Barriers and limitations during implementation of the surgical safety checklist of the World Health Organization
Abstract
Introduction: The surgical safety checklist of the World Health Organization (WHO) is a tool that checks and evaluates each procedure in the operating room. Despite its demonstrated effectiveness, it has many limitations and barriers to its implementation. The aim of this article was to present the current evidence regarding limitations and barriers to achieve a successful implementation of the surgical safety WHO checklist. Methods: A narrative review was designed. We performed a systematic literature search in PubMed/MEDLINE. Articles that describe or present as primary or secondary endpoints barriers or limitations during the implementation of the checklist WHO were selected. Observational or experimental articles were included from the date of the official launch of the WHO list. To describe the data a summary table was designed. Detailed results were organized qualitatively extracting the most prevalent limitations. Results: 17 studies were included in the final review process. The main findings were: 1) a large number of constraints reported in the literature that hinder the implementation process, 2) limitations were grouped into 9 categories according to their similarities and 3) the most frequently reported category was “knowledge”. Discussion: There are several factors that limit the proper implementation of the surgical safety checklist WHO. Among these, cultural factors, knowledge, indifference and / or relevance, communication, filling completeness, among others. Effective implementation strategies would reach its successful implementation.Downloads
References
Haynes A, Weiser T, Berry W, Lipsitz S, Breizat A-H, Dellinger E et al. A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population. N Engl J Med. 2009; 360:491-9.
World Health Organization. Patient safety: surgical safety Web map. (Acceso 8 de enero de 2014). Disponible en: http://maps.cga.harvard.edu:8080/Hospital/.
Collazos C, Bermúdez L, Quintero A, Quintero L, Díaz M. Verificación de la lista de chequeo para seguridad en cirugía desde la perspectiva del paciente. Rev Colomb Anestesiol. 2013; 41(2):109–113.
De Vries E, Prins H, Crolla R, Den Outer A, Van Andel G, Van Helden S et al. Effect of a Comprehensive Surgical Safety System on Patient Outcomes. N Engl J Med. 2010; 363: 1928-37.
Kasatpibal N, Senaratana W, Chitreecheur J, Chotirosniramit N, Pakvipas P, Junthasopeepun P. Implementation of the World Health Organization Surgical Safety Checklist at a University Hospital in Thailand. Surgical Infections. 2012; 13 (1): 50-56.
Lee A, Raniga S, Hooper G, Perry A, Bisset R, Darley D et al. The Time Out Procedure: have we changed our practice? NZMJ. 2012; 125 (1362): 26-35.
Mahajan R. The WHO surgical checklist. Best Practice & Research Clinical Anaesthesiology. 2011; 25: 161-168.
Nugent E, Hseino H,Ryan K, Traynor O, Neary P, Keane F. The surgical safety checklist survey: a national perspective on patient safety. Ir J Med Sci. 2013; 182:171–176.
Paugam-Burtz C, Guerrero O. French surgical checklist in a universitary hospital: Achievements one year after implementation. Annales Francaises d’Anesthésie et de Réanimation. 2011; 30: 475-478.
Robinson L, Paull D, Mazzia L, Falzetta L, Hay J, Neily J et al. The Role of the Operating Room NurseManager in the Successful Implementation of Preoperative Briefings and Postoperative Debriefings in the VHA Medical Team Training Program. Journal of PeriAnesthesia Nursing. 2010; 25 (5): 302-306.
Rodrigo-Rincón M, Tirapu-León B, Zabalza-López P, Martín- Vizcaino M, De la Fuente-Calixto A, Villalgordo-Ortín P et al. Percepción de los profesionales sobre la utilización y la utilidad del listado de verificación quirúrgica. Rev Calid Asist. 2011;1-6.
Rydenfalt C, Johansson G, Odenrick P, Akerman K, Larsson P. Compliance with the WHO Surgical SafetyChecklist: deviations and possible improvements. International Journal for Quality in Health Care. 2013; 25, (2): 182–187.
Sheena Y, Fishman J, Nortcliff C, Mawby T, Jefferis A, Bleach R. Achieving flying colours in surgical safety: audit of World Health Organization ‘Surgical Safety Checklist’ compliance. The Journal of Laryngology & Otology. 2012;126: 1049–1055.
Soria-Aledo V, Da Silva Z, Saturno P, Grau-Polan M, Carrillo-Alcaraz A. Dificultades en la implantación del check list en los quirófanos de cirugía. Cir Esp. 2012;90 (3): 180-185.
Vogts N, Hannam J, Merry A, Mitchell S. Compliance and quality in administration of a surgical safety checklist in a tertiary New Zealand hospital. NZMJ. 2011;124 (1342): 48-58.
Böhmer A, Wappler F, Tinschmann T, Kindermann P, Rixen D, Bellendir M et al. The implementation of a perioperative checklist increases patients’ perioperative safety and staff satisfaction. Acta Anaesthesiol Scand.
; 56: 332–338.
Fourcade A, Blache J, Grenier C, Bourgain J, Minvielle E. Barriers to staff adoption of a surgical safety checklist. BMJ Qual Saf .2012; 21:191-197.
Levy S, Senter C, Hawkins R, Zhao J, Doody K, Kao L et al. Implementing a surgical checklist: More than checking a box. Surgery. 2012; 152:331-336.
Delgado J, Jiménez X, Peñalonzo M, Villatoro C, De Izquierdo S, Cifuentes M. Acceptance of the WHO Surgical Safety Checklist among surgical personnel in hospitals in Guatemala city. BMC Health Services Research.2012; 12 (169): 1-5.
Healy J. How hospital leaders implemented a safe surgery protocol in Australian hospitals. International Journal for Quality in Health Care. 2012; 24 (1): 88–94.
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