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Safe surgery checklist: Barriers and facilitators for its implementation
Vander Trindade Pereira1, Simone Seixas da Cruz2, Isaac Suzart Gomes-Filho3
1University of the Federal District, Brasília, Brazil.
Implementing the Surgical Safety Checklist improves patient safety, but institutional barriers, team resistance, and workload pressures hinder its full adoption. Understanding these challenges is key to enhancing surgical care.
Area of Science:
- Healthcare Management
- Patient Safety Research
- Surgical Quality Improvement
Background:
- The Surgical Safety Checklist is a critical tool for enhancing patient safety in operating rooms.
- Implementation challenges can limit the effectiveness of this vital safety measure.
Purpose of the Study:
- To systematically review and identify barriers and facilitators affecting the implementation of the Surgical Safety Checklist.
- To synthesize evidence on professional perceptions and adherence rates.
Main Methods:
- A comprehensive systematic search was performed across major databases (PubMed, VHL, Embase, Scopus, Web of Science).
- Keywords included 'Communication Barriers', 'Patient Safety', 'Checklist', and 'Surgical Procedures'.
- Proportion meta-analyses were used to estimate prevalence, with data extraction on study characteristics, barriers, and facilitators.
Main Results:
- Forty-three studies were included in the meta-analysis.
- Significant barriers included 22% viewing the checklist as a waste of time, 44% experiencing resistance or disbelief, and 14% perceiving it as redundant.
- Substantial heterogeneity was observed across all outcomes.
Conclusions:
- Despite its proven benefits for patient safety, the Surgical Safety Checklist faces significant implementation hurdles.
- Institutional barriers, team resistance, and workload pressures are primary factors limiting adherence.
- Addressing these barriers is crucial for maximizing the impact of the checklist on surgical outcomes.
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