1. WHO Surgical Safety Checklist
Mr Peter O’Leary
14/01/09

2. Introduction
WHO Surgical Safety Guidelines was established by the World Alliance for patient safety to reduce the number of surgical deaths worldwide
The aim of this initiative was to harness political commitment and clinical will to address important safety issues including
Inadequate anaesthetic practices
Avoidable surgical infection
Poor communication between team members
To assist operating teams to reduce the number of these events, the Alliance identified a set of 19 safety checks that could be performed in any operating theatre

3. Introduction
Operating team is understood to comprise of surgeons, anaesthetics, nurses, technicians and other theatre personnel
The checklist was designed for simplicity and brevity
Each safety check has been included based on clinical evidence or expert opinion
8 pilot sites worldwide

6. How to run One designated person is responsible for checking the boxes
A circulating nurse is suggested but any healthcare professional or clinician
3 phases
Sign in – period before induction
Time out – period after induction and before surgical incision
Sign out – period after wound closure but before removing the patient from the theatre
The checklist co-ordinator should prevent the team from progressing to the next phase of the operation until each step is completed

7. A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population - New England Journal of Medicine Jan ‘09
Prospective study
Between October ’07 and September ’08
Eight centres
Toronto
New Delhi
Amman
Auckland
Manila
Ifkara
London
Seattle
3955 patients enrolled
Primary end point – rate of complications

8. A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population - New England Journal of Medicine Jan ‘09
Results
Rate of death prior to checklist introduction
1.5%
Rate of death after checklist introduction
0.8% (p=0.003)
Inpatient complications prior to checklist introduction
11%
Inpatient complications after checklist introduction
7.0% (p<0.001)

9. A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population - New England Journal of Medicine Jan ‘09
Conclusion
Implementation of the checklist was associated with concomitant reductions in the rates of death and complications among people over the age of sixteen and undergoing non-cardiac surgery

10. Thank you