Dificuldades na aplicação do checklist cirúrgico: estudo qualitativo de abordagem ecológica restaurativa

Abstract

Aim: analyze the application of the safe surgery checklist, seeking to describe the main factors that can affect its completion and follow-up, according to the perception of nursing technicians. Method: this is a qualitative study performed with nursing technicians from an outpatient surgical center in southern Brazil. The data were collected through focus groups and photographic methods, from the perspective of ecological and restorative thinking. Results: three categories emerged from the information grouping: Checklist for patient safety – still a challenge; difficulty of adherence to the safe surgery checklist; and Checklist Steps. Discussion: the data indicate that some stages of this process are still not met and there is difficulty of adherence by the teams. Conclusions: among the main failures is the low adherence of the medical team to perform the time out and to the confirmation of the place and the procedure. The restorative ecological approach made it possible to engage professionals.

A Scoping Review of Strategies Used to Implement the Surgical Safety Checklist

“…We classified each of the 14 intervention-related articles according to the identified subcategories for each intervention phase (ie, before, during, and after implementation). We found that 6 (42.9%) of the 14 articles addressed at least one strategy before implementation, 17,19,21,22,30,36 13 (92.8%) of the 14 articles addressed at least one strategy during implementation, 16,17,19,21,22,25,29,30,33,34,36,38,39 and 8 (57.1%) of the 14 articles addressed at least one strategy after implementation. 17,19,[21][22][23]33,34,36 Although the remaining 14 articles did not address interventions, they provided support for the intervention strategies.…”

“…33 Some programs include the use of technologies during educational activities, 19,38 including explanatory videos showing how the SSC should and should not be used. 16,21,28,39 Adapting Surgical Safety Checklist training tools to meet the specific needs of an organization and its staff members rather than using the WHO standardized tools can result in higher participation.…”

Barriers and facilitators associated with the implementation of surgical safety checklists: A qualitative systematic review

“…Of the 1912 publications retrieved from the database searches, a total of 34 studies were included (Figure 1) (Page et al, 2021). The studies were conducted in a range of countries: Jordon 1 (Albsoul et al, 2022), Turkey 1 (Aydin Akbuga et al, 2023), Brazil 1 (De Oliveira Junior & De Magalhães, 2017), France 1 (Fourcade et al, 2012), Cyprus 1 (Georgiou et al, 2018), Thailand 1 (Kasatpibal et al, 2018), Sweden 3 (Krupic et al, 2020; Nordström & Wihlborg, 2019; Rönnberg & Nilsson, 2015), Saudi Arabia 1 (Manamela et al, 2022), Zambia 1 (Munthali et al, 2022), Spain 1 (Peñataro‐Pintado et al, 2021), Switzerland 1 (Schwendimann et al, 2019), New Zealand 1 (Weller et al, 2018) and Madagascar 1 (White et al, 2018), USA 2 (Alidina et al, 2017; Conley et al, 2011), multiple countries 2 (Aveling et al, 2013; Elam et al, 2022), Norway 3 (Haugen et al, 2015; Høyland et al, 2014; Wæhle et al, 2012), UK 3 (O'brien et al, 2017; Robertson‐Smith, 2016; Russ et al, 2015), Australia 4 (Braaf et al, 2013; Gillespie, Marshall, et al, 2016; Gillespie, Withers, et al, 2016; Rogers et al, 2020) and Canada 6 (Dharampal et al, 2016; Gagliardi et al, 2014; Mahmood et al, 2019; Mobilio et al, 2022; Spence et al, 2011; Ziman et al, 2018). The sample sizes ranged from 8 to 196 participants and represented the total number of all members of the perioperative MDT: surgeons, anaesthesiologists, operating room nurses, medical students, nurse anaesthetists, surgical trainees, theatre support workers, radiographers, nursing students, administrative staff, management and consumers (see Table 1).…”

“…Resistance, attitudes and understanding, surgeon participation, patient anxiety and individual non‐technical skills were identified as individual barriers to the implementation of the WHO Surgical Safety Checklist. Across the studies, the main barrier to successful implementation was the behaviours and attitudes of senior medical staff, and in particularly the lead surgeon (Albsoul et al, 2022; Alidina et al, 2017; Aveling et al, 2013; Braaf et al, 2013; De Oliveira Junior & De Magalhães, 2017; Dharampal et al, 2016; Fourcade et al, 2012; Gagliardi et al, 2014; Georgiou et al, 2018; Kasatpibal et al, 2018; Manamela et al, 2022; Mobilio et al, 2022; Nordström & Wihlborg, 2019; Robertson‐Smith, 2016; Rönnberg & Nilsson, 2015; Russ et al, 2015; White et al, 2018; Ziman et al, 2018).…”

“…Workload, time pressures, competing tasks, emergency procedures and distractions were key environmental factors that created barriers to the successful use of the checklist. In particular, time pressures because of extended surgical patient lists, high patient turnover rates and brief non‐complex procedures were significant environmental barriers (Albsoul et al, 2022; Alidina et al, 2017; Aydin Akbuga et al, 2023; Braaf et al, 2013; De Oliveira Junior & De Magalhães, 2017; Fourcade et al, 2012; Gagliardi et al, 2014; Georgiou et al, 2018; Gillespie, Marshall, et al, 2016; Gillespie, Withers, et al, 2016; Haugen et al, 2015; Munthali et al, 2022; Peñataro‐Pintado et al, 2021; Robertson‐Smith, 2016; Schwendimann et al, 2019). Furthermore, the impact of increased staff workloads and disruption to the perioperative workflow created perceived delays which compounded suboptimal checklist compliance rates (Aveling et al, 2013; Fourcade et al, 2012; Gagliardi et al, 2014; Mahmood et al, 2019; O'brien et al, 2017; Rönnberg & Nilsson, 2015; Russ et al, 2015; Wæhle et al, 2012; Ziman et al, 2018).…”