Implementation of the safe surgery checklist of the World Health Organization at the University Hospital of Monastir (Tunisia)

OBJECTIVE: To evaluate the impact of introduction of the WHO safe surgery checklist in the university hospital of Monastir over a period of five months. METHODS: We conducted a longitudinal study (before - after) with evaluation of five result indicators which were: percentage of surgical site infections, not prescribed antibioprophylaxis, unplanned return to the operating room, postoperative length of stay and postoperatively death. RESULTS: We identified 185 patients during the period and 323 patients after the introduction of the WHO checklist. The proportion of surgical site infection decreased significantly from 13.5% in the reference period to 1.3% after the introduction of the checklist (p < 0.001). The proportion of unplanned return to the operative room was 10.3% before the introduction of the checklist and deceased significantly to 1.3% at the intervention period (p = 0.003). The proportion of not prescribed antibioprophylaxis and median post-operative length of stay deceased also significantly during the study period (p < 0.001). CONCLUSION: The surgical checklist control contributes to the development of a safety culture in the operating room. Maintaining its use should be supported by incentives such as certification and accreditation.