Safe surgery checklist: Barriers and facilitators for its implementation

INTRODUCTION: This study aimed to identify barriers and facilitators to the implementation of the Surgical Safety Checklist through a systematic review. METHODS: A systematic search was conducted in PubMed, Virtual Health Library (VHL), Embase, Scopus, and Web of Science using the descriptors 'Communication Barriers', 'Patient Safety', 'Checklist', and 'Surgical Procedures'. The strategy was peer-reviewed using the Peer Review of Electronic Search Strategies tool. Data extraction included study characteristics, sample size, sociodemographic data, barriers, and facilitators. Proportion meta-analyses estimated prevalence with 95% confidence intervals. RESULTS: Forty-three studies were included. The meta-analysis showed that 22% of professionals considered the checklist a waste of time, 44% reported resistance or disbelief in its benefits, and 14% perceived it as redundant. All outcomes demonstrated substantial heterogeneity. CONCLUSION: Although the Surgical Safety Checklist enhances patient safety, its implementation is hindered by institutional barriers, team resistance, and workload pressures, limiting full adherence.