EFFECT OF CHECKLIST ON THE OCCURRENCE OF POSTOPERATIVE COMPLICATION ON SURGICAL PATIENT

Background: Surgical safety checklists (SSCs) are designed to improve inter professional communications and ultimately avoiding catastrophic errors that often characterizes the culture of surgical teams. However, data on effect of surgical checklists implementation are scarce in the study area. The purpose of this research project was to directly examine the effect of utilization surgical safety checklist on patient outcomes at University of Gondar Hospital, in Northwest Ethiopia. Material and methods: Institution based cross sectional study was done at Gondar university teaching hospitals from January to May 2013. We reviewed medical records of all consecutive patients admitted to the surgery department (N=403). For those who have clinical symptoms of surgical site infection a laboratory diagnosis were performed to compare occurrences of all postoperative complication among patients with and without utilization of surgical safety checklist. Results: During the study period from 403 patients operated, SSCs were attached for only 158 (39.2%) of the surgical patients. Post-operative complication were observed in 238 (59 %) of the patients and postoperative fever was the major complication accounting for 70 (17.3%) of all the complication. Surgical wound infection and pneumonia accounted for 47(16.6%) and 33(11.7%) respectively. S. aurous was the predominant isolated bacteria accounted for 7(30%), In addition, a statistically non-significant 11.2% decline the rate of surgical wound infection in the checklist group. In a logistic regression model of postoperative fever, the SSCs emerged as a significant independent predictor of this outcome: (OR = 0.49, 95% CI 0.31–0.75, and P value = 0.001). Conclusions and recommendation: patients with checklist have observed significant reductions of post operative complication particularly bacterial infection. It is possible to some extent that the improved usage of check list and preoperative prophylactic antibiotics may be implicated in the reduction of postoperative fever and bacterial infection