Surgical Procedures and Team Compliance with the Surgical Safety Checklist

Authors

(1) Program Anestesi, Institut Teknologi, Sains, dan Kesehatan RS. DR. Soepraoen Kesdam V/BRW, Malang, Indonesia, ID
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How to Cite

Surgical Procedures and Team Compliance with the Surgical Safety Checklist. (2025). Jurnal Keperawatan Profesional (KEPO), 6(2), 407-416. https://doi.org/10.36590/kepo.v6i2.1590

Abstract

Patient safety is a critical component of surgical procedures, with the Surgical Safety Checklist (SSC) playing a key role in minimizing medical errors. However, its implementation in healthcare settings continues to face challenges in medical team compliance. This study aimed to examine the relationship between the type of surgical procedure and the level of compliance of medical teams in implementing SSC. An analytic survey with a cross-sectional approach was conducted at a maternal and child specialty hospital in urban Yogyakarta. Data were collected through observation of 65 surgical procedures using a checklist based on the three SSC phases (sign-in, time-out, sign-out), and analyzed using the chi-square test. Results showed elective surgeries were more dominant (55,4%), with the majority of patients undergoing cesarean section (84,6%). A significant association was found between surgery type and compliance during the time-out (p-value = 0,004) and sign-out (p-value = 0,011) phases, but not during the sign-in phase (p-value = 0,195). Overall, only 27,7% of surgeries were performed with full SSC compliance. These findings indicate that surgical procedure type significantly influences SSC compliance, particularly in the time-out and sign-out phases, and underline the need for targeted system strengthening through structured training, standardized workflow integration, and continuous compliance monitoring to improve patient safety outcomes.

References

Amrita, A., Kumari, J., Sinha, A., Singh, A., Goel, N., Poonam, P., Hussain, M., 2024. Role of The WHO Surgical Safety Checklist in Reducing Morbidity and Mortality Among Obstetrics and Gynecology Patients Undergoing Surgery: A Prospective Comparative Study. Cureus 16(5), 1-12. Https://Doi.Org/10.7759/Cureus.60775

Dhamanti, I., Leggat, S., Barraclough, S., Liao, H., Bakar, N.A., 2021. Comparison of Patient Safety Incident Reporting Systems in Taiwan, Malaysia, and Indonesia. Journal of Patient Safety 17(4), 299-305. https://doi.org/10.1097/pts.0000000000000622

Dirie, N.I., Elmi, A.H., Ahmed, A.M., Ahmed, M.M., Omar, M.A., Hassan, M.M., Abdi, A.O., 2024. Implementation of The WHO Surgical Safety Checklist in Resource-Limited Somalia: A New Standard in Surgical Safety. Patient Safety in Surgery 18(30), 1-11. Https://Doi.Org/10.1186/S13037-024-00410-2

Girma, T., Mude, L.G., Bekele, A., 2022. Utilization and Completeness of Surgical Safety Checklist with Associated Factors in Surgical Units of Jimma University Medical Center, Ethiopia. International Journal of General Medicine 15, 7781–7788. Https://Doi.Org/10.2147/Ijgm.S378260

Gul, F., Nazir, M., Abbas, K., Khan, A.A., Malick, D.S., Khan, H., Kazmi, S.N.H., Naseem, A.O., 2022. Surgical Safety Checklist Compliance: The Clinical Audit. Annals of Medicine and Surgery 81, 1-4. Https://Doi.Org/10.1016/J.Amsu.2022.104397

Habtie, T.E., Feleke, S.F., Terefe, A.B., Adisu, M.A., 2025. Beyond Compliance: Examining The Completeness and Determinants of WHO Surgical Safety Checklist - A Systematic Review and Meta-Analysis. BMC Health Services Research 25(504), 1-12. Https://Doi.Org/10.1186/S12913-025-12569-0

Levy, B., Wilt, W., Lantz, S., Ballert, E., Harris, A., 2023. Standardization and Visualization of The Surgical Time-Out. Journal of Patient Safety 19(7), 453-459. Https://Doi.Org/10.1097/Pts.0000000000001156

Lim, P.J.H., Chen, L., Siow, S., Lim, S.H., 2023. Facilitators and Barriers to The Implementation of Surgical Safety Checklist: An Integrative Review. International Journal for Quality in Health Care 35(4), 1-19. Https://Doi.Org/10.1093/Intqhc/Mzad086

Munthali, J., Pittalis, C., Bijlmakers, L., Kachimba, J., Cheelo, M., Brugha, R., Gajewski, J., 2022. Barriers and Enablers to Utilisation of The WHO Surgical Safety Checklist at The University Teaching Hospital in Lusaka, Zambia: A Qualitative Study. BMC Health Service Research 22(894), 1–9. Https://Doi.Org/10.1186/S12913-022-08257-Y

Pertiwi, R.A., Sjaaf, A.C., Andriani, H., Oktamianti, P., 2024. Peningkatan Pelaporan Insiden Keselamatan Pasien dengan Digitalisasi di Rumah Sakit Pemerintah di Jakarta. Jurnal Ilmiah Indonesia 9(9), 1-9. Https://Doi.Org/10.36418/Syntax-Literate.V9i9.16455

Pratiwi, R.M., Dhamanti, I., 2025. Analysis of Factors Influencing Near Miss Events in Hospitals in Indonesia : Literature Review. Jurnal Kesehatan Komunitas 11(1), 22–32. https://jurnal.htp.ac.id/index.php/keskom/article/view/2074

Qaiser, S., Noman, M., Khan, M.S., Ahmed, U.W., Arif, A., 2024. The Role of WHO Surgical Checklists in Reducing Postoperative Adverse Outcomes: A Systematic Review. Cureus Journal of Medical Science 16(10, 1-9. Https://Doi.Org/10.7759/Cureus.70923

Sibhatu, M.K., Taye, D.B., Gebreegziabher, S.B., Mesfin, E., Bashir, H.M., Varallo, J., 2022. Compliance with The World Health Organization’s Surgical Safety Checklist and Related Postoperative Outcomes: A Nationwide Survey Among 172 Health Facilities in Ethiopia. Patient Safety in Surgery 16(20), 1–7. Https://Doi.Org/10.1186/S13037-022-00329-6

Sima, N., Scribante, J., Perrie, H., Thompson, L., 2024. Perceptions of The Perioperative Team Regarding The Use of The WHO Surgical Safety Checklist. Southern African Journal of Anaesthesia and Analgesia 30(1), 13–19. Https://Doi.Org/10.36303/Sajaa.3036

Tartaglia, A., Matos, M.A.A., 2022. Surgical Safety Checklist: Fact or Fake? Einstein Journal 6(20), 1–2. https://pmc.ncbi.nlm.nih.gov/articles/PMC9469871/

Toru, H.K., Aman, Z., Khan, H., Kundi, W., Khan, M.A., Ali, F., Khan, S., Zahid, M.J., Jan, Z.U., 2023. Compliance with The World Health Organization Surgical Safety Checklist at A Tertiary Care Hospital: A Closed Loop Audit Study. Cureus Journal of Medical Science 15(5), 1-12. Https://Doi.Org/10.7759/Cureus.39808

Wyss, M., Kolbe, M., Grande, B., 2023. Make A Difference: Implementation, Quality and Effectiveness of The WHO Surgical Safety Checklist A Narrative Review. Journal of Thoracic Disease 15(10), 5723–5735. Https://Doi.Org/10.21037/Jtd-22-1807

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