Perioperative nurses’ engagement with the surgical safety checklist: A focused ethnography

Purpose: To gain greater insight into how nurses engage with the multidisciplinary team during the surgical safety checklist process. Participants and setting: Participants were a purposeful sample of eight operating room nurses. The study was conducted in the operating room department of a major tertiary teaching hospital in South Australia. Methods: Phase 1 employed participant observations while phase 2 employed semi-structured interviews. Findings: Participants supported the use of the surgical safety checklist and valued its role to enhance patient safety. Multidisciplinary team culture played a significant role in how the checklist was conducted and heavily influenced the level of nurse participation in the process. Observations indicated poor compliance with the nursing review section of the checklist. Conclusions: Multidisciplinary team engagement is important for effective communication during the process of utilising the surgical safety checklist to promote safe outcomes for patients. Nurses are more likely to actively participate in the checklist process if they feel their role is valued by other team members. The nurse-specific area of the checklist is an area for improvement as this tends to be overlooked and considered less important than other checklist items. Modifications in timing the checklist and nurse training may be beneficial to address non-compliance with the nurse area of the checklist.