Browsing by Author "Koopman, Gerda"
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- ItemAn investigation into the barriers preventing the implementation of the surgical safety checklist in the operating room in tertiary hospitals in the Cape Metropole(Stellenbosch : Stellenbosch University, 2018-03) Koopman, Gerda; Schutte, Loraine; Stellenberg, Ethelwynn L.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.ENGLISH SUMMARY: Background Peri-operative patient safety remains crucial in healthcare to prevent avoidable errors. The World Health Organization developed a surgical safety checklist that was implemented by the Western Cape Department of Health in 2009. However, no evidence could be found regarding barriers during the implementation thereof in the South African context. Research question The study was guided by the question: “What are the barriers preventing the implementation of the surgical safety checklist in the operating room in tertiary hospitals in the Cape Metropole?” Aim The aim of the study was to investigate the barriers that prevent the implementation of the surgical safety checklist in the operating room in two tertiary hospitals in the Cape Metropole. Objectives The objectives of the study were to determine: The attitudes of the staff towards the implementation of the checklist Communication amongst surgical team members, related to the checklist Beliefs of surgical team members about the checklist Support from surgical team members, implementing the checklist Feedback on potential barriers Any statistical associations between the biographical data and the barriers preventing the implementation of the checklist Research methodology To reach the objectives of this study, a descriptive design with a quantitative correlational approach was followed. Approval was granted from the Health Research Ethics Committee of Stellenbosch University (Ethics reference 0557), and the two tertiary hospitals. After a pilot-study, data was collected through a self-administered questionnaire and analysed using descriptive and inferential data analyses. The population of 304 participants included surgeons, surgical assistants, anaesthetists, nurses and theatre technicians. Reliability and Validity The instrument used in this study was used in a previous study where an alpha score of 0.7 indicated an acceptable level of internal consistency. A pilot-study was done to test the methodology and the data collection tool. The instrument was reviewed by experts to ensure validity. Results The study results confirm that the surgical checklist is well suited, although participants over 50+ (23.8%), with more than 10 years’ experience (19.4%) and doctorate education (30.8%) disagreed that the SSC was always implemented. A statistical significant difference (p=0.010) between the years of experience and proper training on the implementation of the checklist was identified. Congruently, participants (59.9%) observed that nurses just tick off the checklist. Anaesthetists (60.9%) and participants with a degree (47.7%) indicated that sections of the checklist were sometimes not completed. Also, statistical significant differences between occupation (p=0.004), age (p=0.030), education (p=0.006) and that the checklist is an added responsibility, were identified, and 88.1% find it time consuming. Recommendations Identify and train local champions to represent management in quality improvement initiatives to promote the correct use of the checklist. Inter-professional team training on quality improvement initiatives should be instituted to address practical issues regarding the correct implementation of the surgical safety checklist. Conclusion The study highlighted incomplete use of the checklist and insufficient training that may result in a tick-box exercise. Consequent to improper use of the SSC, institutions may not experience the full benefits of the surgical safety checklist.