Introduction
This paper reports on the development of a scale to measure intrapersonal factors (IPF) that may influence speaking up behaviour in the operating room.
Methods
Participants were postgraduate year 2, 3, and 4 anaesthesiology residents and practising faculty anaesthesiologists at a large quaternary care academic hospital. Based on a literature review, the authors constructed the initial scale. Exploratory factor analysis was conducted to identify the underlying factor structure for the scale. A set of one-way ANOVAs and multiple ordinal regressions were carried out to provide additional validity evidence for the new scale.
Results
Exploratory factor analysis indicated a three-factor solution accounting for 73% of the variance. The self-efficacy subscale included four items (Cronbach’s α = 0.86), and the social outcome expectations (Cronbach’s α = 0.86) and assertive attitude (Cronbach’s α = 0.67) subscales contained three items each. The effect of training level was significantly associated with self-efficacy (
p
< 0.001) and assertive attitude subscale scores (
p
< 0.001). Multiple ordinal regressions indicated that IPF predicted participants’ likelihood of speaking up in various hypothetical scenarios.
Discussion
Our analyses provided initial evidence for the validity and reliability of a 10-item IPF scale. This instrument needs to be validated in other cohorts.
BACKGROUNDThe physics of ideal fluid flow is well characterized. However, the effect of catheter size, tubing types, injection port adjuncts, and viscosity on flow is not well described. We used a simulated environment to determine how various permutations of common elements affect fluid flow.STUDY DESIGN AND METHODSWe tested 16 peripheral and central venous catheters to assess flow through several standard infusion sets and a rapid infuser set; tested flow through standard and blood infusion sets with the addition of intravenous extension tubing, stopcocks, and a needleless connector; and compared the relative viscosity of commonly used blood products and colloids to that of normal saline.RESULTSThe maximal flow rate was 200 mL/min for the standard infusion set but 800 mL/min for the rapid infusion set. Choice of infusion tubing was the rate‐limiting component for many larger catheters. A 14‐gauge, single‐lumen central venous catheter (CVC) and 18‐gauge peripheral intravenous catheter (PIV) had equivalent flow rates with all infusion sets. A 16‐gauge single‐lumen CVC allowed a flow rate that was slower than that of a 20‐gauge PIV, and faster than that of a 22‐gauge PIV. The addition of adjuncts slowed flow rate. Needleless connectors had the greatest impact, reducing flow by 75% for the blood infusion set. Packed red blood cells had a viscosity 4.5 times that of normal saline and thereby reduced flow.CONCLUSIONCatheter and tubing choice, adjuncts, and fluid viscosity influence flow rates. Our results will help inform adequate vascular access planning in the perioperative environment.
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