gms | German Medical Science

Objective: The World Health Organization (WHO) „Surgical Safety Checklist“ (SSC) is recommended for operating theatres since 2009 in order to improve communication and therefore reducing mistakes. The checklist contains simple-to-answer details of the patient and operating team identity, basic surgical and medical issues. It contains three sections: (1) “Sign” in to be completed when the patient arrives in the anesthetic bay, (2) “Time out” when the surgical procedure in going to be started and (3) “Sign Out” when the procedure has been finished (OR). The aim of this study was to evaluate the consequences of SSC implementation into the neurosurgical OR.

Method: Neurosurgical and anesthesiological staff (doctors and nurses) answered a standardized Safety Assessment Questionnaire (SAQ) 2 weeks before (n=34) and two months after (n=21) the introduction of the WHO SSC into the OR. Furthermore, the introduction was supervised, the observations were documented.

Results: „Sign in“ was completed in 76% of cases, „time out“ was completed in 93% and “Sign Out“ was completed in 67% of cases. 96% (22/23) of the staff found the list easy to use and 74% (17/23) found the additional time needed appropriately short. 56% of the staff (13/23) confirmed that communication was improved due to the use of the SSC. 87% of the staff (20/23) confirmed that SSC helped to reduce mistakes. 91% of the staff (21/23) would prefer usage of the SSC in case of surgical interventions on themselves. The mean SAQ Score was 1,29 (± 0,38) before and 1,16 (± 0,45) after implementation. This difference was not statistically significant.

Conclusions: The overall acceptance of the SSC in the neurosurgical OR was good. According to OR staff personal impressions evaluated by the SAQ the list helps to improve communication and reduce mistakes. Limited statistical evaluation revealed no significant differences. We found it helpful to modify the safety list according to our special requirements in neurosurgery.