Barreiras para adesão ao checklist de cirurgia segura: revisão de escopo

Abstract

Objective: To map, in the literature, the barriers faced by nursing professionals in adhering to the Surgical Safety Checklist developed by the World Health Organization in 2009. Method: This is a scoping review conducted following the methodology of the Joanna Briggs Institute (JBI) and the PRISMA-ScR guidelines. Searches were carried out in PUBMED via MedLine, Latin American and Caribbean Health Sciences Literature (LILACS), Nursing Database (BDENF), Scopus, Embase, Scientific Electronic Library Online (SciELO), Food Science and Technology Abstracts (FSTA – EBSCO), Google Scholar, and Open Access Theses and Dissertations (OATD). Studies addressing the role of the nursing team in activities related to the Surgical Safety Checklist were considered, focusing on surgical wards and operating rooms as settings. Moreover, there were no time frame or language restrictions. The studies were included in Mendeley software and subsequently exported to the Rayyan platform. In the latter, study selection was conducted blindly and independently by two reviewers, with conflicts resolved by a third researcher. Data were extracted in pairs using a specific tool developed for this purpose. Results: A total of 350 articles were identified in the databases and gray literature. After screening and duplicate removal using Mendeley® and Rayyan, 328 articles were assessed. Based on the inclusion criteria, 283 were excluded during the title and abstract screening, leaving 45 for full-text review. Of these, 20 were included, and one additional article was retrieved through reverse search, totaling 21 studies. The publications, dated from 2012 to 2025, are predominantly Brazilian and written in Portuguese (76.19%). The included studies present varied methodological designs, with a predominance of qualitative approaches (47.62%) and were mostly conducted in operating rooms (66.67%). Participants included nursing professionals, multiprofessional teams, and institutional documents. The main barriers to adherence to the Surgical Safety Checklist identified were: lack of knowledge and professional training, ineffective communication between teams, absence of active leadership, work overload, and structural and resource limitations. Conclusion: The identified barriers compromise the quality of care and patient safety. The need for continuous training, multiprofessional engagement, strengthening of communication, leadership designation, and checklist review is highlighted. The adoption of these strategies can enhance the safety culture, reduce errors, and improve the effectiveness of surgical care.