Attitudes to Surgical Checklist Questionnaire

Background:

Surgical checklists have been shown to be effective in reducing mortality rates and improving teamworking when applied in operating theatres. However, despite the benefits of checklist for patient safety, in some cases the practical implementation of the checklist has been found to be less than universal, and to decay over time. Based upon 14 semi-structured interviews, the 27-item questionnaire attitudes to surgical checklist questionnaire were developed. The questionnaire consisted of five subscales: attitudes towards hospital norms on the use of the checklist (five items), the impact of the checklist on safety and teamwork (five items), support of the checklist from specific groups (six items), intent to initiate the checklist (2 items), and barriers to the use of the checklist (five items). Also included were an item asking whether there was a difference between the surgical checklist used at the hospital and the WHO surgical checklist, an open-ended question allowing the respondent to identify additional barriers to the use of the checklist, and two demographic questions.

Psychometrics:

The Cronbach’s alphas for each subscale were: norms (0.70), impact on teamwork and safety (0.84), support (0.73), initiate (0.87), and barriers (0.56).

Author of Tool:

O’Connor, Reddin, O’Sullivan, O’Duffy, & Keogh

Key references:

O’ Connor, P., Reddin, C., O’Sullivan, M., O’Duffy, F. & Keogh, I. (2013). Surgical checklists: the human factor. Patient Safety in Surgery, 7,14. Open access article available for download from: www.pssjournal.com/content/7/1/14/abstract

Primary use / Purpose:

To assess attitudes towards the use of surgical checklists by operating theatre personnel

Attitudes to Surgical Checklist Questionnaire

(Responses range from 1 ‘strongly disagree’ to 5 (strongly agree’)

NormsThere is little difference between the surgical checklist at GUH and the WHO surgical checklist.
The complete checklist is used for every procedure in every theatre at UHG.
The complete checklist is used for every procedure in which I am involved in theatre.
When the checklist is being carried out, everyone in theatre stops what they are doing and listens until it is completed.
Sometimes sections of the checklist are not completed. *
The individual who signs the checklist personally ensures that the relevant steps have been completed.
Impact on teamwork & safetyI believe that failing to use the checklist is poor professional practice.
I believe using the checklist reduces the likelihood of human error.
I believe using the checklist improves patient safety.
I believe using the checklist improves teamwork in theatre.
The use of the checklist should be mandatory for every case.
SupportSurgical personnel support the use of the checklist.
Anaesthetic personnel support the use of the checklist.
Nursing staff support the use of the checklist.
Senior theatre personnel support the use of the checklist.
Junior theatre personnel support the use of the checklist.
Management supports the use of the checklist.
InitiateI have initiated the use of the checklist in the past.
I intend to initiate the use of the checklist in the future.
BarriersThe requirement for signatures.
Lack of assertiveness of staff.
Lack of time.
Lack of training.
The lack of an electronic version of the checklist.