Implementation of the WHO surgical safety checklist in Kenya - a case of Mater Misericordiae hospital
Date
2023
Authors
Gebre, T. S.
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Journal ISSN
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Publisher
Strathmore University
Abstract
Surgical checklists have been used by hospitals around the world to improve process efficiency, and team coordination, reduce the adverse outcomes of surgery, and further decrease the overall cost of care. However, studies have shown that despite the use of surgical checklists, the adverse effects of surgical operations, including the rate of mortality and reoperations, remain high, especially in sub-Saharan Africa. To improve the safety of surgery worldwide, in 2008, the World Health Organization’s (WHO) Patient Safety Program published the WHO Surgical Safety Checklist, a nineteen- item checklist that acts as a visual aid designed to foster adherence to recommended standards of care and team communication. The checklist has had significant improvements in surgical processes and surgical outcomes in different hospitals, though most of the evidences are reported from high-income countries. The implementation of the checklist, the information on its use, and its impact in low-income countries remain poorly understood. This study sought to examine the implementation experiences of using the WHO surgical checklist and its influence on the delivery of surgical services in a private hospital in Kenya. The study was anchored on Causal Analysis based on Systems Theory. The study was limited to Mater Misericordiae Hospital since it’s the leading institution in the country providing a surgical training program and is aacreditaed as a center of excellence for cardiac surgeries. A mixed-methods research design was adopted. The population comprised surgeons, anesthetists, theatre nurses, and medical officers working in the surgical department. Data was collected using semi-structured questionnaires and an interview guide. Quantitative data was cleaned, coded, entered, and analyzed through descriptive statistics using SPSS Version 22.0, while qualitative data were manually coded and thematically analyzed through content analysis. The study found that majority of the health care workers at the Mater Misericordiae hospital were aware of the WHO SSC, and majority used the checklist in the surgical processes in the hospital, but not always. The health care workers acknowledged that the WHO SSC was easy to use; helped reduce human errors; and enhanced the patient’s safety in the operating room. The study concludes that aspects such as communication among team members facilitated effective implementation of SSC while barriers such as the high bulk of surgical cases, the turnaround time between cases, lack of resources, understaffing, and lack of adequate training hindered the effective use and implementation of the checklist in the hospital. The study recommends that periodic training for surgical staff to enhance their knowledge and use of the SSC and allocating more resources to ensure adequate and well-trained staff is recommended. This would lead to practical use and implementation of WHO SSC as well as frequent monitoring to ensure compliance with the checklist at all levels in the hospital.
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Citation
Gebre, T. S. (2023). Implementation of the WHO surgical safety checklist in Kenya—A case of Mater Misericordiae hospital [Strathmore University]. http://hdl.handle.net/11071/13509