Awareness and utilization of the who surgical safety checklist among surgical staff in a Nigerian tertiary hospital

Abstract

Context: The WHO Surgical Safety Checklist (SSC) is a standardized tool to improve patient safety and reduce surgical errors. Despite global adoption, consistent use remains limited in many healthcare systems.

Objective: To assess awareness, knowledge, and utilization of the SSC among surgical staff in a Nigerian tertiary hospital, and to describe perceived barriers to its use.

Methods: A descriptive cross-sectional electronic survey used total enumeration of all 93 members of a departmental theatre-users WhatsApp group at Federal Medical Centre Umuahia; 78 responded (83.9%). A structured questionnaire assessed awareness, training, knowledge of checklist phases, and self-reported use. Frequencies and percentages were calculated; associations with professional cadre were assessed using Fisher–Freeman–Halton exact tests with Monte Carlo estimation.

Results: Awareness was reported by 77 (98.7%), while 33(42.3%) had received formal training and 60 (76.9%) stated that they knew the three checklist phases. Routine use was reported by 42(53.8%), but only 13 (16.7%) reported always using the checklist. Sign-in was most often identified as the consistently applied phase (61; 78.2%), while sign-out was most often identified as skipped (49; 62.8%). Professional cadre was associated with reported knowledge of the phases (exact p < 0.001), but not with routine use (exact p = 0.167); the study was not powered for these comparisons.

Conclusion: Awareness was almost universal, but formal training and consistent checklist use remained limited. The sign-out phase was particularly vulnerable to omission. Multidisciplinary training and periodic assessment of actual checklist completion may improve implementation; these self-reported findings do not establish observed adherence.