ReviewPatient safety in surgery2026
Patient safety culture in the operating room of African hospitals: a systematic review.
Review in Patient safety in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Attitudes Toward Patient Safety in Operating Rooms: Cross-Cultural Adaptation and Validation of the French Version of the Operating Room Management Attitudes Questionnaire (ORMAQ).Healthcare (Basel, Switzerland) · 2026Article
- Identified practice gaps and opportunities in anesthesia safety across 14 Arab countries: a multicenter study.Patient safety in surgery · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatient safety in operating rooms has globally improved through interventions such as the World Health Organization (WHO) Surgical Safety Checklist and multidisciplinary team training. However, while evidence from high-income countries is well documented, there remains limited consolidated knowledge on the understanding, application, and effectiveness of safety culture interventions in African surgical settings, which this review seeks to address.
methodsThis systematic review examined factors and protocols affecting surgical safety in African operating rooms. We hypothesized that persistent systemic barriers undermine safety culture despite adoption of global measures. Following PRISMA 2020, we searched eight databases (Medline, Embase, Cochrane, Africa-Wide, CINAHL, Global Health, Global Index Medicus, Web of Science) from inception to 5 December 2024, using variations of text words present in the title, abstract, or keyword fields, alongside relevant subject headings, to identify articles addressing surgical safety and culture throughout Africa. Included studies involved operating room professionals in African countries and used quantitative, qualitative, or mixed-methods designs. We excluded non-operating room settings, patient-only studies, inaccessible full texts, reviews, editorials, letters, conference abstracts, and duplicates. Two reviewers independently screened and appraised studies using the Mixed Methods Appraisal Tool. Findings were synthesized narratively with subgroup analysis by study type and theme.
resultsOut of 9,875 identified records, 22 studies from 12 African countries (2014-2024) met inclusion criteria, with Ethiopia contributing the highest number (n = 4). Various assessment tools, including the Hospital Survey on Patient Safety Culture, the Safety Attitudes Questionnaire, and the National Surgical, Obstetric, and Anaesthesia Plans interview manual, revealed recurring challenges: inadequate non-punitive responses to errors, communication barriers, hierarchical structures, and resource constraints. Four interventions showed promise: implementation and training on the WHO Surgical Safety Checklist, Safe Surgery 2020 initiatives, Non-Technical Skills for Surgeons training, and multidisciplinary training.
conclusionThe heterogeneity of study designs, sample sizes, and outcome measures limited direct comparisons and precluded meta-analysis. Nonetheless, the review highlights persistent barriers and emerging opportunities to strengthen patient safety culture in African operating rooms. While the WHO Surgical Safety Checklist remains valuable, sustainable progress requires multi-level strategies that address systemic constraints and incorporate context-sensitive adaptations. REGISTRATION: PROSPERO, CRD42024627076.
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