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CompletedNCT04965285Updated Oct 31, 2023

Operating Room WHO Surgical Safety Checklist Process Completion: an Observational Study

An observational study in Safety Issues and Patient Acceptance of Health Care, sponsored by Nepal Mediciti Hospital. Completed at 1 site in Nepal. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-10-31.

Sponsored by Nepal Mediciti Hospital · Observational

Study type
Observational
Model
Case-control
Time perspective
Prospective
Enrollment
322
Ages
18 Years and older
Sex
All
01

Study summary

The WHO Surgical Safety Checklist is a simple tool designed to improve the safety of surgical procedures by bringing together the whole operating team (surgeons, anaesthesia providers and nurses) to perform key safety checks during vital phases of perioperative care: prior to the induction of anesthesia, prior to skin incision and before the team leaves the operating room.

In 2007, WHO Patient Safety launched the Second Global Patient Safety Challenge, Safe Surgery Saves Lives.Anaesthetists, operating theatre nurses, surgeons, safety experts, patients and other professionals came together and came up with the WHO Surgical Safety Checklist. The 19 items of the surgical checklist have shown to improve on mortality and morbidity.

Surgical time out is carried out before the start of any surgical procedures to reduce the occurrence of wrong-site, wrong-procedure, and wrong-person surgery where the patient's identity, the procedure, and the surgical site before surgical incision or the start of the procedure is verified. This also helps to raise any concern regarding the procedural risk and any concerns, prevent medical errors, patient morbidity, patient mortality, and reduce surgical complication rates.

The Checklist is intended as a tool for use by clinicians interested in improving the safety of their operations and reducing unnecessary surgical deaths and complications and also help ensure that teams consistently follow a few critical safety steps and thereby minimize the most common and avoidable risks endangering the lives and wellbeing of surgical patients .

The aim of this Checklist is to reinforce accepted safety practices and foster better communication and teamwork between clinical disciplines.

Read the detailed description

Definition of terms A time-out is defined as "an immediate pause by the entire surgical team to confirm the correct patient, procedure, and site," for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery for all accredited hospitals, ambulatory care centers, and office-based surgery facilities Elements that are clearly verbalized by the member of the operating room team performing the time-out were considered compliant Distraction is defined as any involvement in an activity concerning a non-life-threatening issue by any operating room team member, including conversations unrelated to the time-out, loud music playing, unexpected entrances, and personnel engaged in other tasks, among others.

The Checklist divides the operation into three phases, each corresponding to a specific time period in the normal flow of a procedure-the period before induction of anaesthesia, the period after induction and before surgical incision, and the period during or immediately after wound closure but before removing the patient from the operating room.

For each time-out procedure observed, the investigators will record compliance for each element of the time-out. Elements that are clearly verbalized by the member of the operating room team performing the time-out were considered compliant.

As each step of the time-out is verbalized by a team member, the operating room team members are expected to respond. The observations will be conducted by trained study staff using a standardized Checklist/ Proforma to assess surgical team compliance with the time-out protocol and to record general observations of the operating room environment. Any non-routine events that occurred during the time-out process will be recorded.

In each phase, the Checklist coordinator must be permitted to confirm that the team has completed its tasks before it proceeds onward.

Anticipated and actual blood loss, anticipated and actual surgical duration will also be noted

02

Conditions studied

  • Safety Issues
  • Patient Acceptance of Health Care

Keywords

  • Time Out, Healthcare
03

In context

Patient Acceptance of Health Care

308 studies on the registry are indexed under Patient Acceptance of Health Care; 53 are open to participants now.

This study's enrollment of 322 is below the median of 583 across 80 observational studies indexed under Patient Acceptance of Health Care.

Browse Patient Acceptance of Health Care studies →

Lead sponsor

Nepal Mediciti Hospital is the lead sponsor of 6 studies on the registry; 2 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

all surgical cases for elective surgeries, aged 18 and above, will be included on this study

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age above 18 years surgical patients undergoing surgery at Nepal Mediciti Hospital

Exclusion criteria

Exclusion Criteria:

  • Emergency surgical cases, patients not being able to participate verbally
05

Study design

Observational model
Case-control
Time perspective
Prospective
Enrollment
322 participants (actual)
Target follow-up
1 Day
Patient registry
Yes

Interventions

  • Behavioralquality assesment

    For each time-out procedure observed, the investigators will record compliance for each element of the time-out. Elements that are clearly verbalized by the member of the operating room team performing the time-out were considered compliant. As each step of the time-out is verbalized by a team member, the operating room team members are expected to respond. The observations will be conducted by trained study staff using a standardized Checklist/ Proforma to assess surgical team compliance with the time-out protocol and to record general observations of the operating room environment. Any non-routine events that occurred during the time-out process will be recorded. In each phase, the Checklist coordinator must be permitted to confirm that the team has completed its tasks before it proceeds onward.

06

What researchers measure

Primary outcomes

  1. Quality of execution of the WHO surgical safety checklist in routine clinical practice

    to evaluate for quality of execution of WHO surgical safety checklist during routine practice before every surgical procedures in our institute.

    Time frame: 1 day

Secondary outcomes

  1. To evaluate for any distractions and interruptions, deviations from protocol, and the problem-solving strategies used by operating room team members to mitigate the non routine events

    to check for any factors that distracts or disturbs during conductance of WHO surgical checklist. to evaluate if there has been any deviation from protocol to check for any non routine events and any measures taken to overcome them

    Time frame: 1 day

07

Study locations

1 site
  • Nepal mediciti Hospital
    Kathmandu, Bagmati 44600, Nepal
08

References and documents

Individual participant data

Plan to share: Yes — research data will be made available if requested or contacted via Email services

Supporting information: Study protocol, Statistical analysis plan, Informed consent form, Clinical study report

Time frame: Actual Study Start Date: May 2021 Estimated Primary Completion Date: January 2022 Estimated Study Completion Date: February 2022

Access criteria: On contact via Email services, description will be made available

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Oct 31, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04965285
Lead sponsor
Nepal Mediciti Hospital
Responsible party
Bikash Khadka (Principal Investigator, Nepal Mediciti Hospital) — Principal investigator
First posted
Jul 16, 2021
Start date
Aug 1, 2021
Primary completion
Oct 1, 2023
Completion
Oct 28, 2023
Last update
Oct 31, 2023

Study contacts

bikash khadka, MD
principal investigator · Nepal Mediciti Hospital

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Oct 2023. You cannot join it, but the record below documents what was studied.

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