الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 289 |  |  |
| | | from | 289 | | |
Abstract
SUMMARY
The WHO SSC is perioperative communication and safety tool to improve adherence with safety standards so it is a simple, practical tool that any surgical team in the world can use to ensure that the preoperative, intraoperative, and postoperative steps that have been shown to benefit patients are undertaken in a timely and efficient way (Ngonzi et al., 2021). Factors affecting on implementation of surgical safety checklist are work pressure, ineffective communication among surgical team members, wrong surgical site and emergency situations (Mohamed et al., 2022).
This study aimed to:
Identify factors affecting on the implementation of surgical safety checklist in operating room through the following:
• Assess factors affecting on the implementation of surgical safety checklist in operating room.
• Assess the implementation of surgical safety checklist.
Research question:
This study is based on answering the following research question:
- What are the factors affecting on the implementation of surgical safety checklist in operating room?
Research Design:
A descriptive exploratory design utilized to achieve the aim of this study and to answer the research question.
Setting:
This study was conducted in the operating room at Eldemerdash Hospital which affiliated to Ain Shams University, Cairo Governorate, Egypt.
Subjects:
A convenient sample of staff operating room (30 nurses,30 surgeons and 30 anesthesiologists) and accept to participate in the study. And convenient sample of 167 patients who undergoing different type of surgery in the previously mentioned setting.
Tools for data collection:
Data was collected through the following three tools:
Human related factors assessment tools:
Tool (I): Operating staff - related factors assessment tools:
This tool was collected through the following parts:
Part (1): Self–administered operating staff knowledge assessment questionnaire:
It was developed by the investigator based on related literatures review (Haugen et al., 2019; Jones, et al., 2018), it was used to assess operating staff-related factors that will affect on the implementation of surgical safety checklist (SSC) in operating room and validity and reliability were tested. It included three sections as the following:
Section (A): operating staff demographic characteristics: It was used to assess the demographic characteristics of operating staff (nurses, surgeons and anesthesiologists)under study such as age, gender, marital status, level of education, and years of experience and training courses.
Section (B): operating staff level of knowledge regarding surgical safety checklist (SSC): It was used to assess the knowledge of operating staff (nurses, surgeons and anesthesiologists), validity and reliability were tested, this section consist of 20 mcq questions; one question related to definition of SSC, four questions related to indications of SSC, (13) questions related to phases of SSC and two questions related to role of operating staff.
Section (C): staff-related factors assessment tool: It was used to assess opinions of operating staff about staff-related factors that affected on the implementation of surgical safety checklist (SSC) in operating room, this section consist of 6 questions as communication between staff, staff turnover and staff number, increasing workload, lack in training for updating staff and level of education or culture level.
Part (2): operating staff observational checklist:
This tool was adopted from (Safety &WHO, 2009). It was used to assess staff practice regarding implementation of SSC items. It included (sign in that was done by nurses),(time out was done by nurses, surgeons and anesthesiologists) and (sign out was done by nurses, surgeons and anesthesiologists), validity and reliability were tested,it composed of 33 steps.
Tool (II): patients -related factors assessment tool:
It was developed by the investigator based on related literatures review (Schreier & Hayn, 2018; Marshall & Touzell, 2020; Haugen et al., 2019). It was used to assess patients-related factors that affected on the implementation of surgical safety checklist (SSC) in operating room as (type of anesthesia, type of operation, emergency situation, high volume, age of patient and chronic diseases), validity and reliability were tested, it composed of 14 questions.
Non-Human related factors assessment tools:
Tool (III): Environmental related factors assessment tool:
It was developed by the investigator based on related literatures review (Alqattan et al., 2019; Kisacik & Cigerci 2019; Alidina, et al., 2017). It was used to assess the environmental related factors that affected on the implementation of surgical safety checklist (SSC) in operating room as (system design, policies, procedures, noise level and basic equipment and supplies), validity and reliability were tested, it composed of 18 questions.
The present study revealed that:
• About 61.1 % of total operating team had knowledge regarding surgical safety checklist, while 38.9% of total operating team hadn’t have knowledge regarding surgical safety checklist.
• Also 70.0 % of total level of practice of operating team were competent regarding implementation of surgical safety checklist, while 30.0 % of total level of practice of operating team were not competent regarding implementation of surgical safety checklist.
• The study showed that 77.8 % of environmental related factors affected the implementation of surgical safety checklist affect (SSC)
• Illustrated that there were statistically significant relation between total satisfactory level of knowledge and level of education, years’ of experiences and training courses.
• Represented that there were statistically significant relation between total level of practice and level of education, years’ of experiences and training courses.
Conclusion
In the light of the current study findings, it was be concluded that:
Less than two thirds of the operating team had knowledge about surgical safety checklists. Also, more than three quarters of staff related factors opinionnaire sheet agreed that this factors affected on implementation of surgical safety checklist. Also, less than three quarters of the operating team had a competent level of practice. And also, more than three quarters of environmental related factors affected on implementation of surgical safety checklist in operating room. Additionally, there was statistically significant correlation between total knowledge and total staff-related factors, total practice and total patient-related factors.
Recommendations
Based on the current study finding the following recommendations were proposed:
• Hospitals should consider implementing operating room briefings as a strategy to improve operating room efficiency and clinical outcomes in surgical patients.
• Nurses, anesthesiologists and surgeons must be committed to the common goals of patient safety to ensure safe surgery.
• Illustrated manual for the surgical team as a guideline for recent and updates in the surgical safety checklist should be available in the operating rooms.
• Regular scientific meetings for both surgeons, anesthesiologists and nurses who provide direct care for surgical patients must be conducted to discuss patients’ problems and to detect barriers of adherence to the surgical safety checklist.
• The study should apply in other governorate hospitals and non-governorate hospitals to generalize results on large numbers of hospitals to improve patient safety.
• Regular training and education program for the surgical team to improve using surgical safety checklist.