Development of a Contextualized Patient Safety Bundle for Operating Rooms in North Kivu, DRC: A Consensus-Based Approach

Background : Operating rooms are complex, high-risk environments where preventable harm is frequent, especially in resource-limited settings such as North Kivu, a province in eastern Democratic Republic of Congo (DRC). Although global patient safety interventions exist, adapting these strategies to local realities remains challenging. This study aimed to develop a practical patient safety bundle specifically tailored to enhance the safety culture in operating rooms within North Kivu hospitals. Methods : A modified nominal group technique (NGT) was used to gather and prioritize strategies from a multidisciplinary panel of nine stakeholders, including healthcare professionals and patients from Goma hospitals. Participants reviewed evidence, shared perspectives, and ranked strategies to improve patient safety culture in local operating rooms. Results : The implementation of the WHO Surgical Safety Checklist was identified as the most effective and feasible strategy, supported by regular team training, leadership engagement, patient involvement, and continuous monitoring. Other themes included leadership and team culture; Continuous training and improvement; Patient-centered care and Organizational processes. The resulting patient safety bundle reflects consensus-driven, context-sensitive interventions tailored to North Kivu’s unique challenges. Conclusion : This study provides the first consensus-based patient safety bundle for operating rooms in North Kivu, offering a practical foundation for future implementation and effectiveness research. The approach can inform similar initiatives in other low-resource settings. Trial registration: Not applicable