A systematic review of interventions used to enhance implementation of and compliance with the World Health Organization Surgical Safety Checklist in adult surgery

This systematic review aimed to identify and synthesize the evidence for effectiveness of interventions on compliance of the WHO Surgical Safety Checklist (SSC) in adult surgery. Databases searched included CINAHL, MEDLINE, PsycINFO and Cochrane Central. Our review was limited to 24 peer-reviewed articles with quantitative (N=17), qualitative (N=4) and mixed methods design (N=3) published in English from 2008 to 2020. Intervention models were: 1) Modifying the ways of delivering the SSC; 2) Integrating or tailoring SSC to local contexts or existing practice; 3) Promoting clinician awareness and engagement; 4) Institutional policy management. Despite a lack of common outcome measures, all 17 quantitative studies and three mixed method studies found a significant intervention effect on SSC compliance. A few studies reported insignificant or negative changes in certain aspects with the interventions. Further studies must address compliance measures and outcomes in developing countries.

This is the peer reviewed version of the following article: Liu, L.Q. and Mehigan, S. (2021), A Systematic Review of Interventions Used to Enhance Implementation of and Compliance With the World Health Organization Surgical Safety Checklist in Adult Surgery. AORN J, 114: 159-170., which has been published in final form at https://doi.org/10.1002/aorn.13469 . This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.