Compliance with World Health Organization Surgical Safety Checklist: A Clinical Audit

Background: Proper implementation and adherence to the WHO surgical safety checklist are questionable. This audit aims to assess the checklist's completeness and the effectiveness of an educational intervention to improve adherence to it.
Method: A prospective audit in a District General Hospital, Sri Lanka, evaluated the WHO surgical safety checklist's use before and after a staff awareness program. The audit assessed the completeness of the sign-in, time-out, and sign-out sections in three phases. The Wilcoxon sign rank test assessed the significance.
Results: Prior to the intervention, checklists were completed for 21 (22.1%) patients and compliance with 'sign in', 'sign out', and 'time out' on the checklists stood at 49 (51.6%), 34 (35.8%), and 21 (22.1%) respectively. Following the intervention, checklists were completed in 79 (83.2%) and compliance with 'sign in', 'sign out', and 'time out’, reached 84 (88.4%), 80 (84.2%), and 83 (87.4%) respectively. Statistically significant improvements were observed in overall checklist completion. (p<0.001).
Conclusion: Even though the initial compliance with the WHO surgical safety checklist was suboptimal, the implementation of a staff awareness program significantly enhanced compliance rates, thereby reinforcing patient safety protocols within surgical settings.