Adherence to surgical safety checklist and its impact on workload and team attitudes in a Vietnamese hospital

Background: The surgical environment demands meticulous attention to ensure patient safety, and the World Health Organization (WHO) recommends the Surgical Safety Checklist (SSC) as a critical component of risk mitigation and communication among surgical teams. Despite its importance, adherence to the SSC in Vietnam remains inconsistent, highlighting the need for further investigation into the factors influencing compliance and their impact on surgical outcomes. Objectives: This study aimed to (1) evaluate the adherence rates to the SSC, (2) examine causal relationships among workload burden, team attitudes and adherence to the SSC of surgical team members at My Thien hospital in Ho Chi Minh City, Vietnam. Methods: A cross-sectional descriptive study was conducted on 241 surgical team members, Data were collected using a structured questionnaire that included demographic information, the SSC, and the Maslach Burnout Inventory. Adherence rates were calculated, and statistical analyses were performed using Jamovi software to explore correlations and potential predictors of adherence. Results: The overall adherence rates to the SSC was 92.1%, with significant variations observed across different surgical phases. Emotional exhaustion (2.42 ± 0.39)) and depersonalization (2.36 ± 0.38)) scores were low, while personal accomplishment (3.59 ± 0.74)) was high, indicating a manageable workload for the surgical team. The attitudes of the surgical team towards the SSC are largely positive, with high mean scores for its usefulness (4.11 ± 0.52) and effectiveness in preventing mistakes (4.40 ± 0.52). However, concerns about its functionality and potential to cause delays were noted, with lower scores of 2.14 ± 0.45 and 2.59 ± 0.48, respectively. The study found that higher adherence was associated with lower workload burden, while the correlation between attitudes and workload dimensions was negligible. Notably, a significant direct relationship exists between positive attitudes towards the SSC and lower work burnout (estimate of 0.25, p = 0.019), suggesting that fostering positive attitudes may help reduce burnout among surgical team members. Conclusion: The findings underscore the importance of fostering positive attitudes towards the SSC among surgical team members to enhance adherence and improve patient safety. Regular interdisciplinary training and monitoring of workload and burnout levels are recommended to support the surgical team’s well-being and performance. Future research should explore the barriers to effective SSC implementation and the impact of team dynamics on adherence and burnout.