WHO Safety Checklist Introduction In Referral Obstetric Unit: The Way Forward For Quality Improvement

  • Mehwish Khan FCPS Resident Gynecology & Obstetrics, Unit 1, PIMS Hospital, Islamabad
  • Suresh Kumar Assistant Professor, Anesthesia, PIMS Hospital Islamabad
  • Shagufta Yasmin Associate Professor, Gynecology & Obstetrics, PIMS Hospital, Islamabad
  • Syeda Batool Mazhar Professor & Head of Deptt. Gynecology & Obstetrics, PIMS Hospital, Islamabad
Keywords: Anesthesia, Referral Obstetric


Objective: Efficacy of WHO safety checklist in obstetrics in collaboration with anesthesia.
Methodology: The study was conducted to evaluate the implementation of WHO safety checklists in both elective and emergency. Among women undergoing cesarean section either elective or emergency 143 sets of checklists, three per patient were completed in Operation theatre. Obstetrics, anesthesia and nursing professionals completed these checklists. Each checklist was filled at the time of induction of anesthesia (Briefing), before surgical incision (timeout) and before drapes removed (Debriefing). All Proformas were analyzed at the end of the study in regard of filling and attitude of doctors and nurses.
Results: Total number of LSCS conducted during the study period was 1001. Among this 31 % were performed electively and 69% were Emergency LSCS. All three checklists were filled for 143 women undergoing LSCS. In the obstetric checklist, the briefing section was always filled completely. In the timeout section, three questions were about clinical information, critical events and queries were filled in 57% checklists. In the debriefing section, no certain post-operative patient care was mentioned in any checklist. In the anesthesia checklist, briefing and timeout sections were filled properly. While in the debriefing section, specific patient care was filled in 37% checklists. In the nursing checklist, nurses hardly took interest rather the obstetric resident was requested for it. Repeated problems encountered included were the fetal status was not entered, the antibiotic prophylaxis was never given by a nurse and the entry of specimen was irrelevant as no specimen was sent in any case.
Conclusion: The WHO Safety Checklist, if adopted, is a simple tool with better outcome in surgical as well as anesthesia department.

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