Comparing compliance with the WHO surgical safety checklist and complication rates in gynecologic surgery between day and night shifts

Arch Gynecol Obstet. 2022 Oct;306(4):1101-1106. doi: 10.1007/s00404-022-06599-w. Epub 2022 May 27.

Abstract

Purpose: At least half of surgical complications can be avoided by using surgical checklists. However, universal implementation and compliance have been reported as being variable. Patients undergoing urgent surgical intervention are at increased risk for complications. The aim of this study was to evaluate the checklist compliance together with the complication rate during day and night shifts in a European University hospital.

Methods: 51 and 52 consecutive patients who had surgery during day and night shifts were included. The primary outcome measures were compliance and completeness of the WHO safety checklist. The occurrence of postoperative complications was investigated.

Results: The analysis included 103 surgical procedures. The mean compliance rate of use was 93% and the mean completeness rate was 22%. After operations were broken down by day or night shift, we found that checklists were less often available in night shifts compared to day shifts. The completeness of the checklist and the occurrence of postoperative complications did not differ between day and night shifts.

Conclusion: This study reports worse checklists availability in night shifts when compared to day shifts, but complication rates did not increase. Further studies are warranted to investigate postoperative complication rates together with checklist compliance in day versus night shifts.

Keywords: Checklists; Gynecologic operations; Perioperative management; Postoperative complications; Shifts; Working time.

MeSH terms

  • Checklist*
  • Female
  • Gynecologic Surgical Procedures / adverse effects
  • Humans
  • Patient Safety*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • World Health Organization