Attitudes and barriers to the use of the World Health Organisation’s Surgical Safety Checklist at a specialized academic hospital in the Western Cape, South Africa

Davids, Vanessa Berenice (2023-02-28)


The Surgical Safety Checklist (SSC) of the World Health Organization (WHO) has been developed and adopted by the surgical fraternity worldwide to reduce patient mortality and morbidity in surgical operating rooms (ORs). Further to this, the SSC has been implemented in ORs to enhance communication and teamwork among the OR team members. The aim of this study was to investigate the attitudes and barriers to the WHO’s SSC in a specialised tertiary academic hospital in the Western Cape, South Africa. The degree of impact of the SCC on teamwork and safety, the support rendered by all categories of OR personnel in compliance with the SSC, the initiation of the SSC by all the OR personnel, and the barriers to the use of the SSC where investigated. The Donabedian Structure-, Process- and Outcome models underpinned the study. A self-administered online survey published by O’Connor et al (2013:2) was used to collect data with a six-point Likert scale. English, Afrikaans, and Xhosa versions were provided. The respondents’ demographics were included. The OR personnel employed in all the ORs of the hospital were requested to participate, namely the surgeons, the anaesthetists, the professional registered nurses, the OR trainee professional nurses, the registered enrolled nurses, the registered enrolled nurse assistants, the radiographers, and the cardiac-bypass technicians (N=111). Data was collected over four weeks. The response rate was (N=61). Ethical approval was obtained from the Health Research Ethics Committee of the University of Stellenbosch (Ref: S21/08/150) and the ethical research departments of the Western Cape Department of Health (Ref: WC_202110_034) and the hospital in which the study was conducted. Prof T. Esterhuizen (Stellenbosch University’s Department of Epidemiology and Biostatistics) was consulted for guidance on the analysis using IBM Statistical Product and Services Solutions (SPSS28©). Descriptive and inferential statistics were computed from the raw data and are presented in tables. The research findings found that compliance with the phases of the SSC is inconsistently implemented. It is recommended that this be remedied to enhance patient safety and to promote OR team cohesion.

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