' health, quality of health care and resources (Al Talalwah and McIltrot, 2019). It is important to verify that patients are sufficiently prepared preoperatively to be able to recognize any issue which is contraindicated for surgery (Albsoul et al, 2022). Cancellation of operations due to inappropriately prepared patients could be mitigated by promoting communication between patients and the doctors and nurses (Chalya et al, 2011).…”