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Compliance to the use of surgical safety checklist in elective surgeries

Author: 
Mr. Ernest Xavier Selvakumar, A., Ms. Kalaiselvi, Mr. Karthikeyan, Mr. Prabakaran R., Mr. Sheik Abdulla, A., Ms. Sneha, Ms. Thenmozhi P., Ms. Thulasiammal P., Mrs. Angelin Mary sheela, S. and Mr. Vadivazhagan Rathinam
Subject Area: 
Health Sciences
Abstract: 

An observational study was conducted to assess the compliance to the use of surgical safety checklist in elective surgeries at JIPMER, Puducherry. Background: Surgical service is one of the fundamental health care services given in the health care system. Over 234 million operations performed annually worldwide and this yearly volume now exceeds that of childbirth. The surgical complications are a major cause of morbidity and mortality and pose a major financial burden to the patients and healthcare provider. A strong safety culture that enhances patient safety initiatives has been reiterated in the healthcare system and safety of surgical care is a global concern. As a part of different effort modalities world health organization lunched “safe surgery saves lives campaign”. Around 1800 institutions are now reported to be using the checklist worldwide. The potential for surgical safety checklists to improve safety and outcomes and generate substantial cost swings has attracted global interest. The compliance to surgical safety checklist has many positive effects towards attaining a quality patient care. The effectiveness includes a protective patient environment, reduction in mortality and morbidity, a well co-ordinated teamwork and communication among the health care professionals. Aim: The present study aims to assess the compliance to the use of surgical safety checklist in elective surgeries. Method: The Descriptive Observational design was used in the study with 384 samples of elective surgeries through Convenient Sampling technique. The data was collected in all the Operation Theatres except emergency OT’s for a period of 3 months with help of standardized surgical safety checklist. Results: From the observation about 22.39% of elective surgeries had excellent usage status of surgical safety checklist, 53.9% had very good compliance, 10.41% had fair compliance and 13.28% had poor compliance on usage of surgical safety checklist. There is a significant association between usage status of surgical safety checklist and type of surgery (p<0.05). From the comparison of overall score of the checklist in relation to type of surgeries, major surgery has greater compliance (with mean score 20.96+2.76) than the minor surgeries (with mean score 19.17+3.00) in usage of surgical safety checklist. The total score of different items in time out (item 6-15) and sign out (item 16-25) were statistically significant (<0.05). In relation to the major surgeries, time out phase 193(8.6+3.95) and sign out phase 193(8.4+ 1.6) were observed analytically. There was highly significant difference between sign in items (1-5) with regard to major surgeries 193(3.95+1.7) and minor surgeries 191(4.12+1.5). Conclusion: The study revealed that the level of usage of the surgical safety checklist for elective surgeries was very good. Majority of elective surgeries had very good compliance; a few of elective surgeries had fair and excellent compliance to surgical safety checklist. There was the significant association between the usage status with the type of surgery. The usage of surgical safety checklist shows Time out and Sign out phase had significantly associated and were followed mostly in major surgeries.

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