Correlates of non-technical skills in surgery: a prospective study

Gillespie, Brigid M.; Harbeck, Emma; Kang, Evelyn; Steel, C. M.; Fairweather, N. Ben; Chaboyer, Wendy

doi:10.1136/bmjopen-2016-014480

Cited by 39 publications

(40 citation statements)

References 32 publications

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“…Limited communication may reduce the ability to process required information and influence the ability to follow policy and procedure. An increase in idle conversation and noise escalation were also identified as behaviours that contributed to an ineffective count process [18][19][20][21][22] .…”

Section: Discussionmentioning

confidence: 99%

The patient, case, individual and environmental factors that impact on the surgical count process: An integrative review

Warwick¹,

Gillespie²,

McMurray³

et al. 2019

Journal of Perioperative Nursing

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Problem identification The surgical count is an integral component of the perioperative nurse's role designed to reduce the risk of unintentional retained items (URIs) during surgery. Current literature provides statistical data that URIs continue to occur which has exposed a lack of adherence to the surgical count process as a possible contributing factor. This review was undertaken to identify what is currently known about perioperative nurses' practices in relation to the surgical count and the perceived barriers and enablers when trying to follow best practice as outlined in ACORN's Standards for Perioperative Nursing in Australia. Literature search The objective of the search was to identify empirical data relating to nurses' knowledge and practices in relation to the surgical count. We identified 215 research papers in the literature search using search terms consisting of instrument counts, culture and patient safety. Data evaluation synthesis Studies from 2003 to 2018 were categorised methodologically as qualitative, quantitative and mixed methodologies. All papers were reviewed by the authors separately to extract key information around design, sample size, aim, key findings and limitations. Studies were critically appraised using the mixed method appraisal tool (MMAT) for mixed method studies and the QualSyst tool for quantitative and qualitative studies. The literature search identified a total of 215 studies, 109 of which were identified for further review using the 'preferred reporting items for systematic reviews and meta-analysis' (PRISMA) flow chart. Six exclusion criteria were applied to exclude a further 52 articles from the final review, which resulted in ten articles being included in the final sample.

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Section: Discussionmentioning

confidence: 99%

The patient, case, individual and environmental factors that impact on the surgical count process: An integrative review

Warwick¹,

Gillespie²,

McMurray³

et al. 2019

Journal of Perioperative Nursing

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“…The most frequent number of observers was two (n ¼ 15). 4,[11][12][13]23,24,[26][27][28][29][30][31]33,[36][37][38][39] Thirteen studies involved an observer with a clinical background (e.g. surgeon).…”

Section: Non-technical Skillsmentioning

confidence: 99%

“…4,11,13,16,23,24,26,27,[35][36][37][38][39] Fifteen studies described the training undertaken by observers. 4,11,16,23,24,[27][28][29][30][31]33,[36][37][38][39] Validity and reliability. Validity of NOTECHS was demonstrated by 16 studies (13 of which occurred in the OR and three occurred in simulation settings).…”

Section: Non-technical Skillsmentioning

confidence: 99%

“…Psychometric properties for the 31 tools are reported in Table 3 and in online supplementary material file B provides study results related to validity and reliability. Specifically, the included studies demonstrated content validity (Oxford NOTECHS), 27 predictive validity (Oxford NOTECHS, n ¼ 3; Revised NOTECHS, n ¼ 3; NOTECHS (modified), n ¼ 1; and Oxford NOTECHS II, n ¼ 4), 4,11,26,27,30,31,[33][34][35][36]38 concurrent validity (Oxford NOTECHS, n ¼ 5; Revised NOTECHS, n ¼ 2; and Oxford NOTECHS, n ¼ 1), [11][12][13]16,27,28,33,39 and face validity (Oxford NOTECHS II). 39 Ten studies assessed inter-rater reliability (Cronbach a > 0.…”

Section: Non-technical Skillsmentioning

confidence: 99%

“…Across the 23 studies, the most used two observers (n ¼ 11) 17,64,86,90,91,94,95,[97][98][99]101 ; nine studies had observers with a clinical background 8,9,50,64,68,86,90,93,98 ; and eight studies had observers with a nonclinical background. 50 Non-technical skills * NOTECHS 2 24,25 Oxford non-technical skills Oxford NOTECHS 6 [11][12][13]16,26,27 Revised non-technical skills Revised NOTECHS 6 [28][29][30][31][32][33] Non-technical skills (modified) NOTECHS (modified) 1 34 Oxford Non-technical skills II Oxford NOTECHS II 6 4,[35][36][37][38][39] Non-technical skills for surgeons y NOTSS 19 9,[40][41][42][43]…”

Section: Observational Teamwork Assessment For Surgerymentioning

confidence: 99%

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Observational Tools That Quantify Nontechnical Skills in the Operating Room: A Systematic Review

McMullan

Urwin

Sunderland

et al. 2020

Journal of Surgical Research

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a b s t r a c tBackground: Errors and adverse events in the operating room (OR) are associated with not only poor technical performance but also deficits in nontechnical skills (NTSs). Numerous tools have been developed to assess NTS in the OR. Our aim was to conduct a systematic review of observational tools and report on their implementation and psychometric properties to guide healthcare professionals, educators, and researchers in tool selection and use.Methods: A systematic literature search (January 1, 1990eMay 28, 2019) was conducted across databases (MEDLINE, Embase, CINAHL, and PsycINFO) and reference lists of included studies. Reviewers independently screened articles for inclusion, assessed study quality, and extracted data.Results: Thirty-one tools were identified across 88 studies, most commonly conducted in a real-world OR (n ¼ 50), involving two observers (n ¼ 50). The NTS of individuals (n ¼ 62)were assessed more often than that of subteams (n ¼ 21) or entire teams (n ¼ 20). The NOn-Technical Skills for Surgeons demonstrated content validity, concurrent validity, predictive validity, and face validity across a range of studies. Oxford NOn-TECHnical Skills demonstrated content validity, concurrent validity, and predictive validity with good inter-rater reliability and test-retest validity. Conclusions:The NOn-Technical Skills for Surgeons has the strongest evidence of validity and reliability for assessing individuals, whereas the most robust tool for evaluating teams was Oxford NOn-TECHnical Skills. We recommend continued investigation of these observational tools regarding their feasibility and reproducibility of methods. Further research is needed to determine the training requirements for observers and the potential of video and audio recordings in the OR. CrownThe operating room (OR) is a complex, high-risk environment in which many factors influence team performance and patient safety. The complexity that is manifested within and across the patient, procedure, equipment, team, and culture increases the likelihood of adverse events. 1 It has been estimated that approximately 40% to 65% of all in-hospital ScienceDirect jo urnal homepage: www.J ou rn alofS urgicalR esearch.com j o u r n a l o f s u r g i c a l r e s e a r c h m a r c h 2 0 2 0 ( 2 4 7 ) 3 0 6 e3 2 2

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Assessing Perceptions of Teamwork Quality Among Perioperative Team Members

Müller¹,

Tschan²,

Keller³

et al. 2018

AORN Journal

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Successful surgery depends on collaboration and mutual trust among interdisciplinary team members. We compared teamwork quality as perceived by surgeons, anesthesia care providers, and perioperative nurses using two surveys in the same hospital. The general survey sent to the homes of the OR personnel revealed teamwork climate scores in the medium to high range. Attending surgeons were significantly more satisfied than perioperative nurses and resident surgeons; anesthesiologists were significantly more satisfied than perioperative nurses. A second single-item survey administered immediately after elective open abdominal surgical procedures also showed relatively high satisfaction with teamwork. Results of the second survey, however, showed that attending surgeons were significantly less satisfied than the members of all the other professions, and perioperative nurses were significantly more satisfied than the members of all the other professions. We conclude that general surveys about teamwork quality among members of surgical teams may not necessarily reflect teamwork quality during actual surgical procedures.

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Correlates of non-technical skills in surgery: a prospective study

Cited by 39 publications

References 32 publications

The patient, case, individual and environmental factors that impact on the surgical count process: An integrative review

The patient, case, individual and environmental factors that impact on the surgical count process: An integrative review

Observational Tools That Quantify Nontechnical Skills in the Operating Room: A Systematic Review

Assessing Perceptions of Teamwork Quality Among Perioperative Team Members

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