Abstract:
Background: Appropriate utilization and compliance of Surgical Safety Checklist reduces occurrence of perioperative
surgical complications and improve patient outcomes. However, data on compliance of surgical checklists are
scarce in the study area. Therefore, the aim of this study was to evaluate compliance of checklist completion and its
barrier for utilization at University of Gondar Hospital, Northwest Ethiopia.
Methods: A prospective observational study was conducted among 282 patients undergoing elective and emergency
surgery from January to March 2013. Compliance and completeness rate with implementation of Sign-in,
Time-out, and Sign-out domains was computed with SPSS 20 package.
Results: A total of 282 operations were performed and checklists were utilized in 39.7 % (112/282) of cases. Among
these, most checklists were employed during emergency procedures (61.6 %) that need general anesthesia (75.9 %) in
department of surgery (58.9 %). The overall compliance and completeness rate were 39.7 and 63.4 % respectively. The
sign-in, time-out and sign-out were missed in 30.5 % (273/896), 35.4 % (436/1,232) and 45.7 % (307/672) respectively.
The main reasons cited for non-user were lack of previous training (45.1 %) and lack of cooperation among surgical
team members (21.6 %).
Conclusions and recommendations: The completeness rate was satisfactory but the overall compliance rate was
suboptimal. An instrument that is used 40 % of the time has been a fairly basic introduction without significant reinforcement
training. Moreover, frequent use of the checklist during emergency cases has been deemed to be of value
by clinicians. Supplementary training and attention to actual checklist use would be indicated to ensure that this valuable
tool could be used more routinely and improve communication. Conducting regular audit of checklist utilization
is also recommended.
