COMPLIANCE WITH THE WHO SURGICAL SAFETY CHECKLIST AND BARRIERS TO ITS LONG-TERM USE: A MIXED-METHODS EVALUATION STUDY IN A BENIN TEACHING HOSPITAL. yedzinck@gmail.com

 

COMPLIANCE WITH THE WHO SURGICAL SAFETY CHECKLIST AND BARRIERS TO ITS LONG-TERM USE: A MIXED-METHODS EVALUATION STUDY IN A BENIN TEACHING HOSPITAL.

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Benin

Oral or Poster

As surgical volume continues to increase globally, so does the risk of surgical adverse events. The WHO Surgical Safety Checklist (SSC) was designed to enhance patient safety in the operating theatre. In Benin, despite nationwide checklist implementation in 2018 across thirty-six hospitals, concerns remain about its sustained use. This study sought to assess compliance with the SSC, investigate associated factors, and identify barriers to its sustained use in the surgery department of CHUD-OP teaching hospital five years after implementation.

We employed a sequential explanatory mixed-methods design. The quantitative strand (October-December 2023) was based on a cross-sectional analytical study with both retrospective and prospective data collection to assess operative volume, SSC compliance rate, and associated factors. The qualitative strand (January 2024) involved audio-recorded in-depth interviews with four categories of surgical staff using a semi-structured interview guide.

A total of 204 surgeries were performed during the study period, with 192 complete surgical records available for analysis. Of these, 26 checklists were found, representing a compliance rate of 13.5%. Among the 26 available checklists, 53.9% were fully completed. Sign In (80.8%) and Time Out (88.5%) were more frequently completed than Sign Out (73.1%). Factors significantly associated with SSC utilisation included the operating surgeon, weekday versus weekend operations, and checklist standardisation. Qualitative interviews identified the main barriers to sustained use as staff shortages, inadequate training, and the emergency nature of surgeries.

SSC compliance remains critically low five years post-implementation, associated with surgeon seniority and institutional factors rather than clinical variables.