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Peer Reviewed Journal

Observational Study to evaluate compliance with WHO Safety Surgery Checklist in Operation at Goyal Hospital Jodhpur Rajasthan

  • Author(s) :

    Observational Study to evaluate compliance with WHO Safety Surgery Checklist in Operation at Goyal Hospital Jodhpur Rajasthan

  • Abstract :

    Background: The World Health Organization (WHO) Surgical Safety Checklist (SSC) is an evidence-based tool to enhance communication, teamwork, and patient safety in operating theatres. Although its helps in reductions in perioperative morbidity and mortality, compliance remains inconsistent, In India, partial or superficial checklist use is frequently reported, especially during emergency surgeries. At Goyal Hospital & Research Centre, Jodhpur, the WHO SSC has been implemented since 2018 under NABH requirements.

    Aim: To assess compliance with the WHO Surgical Safety Checklist and identify factors associated with incomplete or incorrect use.

    Methods: A prospective observational study was conducted over three months (January–March 2024) in the main and emergency operation theatres of Goyal Hospital & Research Centre. A total of 385 surgical procedures were observed using a structured audit proforma. Completion of checklist sections (Sign In, Time Out, Sign Out), checklist leadership, time taken, interruptions, and teamwork were recorded. Staff-reported barriers were collected through questionnaire. Data were analysed using descriptive statistics, chi-square tests, and multivariate logistic regression.

    Results: Overall checklist compliance was 67.5% (260/385). Compliance was significantly higher in elective surgeries (73.7%) than emergency surgeries (50.0%; p = 0.001). Sign In had the highest completion rate (90.9%), followed by Time Out (72.7%) and Sign Out (70.1%). Nurse-led checklists showed the highest compliance (75.0%) compared to anaesthetist-led (70.0%) and surgeon-led (55.0%). Emergency surgery, were significant predictors of incomplete compliance. Major barriers included time pressure, heavy workload, and poor team cooperation.

    Conclusion: Moderate compliance with the WHO SSC was observed, with notable gaps during emergency procedures. Nurse-led checklist execution improved adherence. Addressing workload, strengthening leadership, and regular audit with feedback are essential to enhance surgical safety practices.