Faculty of Health, University of Canberra, Bruce ACT, Australia.
Caring Futures Institute, Flinders University, Australia.
J Adv Nurs. 2024 Feb;80(2):465-483. doi: 10.1111/jan.15841. Epub 2023 Sep 7.
Despite the documented benefits of the World Health Organisation Patient Safety Checklist compliance rates with implementation continue to cause risk to patient safety. This qualitative systematic review aimed to explore the reported factors that impact compliance and implementation processes related to surgical safety checklists in perioperative settings.
A qualitative systematic review.
A systematic review using the Joanna Briggs Institute (JBI) approach to synthesize qualitative studies was conducted and reported according to PRISMA guidelines. Electronic databases were expansively searched using keywords and subject headings. Articles were assessed using a pre-selected eligibility criterion. Data extraction and quality appraisal was undertaken for all included studies and a meta-aggregation performed.
The CINAHL, Medline and Scopus databases were searched in August 2022 and the search was repeated in June 2023.
34 studies were included. Following the synthesis of the findings there were multiple interrelating barriers to checklist compliance that impacted implementation. There were more barriers than enablers reported in existing studies. Enablers included effective leadership, education and training, timely use of audit and feedback, local champions, and the option for local modifications to the surgical checklist. Further research should focus on targeted interventions that improve observed compliance rates to optimize patient safety.
This qualitative systematic review identified multiple key factors that influenced the uptake of the Surgical Safety Checklist in operating theatres.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Surgeon participation, hierarchical culture, complacency, and duplication of existing safety processes were identified which impacted the use and completion of the checklist.
尽管世界卫生组织患者安全检查表的实施已被证明有益，但执行率仍持续对患者安全构成风险。本定性系统评价旨在探讨报告的影响手术安全检查表在围手术期环境中实施相关的合规性和实施过程的因素。
定性系统评价。
使用乔安娜·布里格斯研究所（JBI）方法进行系统评价，按照 PRISMA 指南进行报告。使用关键字和主题词广泛搜索电子数据库。使用预先选定的合格标准评估文章。对所有纳入的研究进行数据提取和质量评估，并进行荟萃综合。
2022 年 8 月在 CINAHL、Medline 和 Scopus 数据库中进行了搜索，并于 2023 年 6 月再次进行了搜索。
纳入了 34 项研究。在综合研究结果后，发现了多个相互关联的检查表合规障碍，这些障碍影响了实施。现有的研究报告了更多的障碍而不是促进因素。促进因素包括有效的领导、教育和培训、及时使用审核和反馈、当地拥护者以及对手术检查表进行本地修改的选择。进一步的研究应集中于改善观察到的合规率以优化患者安全的针对性干预措施。
本定性系统评价确定了影响手术安全检查表在手术室中采用的多个关键因素。
对专业人员和/或患者护理的影响：确定了外科医生参与、等级文化、自满和现有安全流程的重复等因素，这些因素影响了检查表的使用和完成。
