Contextual and interventional factors that affect the implementation of the World Health Organisation surgical safety checklist in the operating theatres of a designated private hospital

Abstract

Introduction: Globally the World Health Organization Surgical Safety Checklist is being used to reduce and prevent adverse events in operating theatres and to increase intraoperative safety for both healthcare practitioners and the patient. Although evidence is available that this checklist can improve team cohesion and patient safety, when used correctly, there are contextual and interventional factors that affect the implementation of this checklist. This study aimed to explore and describe the contextual and interventional factors that affect the implementation of the World Health Organization Surgical Safety Checklist in the operating theatres in the designated hospital, by using the Consolidated Framework for Implementation Research.

Research design and methods: A qualitative approach in an implementation research strategy was deemed relevant for the purpose of this study. The qualitative approach suited the investigation of change, as well as the factors that impacted change. Implementation science assisted in transferring these findings into standard practice in healthcare while improving safety intraoperatively.

A criterion-i purposive sampling method was used as the emphasis was on the similarity of participants. Data collection was conducted through semi-structured interviews. Both inductive and deductive data analysis was used. During the inductive analysis, thematic analysis ensued where transcripts were read and re-read and patterns in the data were identified. These patterns were grouped and used to complement the findings derived from the deductive analysis. In the deductive analysis, priori concepts were used to structure the analysis.

Findings: A deeper understanding of the contextual and interventional factors that affect the use of the World Health Organization Surgical Safety Checklist is provided by the findings. Factors that act as barriers or facilitators to the use of the checklist are crucial to achieving sustainable implementation.