An Anesthesia Checklist: A Survey of Compliance and Attitudes

Document Type: Original Article


Department of Anesthesiology – South Infirmary – Victoria University Hospital, Cork, Ireland.


While anesthesia is regarded as one of the safest clinical specialties, continuing to ensure patient safety requires vigilance. The growing complexity of modern medicine makes it extremely dangerous to rely on the absence of human error. There is evidence to suggest that anesthesiologists are less inclined to use checklists than surgeons and nurses. Seniority has also been shown to dictate the acceptance of checklists.
Materials and Methods:
We assessed compliance with, and attitudes to an anesthesia checklist, comparing by seniority.
1. Analysed a representative sample (n=247, 95% CI, 5% ME) of general anesthesia cases performed in one year (n=747), calculating percentage compliance in each case. We compared groups by seniority with Mann-Whitney U testing using SPSS.
2. We assessed attitudes using a 20-item questionnaire, consisting of five themed sub-scales. Descriptive statistics were generated.
Mean total compliance with the checklist was 91.6% (95% CI: 90.6-92.6%). Non-Consultant compliance was estimated at 94.4% (95% CI: 93.0-95.8%), compared to 91.6% (95% CI: 89.5-93.7%) in the Consultant group. Higher Non-Consultant compliance was significant, compared to the Consultant group (P=0.045).
The Non-Consultant group demonstrated greater compliance. Attitudes to the checklist were similar amongst the two groups with lack of time and lack of training cited as two major barriers to use. Both senior and junior anesthesiologists felt it had a positive impact on patient safety.