Pasientsikkerhet og barrierer for bruk av WHOs sjekkliste ved et norsk universitetssykehus

In 2016, at least one patient injury resulted in the need for measures, extended hospitalization or more serious consequences for the patient at 14% of all patient stays at hospitals in Norway. The risk of injury is greatest in the operating room with a total of 41% of all unfortunate medical events occurring. The patient safety program “in safe hands 24-7” has promoted the need to implement and use the WHO’s checklist in all relevant surgical operations in the country. The main purpose of the checklist is to standardize surgical procedures and promote communication and collaboration in the operation teams. The purpose of this study was to investigate factors that could affect the level of checklist compliance in surgical operations. A random sample of 19,397 registered operations at Haukeland University Hospital from January 1 to December 31 2017 were analyzed using logistic regression analyzes. This study had four outcomes: use of the entire checklist, part 1, part 2 and part 3. Predictors were operating time, surgery day, calendar day, work shift, operation type, comorbidity level, operation duration and section. The results of this quality improvement study showed that compliance at the hospital was below the requirement of Helse Bergen at 90%, and work shift at night and in weekends, emergency operations, high level of comorbidity and short operation duration were factors that could prevent the use of checklists. The study also found differences in compliance between the different sections, where some sections used the checklist to a much lesser extent compared to other sections. This implies that the hospital should focus on the identified barriers and work actively towards raising compliance levels in further quality improvement work