Knowledge and Utilization of the WHO Surgical Safety Checklist among Perioperative Nurses in Two Nigerian Teaching Hospitals: A Comparative Cross-Sectional Study

Abstract

Background and Objective: The World Health Organization Surgical Safety Checklist (WHO SSC) reduces preventable perioperative harm when implemented with fidelity, yet knowledge may not translate into consistent use. This study compared knowledge and utilisation of the WHO SSC among perioperative nurses in two Nigerian teaching hospitals. Materials and Methods: A comparative cross-sectional study included 56 perioperative nurses from two Nigerian teaching hospitals. A structured questionnaire assessed knowledge and self-reported utilisation, while a WHO-adapted checklist assessed observed practice. Descriptive statistics and independent-samples t tests were used; p<0.05 was considered significant. Results: No participant had poor knowledge. Mean knowledge was higher at Hospital A than Hospital B (13.44±1.67 vs 12.43±1.26; mean difference 1.01, 95% CI 0.19-1.83; p=0.01; Hedges g=0.72). Good self-reported utilisation was 75.0% and 85.0%, respectively, but mean utilisation scores did not differ significantly (23.88±4.86 vs 25.18±2.18; p=0.31). No checklist event was observed at Hospital A during the observation period. Among 17 Hospital B procedures, utilisation was poor in 17.6%, moderate in 70.6%, and good in 11.8%. Frequently omitted activities included major blood-loss planning, specimen-label read-back, equipment-problem discussion, and recovery planning. Conclusions: Knowledge and reported utilisation were generally favourable, but observed practice showed incomplete implementation and a substantial knowledge-practice gap. Hospitals should integrate checklist execution into mandatory workflow, designate coordinators, and use direct observation, audit, and feedback to monitor fidelity.