Staffs’ perception of the checklist and patient safety | Concerns about legal implications | Nurses were therefore concerned about the legal implications of signing the checklist as they might be held accountable for errors.68 |
| Concerns about patient perception | For example, some stated that patients often did not understand why they had to confirm their ID/procedure, etc., so many times during their surgical pathway, and others felt that specific questions around blood loss and difficult airway (part of the sign-in checks) would anxiety provoking for certain patients (this was a particular concern if the patient was undergoing a local anaesthetic procedure and therefore witnessed all of the checks).76 |
| Concerns about time consumption and efficiency | …respondents had significant concern about its perceived effect on OR efficiency.70 |
| Perceived importance | Confirming the team members by name and role was the most missed check. The explanation given for this was that a lack of staff turnover and degree of familiarity with each other made this check appear less important.73 |
| Scepticism regarding the evidence base | Scepticism regarding the evidence base: The evidence base behind the checklist is weak and/or not applicable to the current context.76 |
Workflow adjustments | Individual workflow adjustments | Two participants expressed concern about the interruption in workflow that was sometimes required to complete the checklist discussion.61 |
| Aligning the workflow of team members | These asynchronous workflows impacted on a healthcare professional's ability to halt their work and collaboratively meet to communicate at a time-out procedure: Time out was about to commence and the nurse initiating it asked the anaesthetist “Are you joining us?” The anaesthetist replies, “No, we have things to do”. [Obs_circnurs_125]25 |