Implementing a pre‐operative checklist to increase patient safety: a 1‐year follow‐up of personnel attitudes

Nilsson, Lena; Lindberget, O; Gupta, Anil; Vegfors, M.

doi:10.1111/j.1399-6576.2009.02109.x

Cited by 81 publications

(97 citation statements)

References 15 publications

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“…diretamente relacionados com o risco de morte, tais como "alergias" (item 5), "via aérea difícil" (item 6) e "risco de perda sanguínea" (item 7). Estudos apontam que os itens interpretados como mais importantes ou de maior risco ao paciente tendem a ter melhor adesão pelo profissional responsável pela sua verificação 16,17 .…”

Section: Discussionunclassified

Avaliação da adesão ao checklist de cirurgia segura da OMS em cirurgias urológicas e ginecológicas, em dois hospitais de ensino de Natal, Rio Grande do Norte, Brasil

et al. 2014

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O checklist de cirurgia segura da Organização Mundial da Saúde é uma ferramenta útil para diminuir eventos adversos em hospitais, porém sua implantação efetiva ainda é um desafio. Este estudo objetiva avaliar a adesão ao checklist em cirurgias urológicas e ginecológicas de dois hospitais de ensino em Natal, Rio Grande do Norte, Brasil. O desenho foi observacional transversal; selecionaram-se cirurgias eletivas, e a coleta se deu por meio de revisão de prontuários. Descreveu-se a adesão mediante a existência e qualidade do preenchimento do checklist, e analisou-se a associação de fatores estruturais e socioprofissionais valendo-se de análise de regressão múltipla. Das 375 cirurgias revisadas, 61% tinham checklist, e 4% estavam totalmente preenchidos. A existência do checklist se associou às cirurgias ginecológicas (maternidade) (OR = 130,18) e à maior duração da cirurgia (OR = 2,13), enquanto a qualidade do preenchimento se relacionou com as cirurgias urológicas (hospital geral) (β = 26,36). A adesão ao checklist precisa ser aprimorada, e as diferenças sugerem a influência das distintas estratégias de implantação utilizadas em cada instituição.

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Section: Discussionunclassified

Avaliação da adesão ao checklist de cirurgia segura da OMS em cirurgias urológicas e ginecológicas, em dois hospitais de ensino de Natal, Rio Grande do Norte, Brasil

et al. 2014

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“…6 Establishing each team member's identity and responsibilities during SSC initiation enhanced team integrity, functionality, and sense of worth. 32,40 Yet, in the study by Nilsson et al, 36 only 14% of participants thought that ''introduction of team members'' was important in SSC. 36 Additionally, of the 5 studies that examined this category, participants in 3 studies suggested that SSC did not substantially improve team member identification.…”

Section: Staff Perceptionmentioning

confidence: 93%

“…4). 9,[32][33][34][35][36]40,42,43 Improvements noted were increased ''team feeling,'' 36 ''strengthened teamwork and efficiency,'' 33 and identified enhanced team communication evidenced by increased discussion of critical events. 40 Studies undertaken 1-year postimplementation reported 47 to 57% of medical personnel found SSC improved communication.…”

Section: Staff Perceptionmentioning

confidence: 99%

“…32,33,35,36 To compare these studies, 4 common aspects encompassing the key issues that WHO-SSC developers claimed the checklist addressed were adopted Within this review, we considered self-perceived benefit of .70% in any of these categories as being significant enough to signify a positive impact. 41 The SSC was reported to have a positive impact on teamwork within the OR in 9 out of 13 studies (Fig.…”

Section: Staff Perceptionmentioning

confidence: 99%

“…Studies used 2 main methodologies to assess team member attitudes: focused interview of a random sample of operating theatre staff (2 studies) 32,33 and a surgical team questionnaire pre-and post-SSC intervention (8 studies). 9,[34][35][36][37][38][39][40] The studies varied in participant size with 37 to 40 participants in focus group studies across the OR disciplines, 32,33 while the surgical team survey questionnaire studies had participant sizes as large as 1748. The surgical questionnaires were based on resources from previous studies or adapted from the surgical attitudes questionnaire (SAQ).…”

Section: Staff Perceptionmentioning

confidence: 99%

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Compliance and Surgical Team Perceptions of WHO Surgical Safety Checklist; Systematic Review

Wangoo

Ray

2016

International Surgery

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This systematic review aimed to assess surgical safety checklist compliance and evaluate surgical team perceptions and attitudes, post-checklist implementation in the operating room. The World Health Organization (WHO) surgical safety checklist (SSC) has decreased complications and mortality. However, it is unclear whether this reduction is influenced by the vicarious enhancement in teamwork, communication, and staff awareness established by SSC implementation. The preferred reporting items for systematic reviews and meta-analyses model of review guided a search across MEDLINE, PubMed, and Embase databases. English-language studies using any adapted form of the WHO-SSC in operating rooms were reviewed by abstract and full text. Twenty-six studies, 13 assessing SSC compliance and 13 investigating surgical team perceptions of SSC, were evaluated. Compliance studies showed a checklist initiation rate of .90%, but actual observed completion rate varied widely across studies. Sign out was the most poorly performed phase of the checklist (,50%) with time out being the best. Verification of patient identity and procedure demonstrated a high degree (.90%) of compliance across studies, but ''verification of team-members'' was significantly less compliant. Studies assessing surgical team perceptions found that SSC improved participants' perception of teamwork, communication, patient safety, and staff awareness of adverse events. However, when stakeholders placed differing degrees of importance on SSC completion, results indicated the SSC might actually antagonize team relationships. SSC compliance varies significantly across studies, being highly dependent on staff perceptions, training, and effective leadership. Surgical teams have positive perceptions

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A Phenomenographic Study of Swedish Nurse Anesthetists’ and OR Nurses’ Work Experiences

Nordström¹,

Wihlborg²

2019

AORN Journal

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In the complex OR environment, perioperative team members need to practice communication and teamwork to ensure safe, high-quality care. A lack of collaboration among professionals in the OR during surgery results in inefficiency, increased tension, and suboptimal patient care. The purpose of this study was to determine how nurse anesthetists and OR nurses experienced their work in the OR. We used a qualitative design with a phenomenographic approach and conducted 12 interviews in two surgical departments in the southern part of Sweden. We identified four categories of description: team member approach, professional awareness, lifelong learning approach, and safety and the patient's interest. We found that the nurses' work experiences in the OR were multifaceted and correlated with concepts of teamwork, safety, and communication.T he OR is a highly technological and multiprofessional environment where team members must manage medical technology, time pressure, and productivity. In Sweden, the responsibilities of nurse anesthetists and OR nurses are to maintain a safe and secure environment of care for the patient during surgery. 1,2 The nurse anesthetist independently induces and maintains general anesthesia and extubates the patient with support from the anesthesiologist. 1 The OR nurse is responsible for aseptic technique, maintaining a sterile field, preparing supplies and instruments, counts, documentation, supporting the surgical team, and advocating for the patient. 2 Collaboration and communication among surgical team members help to ensure safe care during surgery. [3][4][5] Communication in the OR requires both verbal and nonverbal skills, the ability to listen actively, and basic interpersonal skills, such as being polite and speaking clearly. These skills help to achieve optimal communication among team members and a safe and effective OR environment. 6 Surgical team members who work together often can communicate and collaborate more effectively because working relationships need time to develop. 7,8 The absence of basic communication and respectful acknowledgment among OR staff members affect the ability to develop shared understandings, which is important in enhancing team performance. 8 STATEMENT OF PURPOSEThe purpose of this study was to describe the work experiences of nurse anesthetists and OR nurses in the OR. LITERATURE REVIEWBringing different professionals together does not always lead to optimal collaboration. Members of a team must trust each other to develop a common process, achieve professional collaboration, and develop high-quality care. 9 Four interactional factors are important for effective collaboration among health care teams: willingness to participate in collaborative practice, trust, communication, and mutual respect and understanding. 10 In the study by Lingard et al, 11 team members in the OR lacked insight into the professional roles and obligations of other team members, and when tension in the OR occurred, this often CONCLUSION Nurse anesthetists' and OR nurses' work expe...

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Implementing a pre‐operative checklist to increase patient safety: a 1‐year follow‐up of personnel attitudes

Abstract: Staff attitudes toward a surgical checklist were mostly positive 1 year after their introduction in two large hospitals in central Sweden.

Cited by 81 publications

References 15 publications

Avaliação da adesão ao checklist de cirurgia segura da OMS em cirurgias urológicas e ginecológicas, em dois hospitais de ensino de Natal, Rio Grande do Norte, Brasil

Avaliação da adesão ao checklist de cirurgia segura da OMS em cirurgias urológicas e ginecológicas, em dois hospitais de ensino de Natal, Rio Grande do Norte, Brasil

Compliance and Surgical Team Perceptions of WHO Surgical Safety Checklist; Systematic Review

A Phenomenographic Study of Swedish Nurse Anesthetists’ and OR Nurses’ Work Experiences

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