A meta-analysis of the efficacy of preoperative surgical safety checklists to improve perioperative outcomes

Biccard, BM; Rodseth, RN; Cronjé, Larissa; Agaba, Peter; Chikumba, Edson; Toit, Leon du; Farina, Zane; Fischer, Sandra E.; Gopalan, P D; Govender, Komalan; Kanjee, J; Kingwill, AC; Madzimbamuto, Farai; Mashava, Doreen; Mrara, Busisiwe; Mudely, M; Ninise, E; Swanevelder, Justiaan; Wabule, Agnes

doi:10.7196/samj.2016.v106i6.9863

Cited by 20 publications

(15 citation statements)

References 16 publications

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“…Risk of bias was low for each systematic review included in our study. Of the 20 systematic reviews included in our study, 15 systematic reviews [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] were given an overall quality of "good" (least risk of bias) and 5 systematic reviews [34][35][36][37][38] were rated as "fair" (susceptible to some bias).…”

Section: Risk Of Bias In Individual Studiesmentioning

confidence: 99%

Impact of the WHO Surgical Safety Checklist Relative to Its Design and Intended Use: A Systematic Review and Meta-Meta-Analysis

Sotto

Burian

Brindle

2021

Journal of the American College of Surgeons

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BACKGROUND:The aim of this study was to identify what parts of the World Health Organization Surgical Safety Checklist (WHO SSC) are working, what can be done to make it more effective, and to determine if it achieved its intended effect relative to its design and intended use. STUDY DESIGN: We conducted a qualitative thematic analysis and meta-meta-analyses of findings in WHO SSC systematic reviews following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. RESULTS:Twenty systematic reviews were included for qualitative thematic analysis. Narrative information was coded in 4 primary areas with a focus on impact of the WHO SSC. Four themesd-Clinical Outcomes, Process Measures, Team Dynamics and Communication, and Safety Culturedpertained directly to the aims or purposes behind the development of the SSC.The other 2 themesdEfficiency and Workload involved in using the checklist and Checklist Impact on Institutional Practicesdare associated with SSC use, but were not focal areas considered during its development. Included in the 20 systematic reviews were 24 unique observational cohort studies that reported pre-post data on a total of 18 clinical outcomes. Mortality, morbidity, surgical site infection, pneumonia, unplanned return to the operating room, urinary tract infection, blood loss requiring transfusion, unplanned intubation, and sepsis favored the use of the WHO SSC. Deep vein thrombosis was the only postoperative outcome assessed that did not favor use of the WHO SSC. CONCLUSIONS: The WHO SSC positively impacts the things it was explicitly designed to address and does not positively impact things it was not explicitly designed for.

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Section: Risk Of Bias In Individual Studiesmentioning

confidence: 99%

Impact of the WHO Surgical Safety Checklist Relative to Its Design and Intended Use: A Systematic Review and Meta-Meta-Analysis

Sotto

Burian

Brindle

2021

Journal of the American College of Surgeons

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“…Since the publication of the SSC, there are initiatives for its implementation in health services around the world, and there is evidence on the beneficial effects for the patient, such as: the significant decrease in surgical complications and mortality (3) ; improving communication and teamwork (4) , optimization of the work process, quality improvement and cost reduction (5)(6) . However, the barriers imposed to the implementation of the list may compromise its effectiveness in clinical practice (6)(7) .…”

Section: Introductionmentioning

confidence: 99%

Lista de verificação de segurança cirúrgica: benefícios, facilitadores e barreiras na perspectiva da enfermagem

Tostes

Galvão

2019

Rev. Gaúcha Enferm.

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Resumo OBJETIVO Identificar os benefícios, facilitadores e barreiras na implementação da lista de verificação de segurança cirúrgica, segundo o relato de enfermeiros que atuavam no centro cirúrgico de hospitais. MÉTODO Estudo transversal, com 91 enfermeiros em 25 hospitais de dois municípios do Paraná. Na coleta dos dados, entre 2015 e 2016, utilizou-se dois instrumentos estruturados. Para a análise, utilizou-se o teste exato de Fisher ou Qui-Quadrado. RESULTADOS A implementação do checklist acarretou benefícios para o paciente, equipe cirúrgica e hospitais. Sobre os facilitadores, os resultados apresentaram diferença estatisticamente significante entre os grupos nos itens oferta de educação (p=0,006) e aceitação pelos cirurgiões (p=0,029). E, nas barreiras, para a falta de apoio administrativo (p=0,006) e chefias (p=0,041), ausência do núcleo de segurança do paciente (p=0,005), lista introduzida abruptamente (p=0,001) e ausência de educação (p<0,001). CONCLUSÃO As evidências geradas possibilitaram identificar os benefícios, facilitadores e barreiras na implementação do checklist no contexto nacional.

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“…In the world context, SSC was implemented in different health services and in clinical practice. Among the benefits obtained with the use of this tool are the increase to detect potential adverse events, reduction of surgical complications, improvement of communication and teamwork 4 - 5 . In contrast, the way the SSC implementation process occurs can lead to incomplete or inconsistent execution of the tool and low compliance rate by the surgical team 6 .…”

Section: Introductionmentioning

confidence: 99%

Implementation process of the Surgical Safety Checklist: integrative review

Tostes

Galvão

2019

Rev. Latino-Am. Enfermagem

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Objective:to analyze the evidence available in the literature on the process of implementing the Surgical Safety Checklist, proposed by the World Health Organization, in the practice of health services. Method:integrative review, the search for primary studies was performed in three relevant databases in the health area, and the sample consisted of 27 studies, which were grouped into three categories. Results:the synthesis of the evidence indicated the different strategies that can be adopted in the implementation process (introduction and optimization) of the Surgical Safety Checklist, and the facilitators and barriers that determine the success in using this tool. Conclusion:in health services, implementing the checklist is a complex and challenging process that requires effective leadership, clear delegation of responsibilities from each professional, collaboration between team members, and institutional support. The synthesis of the generated knowledge can assist nurses in decision making, especially in identifying strategies for the effective implementation of the Surgical Safety Checklist, since nursing has the potential to be a protagonist in the planning and implementation of best practices for patient safety.

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A meta-analysis of the efficacy of preoperative surgical safety checklists to improve perioperative outcomes

Abstract: There is sufficient RCT evidence to suggest that SSCs decrease hospital mortality and surgical outcomes in tertiary and community hospitals. However, randomised evidence of the efficacy of the SSC at rural hospital level is absent.

Cited by 20 publications

References 16 publications

Impact of the WHO Surgical Safety Checklist Relative to Its Design and Intended Use: A Systematic Review and Meta-Meta-Analysis

Impact of the WHO Surgical Safety Checklist Relative to Its Design and Intended Use: A Systematic Review and Meta-Meta-Analysis

Lista de verificação de segurança cirúrgica: benefícios, facilitadores e barreiras na perspectiva da enfermagem

Implementation process of the Surgical Safety Checklist: integrative review

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