Use of the World Health Organization Checklist-Swedish Health Care Professionals' Experience: A Mixed-Method Study

Abstract

Purpose: The purpose was to describe health care professionals' experience of using the World Health Organization (WHO) surgical safety checklist.

Design: A descriptive cross-sectional mixed-method study, including health care professionals from two clinics at the same university hospital in the western part of Sweden was conducted.

Methods: Data were collected from one hundred ninety-six health care professionals using a self-administered questionnaire that contained 12 questions. The Mantel-Haenszel and Pearson χ² tests were used for ordered and unordered categorical variables. The text analysis was inspired by Malterud.

Findings: The most statistically significant difference between the clinics related to the responsibility for administering the checklist (P = .0010) and always using the checklist in all emergency situations (P = .045). Among the health care professionals who were educated and trained in using checklists, 63% and 65.5% stated that the checklist was adapted to the department. Sixty four percent stated that the assistant nurses were responsible for implementing the checklist. The health care professionals also mentioned a large number of positive and negative aspects of using the WHO checklist.

Conclusions: The health care professionals had difficulties using the WHO checklist in the Swedish health care system. More research is needed to determine why specific items are overlooked and whether these items could form the basis of the further elaboration of a modified checklist. An increased understanding of why the checklist is important, as well as updated knowledge on the content could produce greater compliance and thereby increase patient safety.

Keywords: WHO checklist; health care professionals; patient safety; questionnaire; research; surgery.