Key result
Only 34.31% of WHO Surgical Safety Checklists were fully completed, with just 13.73% completed at the correct time, indicating critical gaps in compliance.
Why the study?
Despite the efficacy of the WHO Surgical Safety Checklist, compliance may be variable, particularly in resource-limited settings.
Observational (n=102)
No
The audit reveals critical gaps in compliance with the WHO Surgical Safety Checklist in a resource-limited setting, highlighting the need for targeted interventions like staff training and real-time monitoring.
Identified compliance gaps in this peripheral hospital warrant targeted training; leaves open whether interventions improve outcomes in similar resource-limited settings.
Background The World Health Organization (WHO) Surgical Safety Checklist is utilised globally to enhance communication and teamwork, ensuring patient safety in surgeries and reducing complications and mortality. Despite its efficacy, compliance with the checklist may be variable, particularly in resource-limited settings. This audit evaluated the adherence to the WHO Surgical Safety Checklist in the surgical theatre of Base Hospital Thambuththegama, Sri Lanka, to identify the gaps and areas for improvement. Methods A prospective audit assessed 102 surgical cases over three weeks, including elective and non-elective procedures. Data collection involved real-time observation of checklist use and assessment of staff participation. Compliance was evaluated based on checklist attachment, completion, and timing, while staff participation rates were analysed across roles. Results In 87.25% of cases, the checklist was attached to the bed head ticket (BHT). Fully completed checklists were observed in only 34.31% of cases, with just 13.73% completed at the correct time. Staff participation was highest among anaesthetists (90.5%) and house officers (88.1%) but significantly lower among consultants (7.1%). Key barriers included incomplete sections, incorrect timing, and inconsistent participation from senior staff. Conclusions The audit highlights critical gaps in compliance with the WHO Surgical Safety Checklist, emphasising the need for targeted interventions. These include staff training, real-time monitoring, and enhanced accountability. Addressing these gaps can significantly improve surgical safety and patient outcomes. A re-audit is planned to evaluate the impact of the proposed changes.
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Munasinghe et al. (2025) conducted an observational in Surgical procedures (n=102). WHO Surgical Safety Checklist was evaluated on Fully completed checklists at the correct time. Only 34.31% of WHO Surgical Safety Checklists were fully completed, with just 13.73% completed at the correct time, indicating critical gaps in compliance.
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