User related factors in implementation of WHO surgical safety checklist (SSC)

WHO Surgical Safety Checklist (SSC) was introduced to address the well-recognized global problem of lack of surgical safety. Although proper implementation of SSC reduces common adverse events occurring during surgical procedures, the practical implementation in some cases has been found to be less than optimal. Objective: To assess the user related factors in the implementation of the SSC at District General Hospital (DGH), Matara . Methods: A descriptive cross-sectional study was carried out at DGH, Matara using a self-administered questionnaire among 76 doctors and 116 nurses who worked in operating theatres of DGH, Matara. A questionnaire based on the SSC and its implementation was used to assess the knowledge, attitudes and practices of doctors and nurses. Results: On the average, the seniority and experience in working in the operating theatres of DGH, Matara had a significant association with the awareness of the SSC. Nurses were more familiar about the SSC compared to doctors. Even when the user of the checklist had good knowledge, favorable attitudes and interest for proper implementation of the SSC, only a minority (8.7%) was trained in SSC. Discussion: The complexity, uncertainty of the definition of the responsibility and frequent unavailability of checklists were the main perceived barriers. It is recommended to simplify and reformat the checklist to make more user friendly and designating a checklist coordinator, training and monitoring implementation for better compliance.