Implementation of the «Safe Surgery» checklist: perception by patients during Caesarean section operation

Abstract

The effectiveness of the checklist in reducing mortality and major postoperative complications is proven, but its implementation is not easy and requires not so much technical as organizational and cultural changes. In conscious patients undergoing surgery under neuraxial or regional anesthesia, completing the checklist may have psychological or mental consequences (anxiety, fear, etc.), as the procedure involves discussing the risks of complications, anesthetic and surgical tactics. Purpose - to assess the perception and compliance of conscious patients during cesarean section with the procedure of filling out the «Safe Surgery» checklist; to identify possible negative psychological effects of this procedure. Materials and methods. The study included 100 patients after planned or urgent caesarean section (except for 1 category of urgency). The study was conducted on the basis of an anonymous survey (online Google form) of patients in the postoperative period (1-2 hours after surgery). Patients were asked to rate the impact of completing the Safe Surgery Checklist on their comfort and anxiety levels, and whether they believed that routine use of such technologies increased their safety. Results. The results of this study indicate that the majority of patients responded positively to the use of the WHO checklist implemented in the operating room. More than half of the surveyed patients (56%) were worried about a possible error during the preparation or carrying out of the surgical intervention. Almost all patients - 13 (92.9%) who had experienced medical errors before, worried that a medical error during this intervention could harm their health (OR=13; 95% CI: 1.6-103.7; p=0.006). The procedure of filling out the checklist alleviated the feeling of loss in 66% of patients and did not cause discomfort in 96% of respondents. 68% of patients agreed that the procedure of filling out the checklist reduced anxiety. The vast majority of patients (90%) agreed that the procedure of filling out the «Safe Surgery» checklist increases their level of safety in the operating room. 96% of patients believed that the checklist should be used before every surgical intervention and 96% would like it to be used during future surgical interventions. Conclusions. Patients who were conscious during Caesarean section positively perceived the procedure of filling out the «Safe Surgery» checklist and believed that the use of such a checklist increases safety during surgery. Most patients also reported no discomfort and reduced fear and anxiety during the Safe Surgery Checklist procedure. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.