KNOWLEDGE, ATTITUDE AND UTILIZATION OF THE WHO SURGICAL SAFETY CHECKLIST AND FACTORS ASSOCIATED WITH UTILIZATION AMONG SURGICAL HEALTH PROFESSIONALS TEAM IN TWO PUBLIC HOSPITALS OF HARAR, EASTERN ETHIOPIA.

Abstract

Background: The World Health Organization Surgical Safety Checklist is an evidence based instrument designed to decrease surgical errors and enhance patient outcomes. Despite its proven value, its use remains inconsistent in many settings, including low resource hospitals. Limited evidence exists on the knowledge, attitude, and utilization of the checklist among surgical teams in public hospitals of Harar, Eastern Ethiopia. Objective: To assess the knowledge, attitude, and utilization of the WHO Surgical Safety Checklist and identify associated factors among surgical health professionals working in public hospitals of Harar, Eastern Ethiopia. Methods: An instutution based cross sectional study was conducted among 170 surgical health professionals selected using simple random sampling. Knowledge, attitude, and practice levels were described using frequency and percentage. Multivariable logistic regression was used to identify independent predictors of consistent checklist utilization. Adjusted odds ratios with 95 percent confidence intervals were reported, and statistical significance was declared at p < 0.05. Results: Most participants demonstrated strong knowledge 78% (CI:0.71-0.83) of the checklist’s key components, and the majority held a positive attitude 65% (CI:0.57-0.72) toward its usefulness and relevance to patient safety. However, utilization was lower 47% (CI:0.4-0.55), particularly for steps such as team introductions and postoperative planning. Nurses were more likely to use the checklist consistently than physicians (AOR 4.38, 95% CI 1.90 to 10.09). Staff working in OBGYN or orthopedic units had lower odds of consistent use compared with those in general surgery (AOR 0.48, 95% CI 0.24 to 0.96). Conclusion: Although surgical staff demonstrated high knowledge and favorable attitudes toward the WHO Surgical Safety Checklist, actual adherence to checklist steps was inconsistent. Profession and working unit were key determinants of checklist utilization. Targeted interventions focusing on training, surgical team engagement, and unit specific implementation strategies may improve consistent use of the checklist.