Patient safety
and willingness to participate. Nevertheless, it was perhaps surprising to discover that time, and the apparent lack of clinical engagement from surgeons, are still an issue over a decade after the initial launch. The study has also raised questions that will be answered in the second Delphi round.
Conclusion To conclude, there is still much work needed to ensure that the surgical safety checklist is fully accepted and used in the operating theatre. It is not possible to say from only one Delphi study round whether the lack of compliance leads to greater risk of never events occurring. While statistical analysis is important, the study hints that a greater qualitative understanding is needed of the factors that impact upon the persistence of ‘never events’. The paucity of the current literature, examples of never events and the stubbornness of the data to improve, have acted as catalysts for further investigation. The intention is not to single out Trusts for
criticism, based on non-compliance and without greater appreciation of context. Murphy (2016)48 has pointed to poor communication and lack of leadership as being common factors in the causation of procedural mishaps. Rather than criticism, the focus needs to shift from simply understanding adverse events, to the introduction of measures that will prevent their occurrence. The application of LocSSIPs 2 must ensure that the clinical approach to safety is the same, irrespective of the location, time, and resources available. Similarly, Radcliffe (2016)49
affirms that such standards aim to minimise risks of variation in practice. Moreover,
Strongly agree 9.09% Agree 27.27% Somewhat agree 27.27% Neither agree nor disagree 31.82% Disagree 4.55%
Figure 4: Has the introduction of NatSSIPs helped in the delivery of the WHO SSC?
safety standards are aimed at embedding best practice by minimising the risk of variation, maximising consistency, and therefore ensuring harmonisation across organisations. Wali et al ’s (2020)50
paper concludes that
high quality training is integral to ensuring that checklists are mistaken for or treated as a tick-box exercise. Atul Gawande’s (2012) checklist manifesto describes how the surgical safety checklist “provides reminders of only the most critical and important steps; the ones that even the highly skilled professionals using them could miss” (cited in Wali et al, 2020).50
Likewise,
collaborative and interdisciplinary approaches do not always feature in the literature. To conclude, teamworking and team learning are essential to effective implementation. The second and third Delphi study rounds will enhance and add to the current knowledge and
*References for this article are available upon request.
literature and provide an over-arching view of the current practice and what needs to change in order for full compliance with the surgical safety checklist. There is a realisation, that these standards alone cannot prevent ‘never events’ from occurring. However, when combined with staff education, the promotion of teamwork, and human factors training, these measures go some way to ensure that the triad designed to standardise, educate and harmonise is complete.
CSJ
About the author
Mr Nigel D Roberts, MSc, BA (Hons) is a PhD student, head theatre practitioner, at Birmingham Children’s hospital, and a visiting lecturer at Birmingham City University. This paper is part of a literature review undertaken by the lead author towards the award of Doctor of Philosophy (PhD). It takes an exploratory approach to inform a more in-depth doctoral research study intended to improve patient safety in the operating theatre, inform policy making and quality improvement.
30
www.clinicalservicesjournal.com I February 2023
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68
