THE ROLE OF THE NURSE IN SAFE SURGERY: THE USE OF CHECKLISTS AS A PATIENT SAFETY-CENTERED TOOL

Abstract

Introduction: Surgery is one of the most complex and high-risk areas in health care, concentrating a significant burden of potentially preventable adverse events. In this scenario, the Surgical Safety Checklist emerges as a key risk management technology, with nurses playing a strategic role in its implementation and daily use.Objective: To analyze the extent to which the use of the surgical safety checklist, under nurses’ leadership, constitutes an effective strategy for patient safety in the surgical setting, identifying obstacles and potentialities in its everyday use. Method: An integrative literature review was conducted in the Virtual Health Library, including full-text articles in Portuguese, published between 2020 and 2024. After applying inclusion and exclusion criteria, the corpus comprised 12 scientific articles addressing the use of the surgical safety checklist in operating rooms, with emphasis on nursing practice. The studies were subjected to thematic analysis, organized into four analytical categories. Results: The analysis highlighted nurses as central actors in operationalizing the checklist, articulating care, managerial and educational dimensions. Important barriers to qualified adherence were identified, such as insufficient resources, productivity pressure, rigid hierarchies, a bureaucratic understanding of the instrument and weaknesses in interprofessional communication. Conversely, the checklist showed significant potential to structure critical steps of care, prevent adverse events, organize formal communication pauses and support continuing education and audit processes in patient safety. Conclusion: When led by nurses whose clinical leadership is institutionally recognized and supported, the surgical safety checklist constitutes a powerful strategy for strengthening patient safety in the perioperative setting. Its effectiveness, however, depends on institutional conditions that address organizational and cultural barriers and embed the protocol within broader policies of continuing education and quality management in health care.