Department of Surgery, Ahmadu Bello University, Zaria, Kaduna State, Nigeria. E-mail:
Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria.
West Afr J Med. 2023 Jul 28;40(7):678-683.
There is a disparity in the provision of quality and safe surgical care in Nigeria. The capacity to track surgical safety through the use of the surgical safety checklist tool is variable in this setting. This study aimed to assess the outcomes of training on this checklist and the results of its pilot implementation.
SUBJECTS, MATERIALS AND METHODS: A mixed-methods research comprising of quantitative and qualitative study designs was conducted to evaluate these 23 weeks intervention in our centre. Implementation was conducted in two phases: training of the surgical team and pilot testing of the intervention. Using the RE-AIM framework, implementation outcomes evaluated included reach of training, adoption of checklist and implementation challenges, while effectiveness outcomes evaluated included change in the knowledge score after the training and self-reported impact of the training and pilot test. Quantitative and qualitative data were collected and analyzed.
There was a 2.4-point significant increase in the knowledge score after the training. During the pilot testing phase, 843 patients had surgery. The weekly checklist utilization rate for elective surgery rose to 64% at project completion. Despite logistic and manpower-related implementation challenges, the training intervention facilitated the translation of participant knowledge into practice (81.5%) and the pilot phase had a high impact on the practice of checklist use (3.8 ± 0.9).
The quality improvement programme enhanced knowledge of checklist use and led to improved behaviour and positive organizational change. However, barriers need to be addressed to strengthen the sustainable use of the checklist tool.
在尼日利亚，外科护理的质量和安全性存在差异。在这种情况下，通过使用外科安全检查表工具来跟踪手术安全性的能力是不同的。本研究旨在评估该检查表培训的结果及其试点实施的结果。
受试者、材料和方法：采用混合方法研究，包括定量和定性研究设计，评估了该中心的 23 周干预措施。实施分两个阶段进行：对外科团队进行培训和试点测试干预。使用 RE-AIM 框架，评估实施结果包括培训的覆盖面、检查表的采用和实施挑战，评估有效性结果包括培训后的知识得分变化以及培训和试点测试的自我报告影响。收集和分析了定量和定性数据。
培训后知识得分显著提高了 2.4 分。在试点测试阶段，843 名患者接受了手术。项目完成时，择期手术的每周检查表使用率上升至 64%。尽管存在后勤和人力相关的实施挑战，但培训干预措施促进了参与者知识向实践的转化（81.5%），试点阶段对检查表使用的实践产生了重大影响（3.8±0.9）。
质量改进计划提高了检查表使用的知识，导致行为改善和积极的组织变革。然而，需要解决障碍，以加强检查表工具的可持续使用。
