Surgical safety practices in Pakistan.

Area of Science:

• Healthcare Quality and Safety
• Surgical Patient Care
• Hospital Management

Background:

• The World Health Organisation (WHO) Surgical Safety Checklist is a vital tool for improving patient safety in operating rooms.
• Current adherence to its elements in tertiary care hospitals in Karachi remains unevaluated.
• Establishing a baseline is crucial for targeted implementation strategies.

Purpose of the Study:

• To assess the current implementation status of individual components of the WHO Surgical Safety Checklist in Karachi's tertiary care hospitals.
• To establish a pre-implementation baseline of surgical safety practices.
• To inform a strategic plan for the effective adoption of the checklist.

Main Methods:

• A qualitative knowledge-attitude-practice (KAP) survey was conducted between May 2009 and January 2010.
• 103 surgeries were observed across 10 tertiary care hospitals in Karachi using simple stratified sampling.
• Data analysis involved SPSS version 12 with appropriate statistical tests.

Main Results:

• Patient identification, surgical site, and procedure confirmation were lacking in 13.4% of observed surgeries.
• A 'timeout' procedure was absent in 88.5% of cases.
• Anesthesia allergy checks (53.8%) and antibiotic prophylaxis (37.5%) were frequently omitted, and instrument counts were incorrect in 21.2% of cases.

Conclusions:

• Surgical patient safety in the reviewed hospitals is suboptimal, highlighting significant risks.
• The introduction and consistent use of a surgical safety checklist are essential.
• Adherence to a safety checklist promises a substantial decrease in surgical mortality and morbidity rates.