Evaluation of compliance and utilization of the World Health Organization surgical safety checklist at the Lagos University Teaching Hospital: A cross-sectional study

Background: The WHO surgical safety checklist (SSC) was introduced in 2008 to ensure consistency in patient safety in surgery worldwide. To be effective, it must be properly utilized. This study was conducted to evaluate the compliance and utilization of the WHO SSC at the Lagos University Teaching...

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Main Authors: Ijeoma Chinenye Ohagwu, J O Seyi-Olajide, A Ofuase, S I Obi, I Desalu
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-04-01
Series:Journal of Clinical Sciences
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Online Access:https://journals.lww.com/10.4103/jcls.jcls_127_24
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author Ijeoma Chinenye Ohagwu
J O Seyi-Olajide
A Ofuase
S I Obi
I Desalu
author_facet Ijeoma Chinenye Ohagwu
J O Seyi-Olajide
A Ofuase
S I Obi
I Desalu
author_sort Ijeoma Chinenye Ohagwu
collection DOAJ
description Background: The WHO surgical safety checklist (SSC) was introduced in 2008 to ensure consistency in patient safety in surgery worldwide. To be effective, it must be properly utilized. This study was conducted to evaluate the compliance and utilization of the WHO SSC at the Lagos University Teaching Hospital (LUTH). Methods: This mixed-method study was conducted over 12 weeks from November 29, 2023, to February 14, 2024. A prospective review of the hospital records of all patients who had surgical procedures was performed to assess the utilization and completeness of the SSC. Direct observation of the use of the SSC assessed the quality of delivery and attention of team members. After data collection, a survey was administered to 100 perioperative staff to determine previous training on the SSC, perception of its usefulness, and barriers to its implementation. Results: Three hundred and twenty surgical procedures were studied, of which 134 had direct observation of checklist implementation. There was 96.9% utilization (310 procedures) of the SSC during the surgeries. Sign-in was done in all but incomplete in 36.6%. Sign-in was similarly performed during emergency cases (98.3%) and elective cases (96.0%), P = 0.253 and during general anesthesia (96.8%), regional anesthesia (97.9%), and monitored anesthesia care (95.2%), P = 0.834. Most surgical specialties recorded 100% sign in except ophthalmology (27.3%). More use of the SSC was noted with the first cases of the day. Time out was done in 89.7% of procedures and completed in all. It was performed significantly more often during emergency cases 95.0% than elective cases 86.6% (P = 0.017). However, general 90.8%, regional anaesthesia 87.5%, and monitored anesthesia care 81.0% were comparable (P = 0.310). Of the 134 observed cases, quality of delivery was good in 72.7% but complete attention was noted in only 48.3%. Sign-out was omitted in all cases (100%). Seventy-four perioperative staff completed the survey, and 62.5% had no formal training on the use of SSC. Ninety-six (96%) agreed that the checklist improves communication and organization in the operating room and the culture of patient safety in the hospital. The main limitation to the use of SSC was stated to be workforce shortage. Conclusion: There are inadequacies in employing the SSC in LUTH. Completeness and quality of delivery required improvement. The importance of sign-out needs to be emphasized. Regular training and retraining of the perioperative staff are necessary to succeed.
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spelling doaj-art-5feef584803b4b8a99254e5cb4c405202025-08-20T02:34:36ZengWolters Kluwer Medknow PublicationsJournal of Clinical Sciences2468-68592408-74082025-04-01222758110.4103/jcls.jcls_127_24Evaluation of compliance and utilization of the World Health Organization surgical safety checklist at the Lagos University Teaching Hospital: A cross-sectional studyIjeoma Chinenye OhagwuJ O Seyi-OlajideA OfuaseS I ObiI DesaluBackground: The WHO surgical safety checklist (SSC) was introduced in 2008 to ensure consistency in patient safety in surgery worldwide. To be effective, it must be properly utilized. This study was conducted to evaluate the compliance and utilization of the WHO SSC at the Lagos University Teaching Hospital (LUTH). Methods: This mixed-method study was conducted over 12 weeks from November 29, 2023, to February 14, 2024. A prospective review of the hospital records of all patients who had surgical procedures was performed to assess the utilization and completeness of the SSC. Direct observation of the use of the SSC assessed the quality of delivery and attention of team members. After data collection, a survey was administered to 100 perioperative staff to determine previous training on the SSC, perception of its usefulness, and barriers to its implementation. Results: Three hundred and twenty surgical procedures were studied, of which 134 had direct observation of checklist implementation. There was 96.9% utilization (310 procedures) of the SSC during the surgeries. Sign-in was done in all but incomplete in 36.6%. Sign-in was similarly performed during emergency cases (98.3%) and elective cases (96.0%), P = 0.253 and during general anesthesia (96.8%), regional anesthesia (97.9%), and monitored anesthesia care (95.2%), P = 0.834. Most surgical specialties recorded 100% sign in except ophthalmology (27.3%). More use of the SSC was noted with the first cases of the day. Time out was done in 89.7% of procedures and completed in all. It was performed significantly more often during emergency cases 95.0% than elective cases 86.6% (P = 0.017). However, general 90.8%, regional anaesthesia 87.5%, and monitored anesthesia care 81.0% were comparable (P = 0.310). Of the 134 observed cases, quality of delivery was good in 72.7% but complete attention was noted in only 48.3%. Sign-out was omitted in all cases (100%). Seventy-four perioperative staff completed the survey, and 62.5% had no formal training on the use of SSC. Ninety-six (96%) agreed that the checklist improves communication and organization in the operating room and the culture of patient safety in the hospital. The main limitation to the use of SSC was stated to be workforce shortage. Conclusion: There are inadequacies in employing the SSC in LUTH. Completeness and quality of delivery required improvement. The importance of sign-out needs to be emphasized. Regular training and retraining of the perioperative staff are necessary to succeed.https://journals.lww.com/10.4103/jcls.jcls_127_24compliancecompletenesssurgical safety checklist
spellingShingle Ijeoma Chinenye Ohagwu
J O Seyi-Olajide
A Ofuase
S I Obi
I Desalu
Evaluation of compliance and utilization of the World Health Organization surgical safety checklist at the Lagos University Teaching Hospital: A cross-sectional study
Journal of Clinical Sciences
compliance
completeness
surgical safety checklist
title Evaluation of compliance and utilization of the World Health Organization surgical safety checklist at the Lagos University Teaching Hospital: A cross-sectional study
title_full Evaluation of compliance and utilization of the World Health Organization surgical safety checklist at the Lagos University Teaching Hospital: A cross-sectional study
title_fullStr Evaluation of compliance and utilization of the World Health Organization surgical safety checklist at the Lagos University Teaching Hospital: A cross-sectional study
title_full_unstemmed Evaluation of compliance and utilization of the World Health Organization surgical safety checklist at the Lagos University Teaching Hospital: A cross-sectional study
title_short Evaluation of compliance and utilization of the World Health Organization surgical safety checklist at the Lagos University Teaching Hospital: A cross-sectional study
title_sort evaluation of compliance and utilization of the world health organization surgical safety checklist at the lagos university teaching hospital a cross sectional study
topic compliance
completeness
surgical safety checklist
url https://journals.lww.com/10.4103/jcls.jcls_127_24
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