The World Health Organization’s Surgical Safety Checklist: Acceptability among Surgical Personnel in Korle Bu Teaching Hospital in Accra, Ghana.

Abstract

Background: Despite the encouraging outcomes, the use of the WHO SSC is poor, with compliance as low as about 12% in some areas. This study was conducted to investigate the factors that influence acceptability and utilization of the WHO SSC among surgical personnel in Korle-Bu Teaching Hospital (KBTH) in Ghana. Methods: A cross-sectional design that employed quantitative method of data collection was conducted among 186 surgical personnel at the KBTH in Ghana. Data was obtained from May to June 2019 using structured questionnaires. A logistic regression analysis was conducted to assess the association between socio-demographic characteristics, training on SSC, surgical subspecialty and adherence to WHO SSC. Results: Out of the 190 personnel recruited, 186 consented and participated in this study giving a response rate of 97.9%. Participants were made up of 69 (37%) surgeons, 66 (36%) anaesthesiologists and 51 (27%) nurses. This study found a high level of awareness and acceptability of the WHO SSC among theatre staff at the KBTH. Adherence however was low. Only 30.4% of surgical personnel at the KBTH use the SSC all the time. The majority (67.7%) of the surgical personnel had no training on the use of the SSC and the proportion was significantly higher among the Surgeons (81.2%) as compared to the Nurses (51%) and Anesthesiologists (66.7%) (p<0.001). Poor communication between anesthesiologists and surgeons is a barrier to the use of the SSC. The surgical subspecialty of a personnel was significantly associated with their knowledge of the SSC (p=0.002) and whether or not they received training on SSC (p=0.030). The Neurosurgery subspecialty had higher odds of frequent use of the SSC as compared to the General surgery subspecialty (OR, 95% CI; 4.86, 1.57-15.04; p=0.006). Training was also significantly associated with frequent use of the SSC. Conclusion: Despite the high level of awareness and acceptability, there are gaps in knowledge and utilization of the WHO SSC among theatre staff. The outcome of this study will provide baseline empirical evidence to serve as a platform for further studies aimed to improve the adherence of the SSC. This study recommends periodic training for surgical staff to enhance their knowledge and use of the SSC.