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Patient Safety in Surgery
Published in: Patient Safety in Surgery 1/2013

Open Access 01-12-2013 | Research

Surgical checklists: the human factor

Authors: Paul O’Connor, Catriona Reddin, Michael O’Sullivan, Fergal O’Duffy, Ivan Keogh

Published in: Patient Safety in Surgery | Issue 1/2013

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Abstract

Background

Surgical checklists has been shown to improve patient safety and teamwork in the operating theatre. However, despite the known benefits of the use of checklists in surgery, in some cases the practical implementation has been found to be less than universal. A questionnaire methodology was used to quantitatively evaluate the attitudes of theatre staff towards a modified version of the World Health Organisation (WHO) surgical checklist with relation to: beliefs about levels of compliance and support, impact on patient safety and teamwork, and barriers to the use of the checklist.

Methods

Using the theory of planned behaviour as a framework, 14 semi-structured interviews were conducted with theatre personnel regarding their attitudes towards, and levels of compliance with, a checklist. Based upon the interviews, a 27-item questionnaire was developed and distribute to all theatre personnel in an Irish hospital.

Results

Responses were obtained from 107 theatre staff (42.6% response rate). Particularly for nurses, the overall attitudes towards the effect of the checklist on safety and teamworking were positive. However, there was a lack of rigour with which the checklist was being applied. Nurses were significantly more sensitive to the barriers to the use of the checklist than anaesthetists or surgeons. Moreover, anaesthetists were not as positively disposed to the surgical checklist as surgeons and nurse. This finding was attributed to the tendency for the checklist to be completed during a period of high workload for the anaesthetists, resulting in a lack of engagement with the process.

Conclusion

In order to improve the rigour with which the surgical checklist is applied, there is a need for: the involvement of all members of the theatre team in the checklist process, demonstrated support for the checklist from senior personnel, on-going education and training, and barriers to the implementation of the checklist to be addressed.
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Metadata
Title
Surgical checklists: the human factor
Authors
Paul O’Connor
Catriona Reddin
Michael O’Sullivan
Fergal O’Duffy
Ivan Keogh
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Patient Safety in Surgery / Issue 1/2013
Electronic ISSN: 1754-9493
DOI
https://doi.org/10.1186/1754-9493-7-14

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