A behaviourally anchored rating scale for evaluating the use of the WHO surgical safety checklist: development and initial evaluation of the WHOBARS

Devcich, Daniel A.; Weller, Jennifer; Mitchell, Simon J; McLaughlin, S; Barker, Lisa; Rudolph, Jenny W.; Raemer, Daniel B.; Zammert, Martin; Singer, Sara J.; Torrie, Jane; Frampton, Chris; Merry, Alan

doi:10.1136/bmjqs-2015-004448

Cited by 32 publications

(37 citation statements)

References 31 publications

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“…Twenty OR teams comprising a consultant surgeon, surgical registrar, anaesthetist, anaesthetic technician, circulating nurse and scrub nurse took part in three simulated scenarios during the day-long MORSim course 42. Participants were from two different hospitals but on any given day the team was from one site and so were more likely to have worked together before and work together again soon after the course.…”

Section: Methodsmentioning

confidence: 99%

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Information transfer in multidisciplinary operating room teams: a simulation-based observational study

2016

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Section: Methodsmentioning

confidence: 99%

“…Checklists themselves are clearly valuable tools, but not sufficient on their own. The way in which they are administered by staff may lead to an effective communication between team members or an unhelpful exercise in compliance 41 42…”

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confidence: 99%

Information transfer in multidisciplinary operating room teams: a simulation-based observational study

2016

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“…The formerly developed behavioral marker systems to assess surgical team´s non-technical skills include some exemplar behaviors that are related to nursing sub-team and circulating nurse´s nontechnical skills (24)(25)(26)(27)(28)(29)(30). Only one ethnographic study (11) has been conducted to extract the circulating nurse´s non-technical skills; however, the study not reported exemplar behaviors, so we studied the references that are related to nursing and operating room to extract more behaviors.…”

Section: Resultsmentioning

confidence: 99%

Circulating nurse´s non-technical skills: a literature review

Kalantari

Zamanian

Faghihi

et al. 2020

Preprint

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Background: Circulating nurses are key members of the surgical team and play an essential role in ensuring patient safety in the operating room. They need to use non-technical skills to provide safe and efficient patient care. This study was conducted to identify the behaviors related to the circulating nurse´s nontechnical skills from the existing literature.Methods: A search of the literature between 1990 and 2020 was conducted using online sources, including Web of Science, MEDLINE, CINHAL, Scopus, OVID, and Cochran library. Furthermore, the publications of the Association of peri-operative registered nurses (AORN) and the National Association of Theater Nurses (NATH) were consulted. Then the skills were grouped into known categories of non-technical skills.Results: Behaviors related to circulating nurse´s non-technical skills were extracted from the existing literature. Then they were grouped into seven domains, including communication, leadership, coping, teamwork, situational awareness, task management, and decision-making and problem-solving. Furthermore, several improper behaviors were extracted.Conclusion: Circulating nurses need to use non-technical skills from the beginning until the end of surgery to perform efficiently. There is still a need for future work to identifying circulating nurses’ non-technical skills using other types of studies to develop an assessment tool.

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“…The adapted Human Factors Attitude Questionnaire has a five‐point Likert scale response format and is used widely to measure organizational safety culture. The WHO Behaviourally Anchored Rating Scale (WHOBARS) is a validated tool that assesses non‐technical skills during checklist administration. For each part of the checklist (sign in, time out, sign out), WHOBARS evaluates five domains on a scale from 1 to 7: setting the stage, team engagement, communication activation, communication of problem anticipation, and communication of process completion.…”

Section: Methodsmentioning

confidence: 99%

Implementation and evaluation of nationwide scale-up of the Surgical Safety Checklist

White

Randall

Capo-Chichi

et al. 2019

British Journal of Surgery

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Background The WHO Surgical Safety Checklist improves surgical outcomes, but evidence and theoretical frameworks for successful implementation in low‐income countries remain lacking. Based on previous research in Madagascar, a nationwide checklist implementation in Benin was designed and evaluated longitudinally. Methods This study had a longitudinal embedded mixed‐methods design. The well validated Consolidated Framework for Implementation Research (CFIR) was used to structure the approach and evaluate the implementation. Thirty‐six hospitals received 3‐day multidisciplinary training and 4‐month follow‐up. Seventeen hospitals were sampled purposively for evaluation at 12–18 months. The primary outcome was sustainability of checklist use at 12–18 months measured by questionnaire. Secondary outcomes were CFIR‐derived implementation outcomes, measured using the WHO Behaviourally Anchored Rating Scale (WHOBARS), safety questionnaires and focus groups. Results At 12–18 months, 86·0 per cent of participants (86 of 100) reported checklist use compared with 31·1 per cent (169 of 543) before training and 88·8 per cent (158 of 178) at 4 months. There was high‐fidelity use (median WHOBARS score 5·0 of 7; use of basic safety processes ranged from 85·0 to 99·0 per cent), and high penetration shown by a significant improvement in hospital safety culture (adapted Human Factors Attitude Questionnaire scores of 76·7, 81·1 and 82·2 per cent before, and at 4 and 12–18 months after training respectively; P < 0·001). Acceptability, adoption, appropriateness and feasibility scored 9·6–9·8 of 10. This approach incorporated 31 of 36 CFIR implementation constructs successfully. Conclusion This study shows successfully sustained nationwide checklist implementation using a validated implementation framework.

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A behaviourally anchored rating scale for evaluating the use of the WHO surgical safety checklist: development and initial evaluation of the WHOBARS

Cited by 32 publications

References 31 publications

Information transfer in multidisciplinary operating room teams: a simulation-based observational study

Information transfer in multidisciplinary operating room teams: a simulation-based observational study

Circulating nurse´s non-technical skills: a literature review

Implementation and evaluation of nationwide scale-up of the Surgical Safety Checklist

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