Experience Summary

In this experience, observe the World Health Organization (WHO) Surgical Safety Checklist being performed for a patient undergoing caesarean section

Clinical Context

Caesarean section is one of the most commonly performed major surgical procedures worldwide and carries inherent risks associated with both obstetric and surgical practice. The clinical environment in which sections take place is often complex, involving multidisciplinary teams that include obstetricians, anaesthetists, midwives, operating department practitioners, neonatologists, and theatre nurses. This environment is further complicated by the fact that many caesarean deliveries occur under time-critical conditions, particularly in emergency cases where maternal or fetal wellbeing may be compromised. Such pressures increase the potential for human error, communication failures, and system lapses that can adversely affect clinical outcomes. Within this context, the use of a standardised theatre safety checklist has emerged as an essential component of safe peripartum care.

The theatre safety checklist—adapted from the WHO’s Surgical Safety Checklist and modified for maternity settings—serves as a structured communication tool designed to ensure that critical safety steps are consistently performed at key phases of the operative process. In caesarean sections, these phases typically include the “sign in” before anaesthesia, the “time-out” before skin incision, and the “sign-out” after the procedure is completed. Each stage promotes deliberate team communication, verification of essential information, and anticipation of potential complications.

The importance of the checklist lies in its ability to reduce preventable harm. By confirming patient identity, surgical indication, consent, allergies, and anaesthetic considerations, the checklist mitigates clinical risks that may otherwise be overlooked during busy or stressful periods. In obstetric surgery, where haemorrhage, anaesthetic complications, and fetal compromise can rapidly escalate, structured team briefings improve situational awareness and readiness for emergencies such as postpartum haemorrhage or difficult neonatal resuscitation. The checklist also ensures availability of necessary equipment, blood products, and neonatal support, all of which are crucial in optimising maternal-fetal outcomes.

Beyond its direct safety role, the checklist fosters a culture of teamwork, accountability, and open communication. Evidence has shown that consistent checklist use enhances team cohesion and reduces variability in practice. Given the emotional and clinical stakes inherent in caesarean delivery, such improvements contribute to safer, more reliable care.

Learning Outcomes

1. Observe the WHO checklist being used in practice.
2. Increase understanding of the components of the WHO safety checklist.
3. Observe the roles of the MDT in the WHO safety checklist.
4. Increase understanding of the importance of using WHO safety checklists in clinical practice.

External Resources

• World Health Organization – Surgical Safety Checklist (First edition, 2008)
• Royal College of Surgeons – Five steps to safer surgery (adapted version of the WHO checklist used in UK practice)