Thesis:

Determinants of the World Health Organization Surgical Safety Checklist Use among Clinicians at Kenyatta National Hospital Nairobi, Kenya

The World Health Organization (WHO) Surgical Safety Checklist (SSC) aids in minimizing harm and lessens adverse surgical complications to the patients by introducing necessary repetitive surgical safety checks thereby reinforcing good surgical practices. Kenyatta National Hospital (KNH) adopted and localized this checklist in its medical record files in the operating rooms around 2012; however, limited studies had been done to assess its use by the clinicians. The primary aim of the research was to ascertain the utilization of the World Health Organization Surgical Safety Checklist (WHO SSC) among medical practitioners at Kenyatta National Hospital in Nairobi, Kenya. The primary aims were to assess the extent of utilization of the WHO SSC among healthcare providers at KNH in Nairobi, Kenya, and to evaluate both clinician-related and institutional-related factors that affect its usage at the same facility. To accomplish this, a cross-sectional study was conducted within the operating rooms of KNH. Through a multi-stage sampling technique, a total of 178 actively practicing healthcare professionals who utilize the SSC were recruited, excluding those on leave. The sample size was determined using Yamane's formula. Data was collected through self-administered questionnaires, and observations were made on 42 procedures performed by various clinicians, resulting in a total of 178 participants. The frequencies and percentages were employed to summarize the descriptive data, while Pearson's Chi-square and Fisher's exact tests were applied to analyze categorical data and investigate the association between practices and variables. IBM SPSS version 20 was utilized to conduct both descriptive and inferential statistical analyses. A substantial majority (98%) of the participants exhibited knowledge about the SSC, and 95% reported utilizing it on the day of the interview. Approximately 52% of the respondents possessed more than 10 years of clinical experience, while 46% had over a decade of experience in the operating theater. Nearly 95% of the participants indicated the availability and utilization of the SSC, and 99% confirmed its mandatory implementation in the operating theaters. The training rate for clinicians on the use of the SSC was 62%, while the rate of sensitization was reported at 70%.Out of 42 surgeries observed in the operating rooms, there were lower levels on use of SSC. The clinicians gave a lot of importance to confirming sterility, followed by confirmation of completion count of surgical instruments, sponges and needles at 83.7% and 82.5% respectively. The studied respondents at KNH were using and aware of SSC as recommended. Improvement for the least important surgical practices and gaps noted will better surgical safety practices in the operating rooms in this institution.