Surgical team members’ views on the implementation of safety checklist in surgical procedures: A qualitative study

Abstract

Introduction: The World Health Organization’s Surgical Safety Checklist was developed to ensure safety in surgeries, reduce mortality and postoperative complications, and improve communication between the surgical team members. Despite the increased awareness of the checklist, surgical team views’ and their degree of compliance with it vary.
Αim: To explore the views of surgical team members’ on the implementation of safety checklist in surgical procedures. Methods: A qualitative study was employed, and semi-structured interviews were conducted in May 2023, using an appropriately designed interview guide. The purposeful sampling consisted of operating room nurses (n=5), as well as doctors of various surgical specialties and anesthesiologists (n=4), working at a General Hospital of the Region. For data analysis, the principles of content analysis with an inductive approach were applied. The study was approved by the Research Ethics Committee of the University of the Peloponnese, the competent Hospital Committee and the 6th Health District. Results: Based on data analysis, one theme emerged describing the surgical team members’ views on the implementation of checklist: “managing safety issues.” Two themes emerged as advantages of its implementation: “benefits for the organization” and “quality of the services provided”, and two themes as disadvantages: “staffing and appropriate preparation” and “checklist effectiveness”. Finally, three themes were identified as factors affecting the implementation of checklist: “staffing”, “work organization” and “training and preparation”. Conclusions: Participants expressed positive views on the implementation of checklist, as the benefit for improving safety and quality of the health services provided is recognized. Provided that appropriate training and adequate staffing are the main prerequisites, the implementation of the WHO checklist ensures positive results, both for patients and organizations. The results of the present study highlight the need for further research efforts in relation to the factors affecting its implementation and the adoption of strategies to enhance surgical team compliance in clinical practice.