Staff attitudes to and compliance with the use of a surgical safety checklist

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Kilbane, H., Oxtoby, C. and Tivers, M.S. (2020), Staff attitudes to and compliance with the use of a surgical safety checklist. Journal of Small Animal Practice, 61 (6), pp 332-337. https://doi.org/10.1111/jsap.13131

Summary

Surgical safety checklists are now widely used in human healthcare, where the incidence of adverse events is reported to be about 10%, of which three-quarters are related to surgery.

The World Health Organization (WHO) developed a surgical safety checklist with the aim of improving patient safety undergoing surgery. The checklist contains 19 items divided into three columns for completion at different time points: before induction, before the first incision and before the patient leaves the operating room.

It has been shown that the use of surgical checklists can

• Reduce mortality and morbidity
• Promote communication and teamwork in the operating theatre
• Take less than 3 minutes to complete

However, the barriers to change, including concern that using checklists will take up staff time and create more paperwork, need to be fully discussed, and implementation must be agreed with all members of the team if the introduction is to be successful.

This recently published paper could be a useful way of discussing the benefits and potential barriers to the introduction of surgical safety checklists in a non-threatening way.

A journal watch summary of this paper  is available.

Support with assessing the relevance of this paper

We have produced a guide that you can use to work through this paper as a practice.  For those less confident in assessing published papers there is a partially completed guide.

For those new to journal clubs, we have a step-by-step guide you might find useful: Setting up and running a journal club.

Next steps

If you decide that you would like to start using surgical safety checklists in your practice RCVS Knowledge has several checklist resources available, which can help you develop and implement your own checklist and provides further examples of checklists that are already in use in practice.

For those of you who would like to follow up with a clinical audit of the use of your surgical safety checklist, RCVS Knowledge also has resources to support Clinical Audit and a Clinical Audit Template.

Further Reading

Davidow, E.B., Owen, T. and Rishniw, M. (2023) Knowledge and attitudes towards surgical safety checklists: a survey of veterinary professionals. Journal of the American Veterinary Medical Association. https://doi.org/10.2460/javma.22.09.0405

Hill, J., Irwin-Porter, G. and Buckley, L.A. (2023) Surgical safety checklists in UK veterinary practice: Current implementation and attitudes towards their use. Veterinary Record. https://doi.org/10.1002/vetr.2484

Bergström, A., Dimopoulou, M. and Eldh, M. (2016) Reduction of surgical complications in dogs and cats by the use of a surgical safety checklist. Veterinary Surgery, 45 (5), pp. 571-576 https://doi.org/10.1111/vsu.12482

Clapham, L. (2015) Surgical safety: Can a checklist really save lives? Veterinary Nursing Journal, 30 (7), pp. 194-198 https://doi.org/10.1080/17415349.2015.1042415

Johnson, K.A. (2016) Human error and surgical complications. Veterinary and Comparative Orthopaedics and Traumatology, 29 (5), pp. V-V  https://dx.doi.org/10.3415/VCOT-16-08-0125 

Oxtoby, C. and Mossop, L. (2016) Checklists and clinical governance: Learning from the NHS. In Practice, 38 (8), pp. 408-410 https://dx.doi.org/10.1136/inp.i4561

Oxtoby, C. and Mossop, L. (2016) Implementing checklists in practice. In Practice, 38 (9), pp. 463-464 https://dx.doi.org/10.1136/inp.i4700