Barriers affecting the implementation of the World Health Organization Surgical Safety Checklist by staff in a private hospital in the Cape Metropole

Sauls, Peter Jonathan (2019-04)

Thesis (MNur)--Stellenbosch University, 2019.

Thesis

ENGLISH SUMMARY : Adverse events or near misses in the operating room (OR) is the result of negligence, medical malpractice and management that compromise patient safety which may result in wrong patient, wrong procedure and wrong site/side surgery. The World Health Organisation developed the Safe Surgical Checklist in 2008 as a systematic approach towards the improvement of peri-operative patient safety and reduces the risk of harm. The reliability of this process when implemented correctly has been widely published as invaluable. However, the researcher of this study, observed in clinical practice that adherence to the protocol is frequently inconsistent and may obstruct its efficacy. Thus, the aim of this study was to explore the OR staff’s perception of the implementation and efficacy of the checklist used in one private hospital in the Cape Metropolitan district of South Africa. A non-experimental, descriptive, cross-sectional quantitative approach using a case study design was applied. A self-administered structured questionnaire was used to collect data. Validity and reliability of the tool was assured by means of published research (Chronbach 0.70), a pilot study and consultation with nursing experts and a statistician. The total population was N=125 and included surgeons, anaesthetists and OR staff specifically involved in the surgical procedure. A response rate of 53% was achieved. Ethical approval was obtained from the Health Research Ethics Committee of the University of Stellenbosch and the institution’s ethical review board. Informed written consent was acquired from the participants. Data was analysed descriptively by the statistician and is presented in frequencies and tables. No inferential statistic calculations were performed as advised by the statistician. The analysis highlighted revealed that improper use of the SSC, a lack of training and a lack of management involvement may limit the benefits of the surgical safety checklist. In summary it is recommended to encourage continuous staff awareness campaigns to enhance the effective implementation of the SSC and promote a culture of safety among the surgical team.

AFRIKAANSE OPSOMMING : Ongewenste gebeurtenis in die operasiesaal kan toegeskryf word as die nalatige en wanpraktyk van gesondheidswerkers met ’n negatiewe effek op pasiëntveiligheid. Hierdie gedrag kan lei tot permanente ongeskikheid en verlengende verblyf van pasiënte in die hospitaal. Hierdie onverwagte gebeurtenisse is skadelik vir enige gesondheidsorganisasie. In 2008 het die Wêreld Gesondheidsorganisasie ’n chirurgiese kontrolelys ontwikkel en geïmplimenteer om peri-operatiewe pasiëntveiligheid en skadelike gebeurtenisse te verminder en te voorkom. Die doel van hierdie studie was om die hindernisse te ondersoek wat die implementering van die chirurgiese veiligheidskontrole-lys in die operasiesaal in ’n privaathospitaal in die Wes-Kaapse Metropool te verhoed. Nie-eksperimentele beskrywende kwantitatiewe navorsingsontwerp was geselekteer om die doelwitte van hierdie studie te berek. ’n Self-geadministreerde vraelys was gebruik om die data in te samel. Die vraelys wat gebruik word in hierdie studie was voorheen in gebruik waarvan ’n alpha-telling van 0.7 ’n aanvaarbare vlak van interne konsekwentheid aangedui is. Die metodologie van die vraelys was getoets deur ’n loods-studie. Kundiges was geraadpleeg om die geldigheid van die instrument te verseker. Die totale populasie van N=125 sluit in: verpleegkundiges, teater tegnici, chiruge, en narkotiseurs wat in ’n operasiesaal van ’n privaathospital in die Kaapstad Metropooldistrik, Suid-Afrika werk, is genooi om aan die studie deel te neem. Terugvoer van 53% was verkry. Etiese goedkeuring is vooraf verkry van die Gesondheids Navorsingsetiek-komitee aan Stellenbosch Universiteit sowel as van die etiese raad van die privaathospitaal. Ingeligte, geskrewe toestemming is van die deelnemers verkry. Die data is geanaliseer deur die statistikus en is aangebied in frekwensietabelle. Die bepaling van inferensiële statistieke was nie aanbeveel deur die statistikus nie. Die analise van die resultate het onbehoorlike gebruik, onvoldoende opleiding en bestuursbetrokenheid geïdentifiseer as potensiële pasientveiligheidsrisiko`s beskou. Die aanbevelings na afloop van hierdie studie sluit in deurlopende professionele opleiding aan teaterpersoneel met die klem op die effektiewe implementering van die chirurgiese vraelys.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/106167
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