Publication: Utilization and Completeness of World Health Organization Surgical Safety Checklist in a Tertiary Hospital in Nepal
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Date
2025
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
The World Health Organization Surgical Safety Checklist (WHO-SSC) reduces surgical
complications and morbidity; however, its utilization remains low in low- and middle-
income countries.
Objective
To assess the utilization and completeness of a modified WHO Surgical Safety
Checklist at a tertiary hospital in Nepal.
Method
A descriptive, observational cross-sectional study was conducted in 300 surgeries
at Kathmandu Medical College Teaching Hospital (February to May 2024) following
ethical clearance. Utilization and completeness of the modified WHO Surgical Safety
Checklist (Pre-procedure check, Sign-in, Time-out, Sign-out) were observed passively.
Data were analyzed using Microsoft Excel and SPSS v 20. Data were presented in
numbers and percentages and Chi-square/ Fisher’s exact test used for categorical
variables. A p-value of < 0.05 was considered significant.
Result
WHO Surgical Safety Checklist was utilized in 48.7% of cases, with full compliance
in only 8.7%. Utilization rate was seen to be 63% in the Pre-procedure check, while
Sign-out was the least performed (29.3%). Highest utilization was seen in the General
Surgery department, while the highest completion rate was seen in Neurosurgery
(100%). Verbal confirmation (70.2%) was done more than written documentation.
Conclusion
Despite proven benefits, adherence to WHO Surgical Safety Checklist remains
suboptimal. Targeted training and regular audits are essential to improve compliance
and patient safety in resource-limited settings.
KEY WORDS
Completeness, Compliance, Utilization, WHO surgical safety checklist
Description
Shrestha U,1 Ghimire P,1 Khatri G2
1Department of Anaesthesiology and Perioperative Critical Care
2Nursing Staff
Kathmandu Medical College Teaching Hospital
Sinamangal, Kathmandu, Nepal
Keywords
Completeness, Compliance, Utilization, WHO surgical safety checklist