Implementation of surgical checklist – A Big Concern.
Abstract
mortality rate has seen to be reduced by remarkable margin, but at many institutions the implementation of surgical checklist is a big concern. The purpose of this retrospective analysis is to find out the reason for poor compliance for WHO SSC and how to make implementation possible.
Method –This study is mixed method observational study which was carried out bin the Dept of Anaesthesia in the tertiary hospital from DEC 2020 – MAY 2021. Data collection was done by two methods, one by structured interview with OR team members who were involved in SSC implantation and non participant who were present at time of time out or sign out in OR. Collected data were subjected to thematic analysis and was compiled with descriptive statistics.
Result – The checklist application was evaluated in 550 cases, over 6 months comprising of Elective as well as emergency cases, and major and minor cases. Adherence to protocol was ranged between 98% in elective and 25% in emergency. Out of three part of checklist, it was noticed sign in part was done well but Time out and sign out part was not followed. Many time sign out was pending due to absence of surgeon. The rest two parts were also not followed due to poor communication skills.
Highest compliance was associated with patient identification, Type of procedure, Antibiotics. The compliance was low with sign out and time out. The sign in was (99%) where as time out (74%) and sign out (44%).
Conclusion – Our institutional data indicate that although implementation of SSC is there but the accuracy for completion of each section is poor. The reason for this discrepancy is poor participation, poor communication, no specific team leader or lagging of teamwork. Identification and improvisation of pitfalls is necessary for better patient safety and care.
Keywords: Anesthetist, Surgical safety checklist, poor participation, poor communication and Antibiotics