Safe Surgery Checklist for robotic surgery: implementation of best practices

To implement and evaluate the effectiveness of a safe surgery checklist for robotic surgery, based on best available evidence.

A quasi-experimental before-and-after study conducted based on the JBI best practice implementation framework. The study was carried out between 2022 and 2024 in a university hospital in the city of Rio de Janeiro, with the participation of nine nurses from the robotic surgery team. Care practices were evaluated by analyzing the medical records of 90 patients who underwent robotic surgery. The study comprised three stages articulated with seven operational phases: context analysis, facilitation of change, and process evaluation. The analysis was guided by 18 criteria derived from the JBI evidence summary and complemented by an integrative review.

In the baseline audit, 17 of the 18 criteria (94.4%) showed noncompliance, including the absence of checks for robotic supplies, materials for surgical conversion, skin assessment at the end of the procedure, and postoperative guidance. After the development and implementation of the specific checklist, combined with training, 16 of the 18 criteria (88.9%) achieved compliance rates equal to or greater than 80% in the follow-up audit. Two criteria dependent on the medical team required additional strategies; in the second audit, communication about critical periods reached 83.3% compliance and time monitoring in procedures lasting three to four hours reached 70.6% among eligible cases.

The implementation of the checklist contributed to improving intraoperative care processes, particularly regarding the prevention of injuries related to surgical positioning and ensuring the availability of materials for surgical conversion, among other measures.