Assessment of Safe Medication Practices in Operating Theatres of Tertiary Hospitals in North West Nigeria

Background: Operating theatres are high-risk environments for medication errors, including anaesthetic drug mix-ups, labelling failures, and dosing miscalculations. Safe medication practices in the perioperative environment are critical patient safety requirements. This study assessed safe medication practices in operating theatres at tertiary hospitals in North West Nigeria. Methods: A structured direct observation study was conducted in the operating theatres of two federal teaching hospitals in Kano and Sokoto. Observations spanning 180 surgical procedures assessed compliance with WHO surgical safety guidelines related to medication use, including drug labelling, anaesthetic agent verification, and high-alert drug protocols. Results: Consistent syringe and drug labelling was performed in only 44 percent of observed procedures. Verbal verification of anaesthetic agents before administration was practised in 58 percent of cases. High-alert medication protocols (for neuromuscular blocking agents and concentrated electrolytes) were formally documented in only one of two institutions. Near-miss medication events were identified in 12 percent of observed cases. Conclusion: Safe medication practices in North West Nigeria operating theatres require urgent and structured improvement. WHO surgical safety checklist implementation specific to drug management steps must be enforced. Keywords: safe medication practices, operating theatre, perioperative safety, North West Nigeria, anaesthesia