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[Implementation of the safe surgery checklist of the World Health Organization at the University Hospital of Monastir (Tunisia)].

OBJECTIVE
To evaluate the impact of introduction of the WHO safe surgery checklist in the university hospital of Monastir over a period of five months.


METHODS
We conducted a longitudinal study (before - after) with evaluation of five result indicators which were: percentage of surgical site infections, not prescribed antibioprophylaxis, unplanned return to the operating room, postoperative length of stay and postoperatively death.


RESULTS
We identified 185 patients during the period and 323 patients after the introduction of the WHO checklist. The proportion of surgical site infection decreased significantly from 13.5% in the reference period to 1.3% after the introduction of the checklist (p < 0.001). The proportion of unplanned return to the operative room was 10.3% before the introduction of the checklist and deceased significantly to 1.3% at the intervention period (p = 0.003). The proportion of not prescribed antibioprophylaxis and median post-operative length of stay deceased also significantly during the study period (p < 0.001).


CONCLUSION
The surgical checklist control contributes to the development of a safety culture in the operating room. Maintaining its use should be supported by incentives such as certification and accreditation.