1
|
Yao L, Zhang L. Study on the psychological health status and influencing factors of operating room nursing staff. Medicine (Baltimore) 2024; 103:e38780. [PMID: 39029018 PMCID: PMC11398775 DOI: 10.1097/md.0000000000038780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2024] Open
Abstract
To comprehensively analyze the psychological health status of operating room nurses and identify influencing factors. The research compares psychological health differences based on nurses' years of experience, specifically examining depression and anxiety scores. A detailed assessment was conducted, focusing on nurses with varying experience levels. Findings revealed higher depression scores among mid to senior-level nurses, while junior-level nurses exhibited elevated anxiety scores. Additionally, overall dissatisfaction with physical health and various subhealth symptoms were reported. Multifactorial analysis identified working hours, disaster relief experience, and perceived occupational benefits as primary influencers. Through comparative analysis, it was found that the average score of self-rating depression scale and self-rating anxiety scale was 53.8 ± 12.2 points and 47.6 ± 10.5 points respectively. The depression score of middle and senior nurses was significantly higher than that of junior nurses (P < .05). The anxiety score of primary nurses was significantly higher than that of middle and senior nurses (P < .05). The results indicate that the duration of work, previous experience in disaster relief, and nurses' perception of occupational benefits were the main factors influencing the psychological health status of operating room nurses (P < .05). Healthcare institutions are recommended to implement targeted interventions based on nurses' experience levels, addressing specific psychological health needs. Future research should delve into specific subgroups, conduct long-term tracking, expand the scope of influencing factors, assess the effectiveness of intervention measures, and explore cross-cultural aspects.
Collapse
Affiliation(s)
- Lan Yao
- Department of Anesthesia Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | | |
Collapse
|
2
|
Parra DA, Gladkikh M, Jones LM. Factors influencing teamwork in healthcare applicable to interventional and diagnostic radiology. Clin Radiol 2023; 78:897-903. [PMID: 37813757 DOI: 10.1016/j.crad.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/01/2023] [Accepted: 09/12/2023] [Indexed: 10/11/2023]
Abstract
Teamwork in healthcare has been analysed extensively in the literature, mainly in acute healthcare settings such as the operating room, emergency room, and intensive care unit, with limited evidence related to diagnostic and interventional radiology. Multiple factors that affect teamwork in different domains have been described, such as communication, hierarchy, and distractions. Teamwork is an important patient safety, job satisfaction and patient outcome determinant, with interprofessional and interdisciplinary healthcare education playing a relevant role in the different domains affecting team performance. The aim of this article is to review the literature to describe domains and specific factors that influence teamwork in diagnostic and interventional radiology practice. This is of particular interest for radiologist involved in quality improvement and/or patient safety initiatives development and implementation. The review will conclude with a summary table highlighting the most important factors that, according to the authors, appear relevant to the radiology practice.
Collapse
Affiliation(s)
- D A Parra
- Division of Image Guided Therapy, Diagnostic Imaging Department, The Hospital for Sick Children, Toronto, ON, Canada; Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
| | - M Gladkikh
- Diagnostic Imaging, McMaster University, Hamilton, ON, Canada
| | - L M Jones
- Centre for Medical Education, School of Medicine, University of Dundee, Dundee, UK
| |
Collapse
|
3
|
Niu A, Ma H, Chen Z, Zhu X, Luo Y. Exploring the competencies of operating room nurses in mobile surgical teams based on the Onion Model: a qualitative study. BMC Nurs 2023; 22:254. [PMID: 37528375 PMCID: PMC10394863 DOI: 10.1186/s12912-023-01417-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 07/21/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND With the frequent occurrence of public health emergencies, conflicts and natural disasters around the world, mobile surgical teams are becoming more crucial. The competency of the operating room (OR) nurse has a substantial impact on the effectiveness and quality of the surgical team's treatment, still there is limited knowledge about OR nurse competencies in mobile surgical teams. This study aimed to explore the competencies of OR nurses in mobile surgical teams based on the Onion Model. METHODS We conducted a qualitative descriptive study of participants from 10 mobile surgical teams in 2022. Twenty-one surgical team members were interviewed, including 15 OR nurses, four surgeons, and two anesthesiologists. Data were collected through semi-structured interviews. The data were analyzed using Mayring's content analysis. RESULTS Twenty-eight competencies were found in the data analysis, which were grouped into four major domains using the Onion Model. From the outer layer to the inner layer were knowledge and skills, professional abilities, professional quality, and personal traits. The qualitative data revealed several novel competencies, including triage knowledge, self and mutual medical aid, outdoor survival skills, and sense of discipline. CONCLUSIONS The application of the Onion Model promotes the understanding of competency and strengthens the theoretical foundations of this study. New competencies can enrich the content of the competencies of OR nurses. The results of this study can be used for clinical recruitment, evaluation and training of OR nurses in mobile surgical teams. This study encourages further research to develop competency assessment tools and training programs for OR nurses.
Collapse
Affiliation(s)
- Aifang Niu
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China
| | - Huijuan Ma
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China
| | - Zhe Chen
- Army Health Service Training Base, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China
| | - Xiaoli Zhu
- Emergency department, General hospital of xinjiang military command, No. 754 Beijing Street, Urumqi, Xin Jiang, P.R. China
| | - Yu Luo
- School of Nursing, Third Military University / Army Medical University, No. 30 Gaotanyan Street, Shapingba District, Chongqing, P.R. China.
| |
Collapse
|
4
|
Parker LA, Bukoski AD, Zelaya-Nunez C, Dodam JR, Varner KM, Torres BT. Pelvic limb anesthesia and analgesia in dogs undergoing tibial plateau leveling osteotomy (TPLO): A survey of board-certified anesthesiologists. Vet Surg 2023; 52:521-530. [PMID: 36881970 DOI: 10.1111/vsu.13947] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/30/2022] [Accepted: 02/15/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVE To report the locoregional anesthesia and analgesia preferences of veterinary anesthesiologists for use in dogs undergoing a TPLO and determine any association with specialty college, time from board-certification, or employment sector. STUDY DESIGN Cross sectional study. SAMPLE POPULATION Diplomates of the American (ACVAA) and European (ECVAA) Colleges of Veterinary Anesthesia and Analgesia. METHODS An electronic survey was distributed to diplomates and responses were used to determine associations between preferred methods. RESULTS The survey response rate was 28% (141/500) with 69% (97/141) of ACVAA diplomates and 31% of diplomates with ECVAA (44/141) certification. Peripheral nerve block (PNB) was preferred by 79% (111/141) of all diplomates, lumbosacral epidural (LE) by 21% (29/141), and peri-incisional infiltration (PI) by <1% (1/141). There was no association (p = .283) with specialty college. There was an association (p < .001) with time from board-certification with increased preference for LE when >10-years from certification and PI preferred by only those board-certified >20-years ago. There was an association with employment sector (p = .003) with more academic diplomates preferring LE. Anesthesiologists reported that treatment decisions were affected by various factors including time pressure and surgeon influence. CONCLUSION Diplomates of ACVAA and ECVAA prefer PNB as the locoregional method of pelvic limb anesthesia in dogs undergoing TPLO. A greater percentage of newer and private practice diplomates prefer PNB while a larger percentage of senior and academic diplomates prefer LE. Decision making is multifactorial and includes perceived time pressure and surgeon influence. CLINICAL SIGNIFICANCE Veterinary anesthesiologists prefer and frequently use PNB in dogs undergoing TPLO and surgeon influence may affect their chosen treatment.
Collapse
Affiliation(s)
- Lindsay A Parker
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - Alex D Bukoski
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - Cristopher Zelaya-Nunez
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - John R Dodam
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - Kelley M Varner
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - Bryan T Torres
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| |
Collapse
|
5
|
Arad D, Rosenfeld A, Magnezi R. Factors contributing to preventing operating room "never events": a machine learning analysis. Patient Saf Surg 2023; 17:6. [PMID: 37004090 PMCID: PMC10067209 DOI: 10.1186/s13037-023-00356-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/09/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND A surgical "Never Event" is a preventable error occurring immediately before, during or immediately following surgery. Various factors contribute to the occurrence of major Never Events, but little is known about their quantified risk in relation to a surgery's characteristics. Our study uses machine learning to reveal and quantify risk factors with the goal of improving patient safety and quality of care. METHODS We used data from 9,234 observations on safety standards and 101 root-cause analyses from actual, major "Never Events" including wrong site surgery and retained foreign item, and three random forest supervised machine learning models to identify risk factors. Using a standard 10-cross validation technique, we evaluated the models' metrics, measuring their impact on the occurrence of the two types of Never Events through Gini impurity. RESULTS We identified 24 contributing factors in six surgical departments: two had an impact of > 900% in Urology, Orthopedics, and General Surgery; six had an impact of 0-900% in Gynecology, Urology, and Cardiology; and 17 had an impact of < 0%. Combining factors revealed 15-20 pairs with an increased probability in five departments: Gynecology, 875-1900%; Urology, 1900-2600%; Cardiology, 833-1500%; Orthopedics,1825-4225%; and General Surgery, 2720-13,600%. Five factors affected wrong site surgery's occurrence (-60.96 to 503.92%) and five affected retained foreign body (-74.65 to 151.43%): two nurses (66.26-87.92%), surgery length < 1 h (85.56-122.91%), and surgery length 1-2 h (-60.96 to 85.56%). CONCLUSIONS Using machine learning, we could quantify the risk factors' potential impact on wrong site surgeries and retained foreign items in relation to a surgery's characteristics, suggesting that safety standards should be adjusted to surgery's characteristics based on risk assessment in each operating room. . TRIAL REGISTRATION NUMBER MOH 032-2019.
Collapse
Affiliation(s)
- Dana Arad
- Department of Management, Health Management Program, Faculty of Sciences, Bar-Ilan University, Ramat Gan, Israel.
- Patient Safety Division, Ministry of Health, Ramat Gan, Israel.
| | - Ariel Rosenfeld
- Department of Information Science, Bar-Ilan University, Ramat Gan, Israel
| | - Racheli Magnezi
- Department of Management, Health Management Program, Faculty of Sciences, Bar-Ilan University, Ramat Gan, Israel
| |
Collapse
|
6
|
Arad D, Finkelstein A, Rozenblum R, Magnezi R. Patient safety and staff psychological safety: A mixed methods study on aspects of teamwork in the operating room. Front Public Health 2022; 10:1060473. [PMID: 36620282 PMCID: PMC9816421 DOI: 10.3389/fpubh.2022.1060473] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives To predict the amount of teamwork that takes place throughout a surgery, based on performing a preoperative safety standards (surgical safety checklist and surgical count) and to explore factors affecting patient safety and staff psychological safety during a surgery, based on interprofessional teamwork. Methods This mixed methods study included quantitative and qualitative analyses. Quantitative data included 2,184 direct observations of surgical cases with regard to the performance of safety standards during surgeries in 29 hospitals, analyzed using multivariate binary logistic regressions. Qualitative data were obtained from an analysis of 25 semi-structured interviews with operating room (OR) clinicians and risk managers, using an inductive thematic analysis approach. Results Analysis of the OR observations revealed that a lack of teamwork in the preoperative "sign-in" phase doubled the chances of there being a lack of teamwork during surgery [odds ratio = 1.972, 95% confidence interval (CI) 1.741, 2.233, p < 0.001] and during the "time-out" phase (odds ratio = 2.142, 95% CI 1.879, 2.441, p < 0.001). Consistent presence of staff during surgery significantly increased teamwork, by 21% for physicians and 24% for nurses (p < 0.05), but staff turnover significantly decreased teamwork, by 73% for physicians (p < 0.05). Interview data indicated that patient safety and staff psychological safety are related to a perception of a collaborative team role among OR staff, with mutual commitment and effective interprofessional communication. Conclusions Healthcare organizations should consider the key finding of this study when trying to identify factors that affect teamwork during a surgery. Effective preoperative teamwork positively affects intraoperative teamwork, as does the presence of more clinicians participating in a surgery, with no turnover. Other factors include working in a fixed, designated team, led by a surgeon, which functions with effective interprofessional communication that promotes patient safety and staff psychological safety.
Collapse
Affiliation(s)
- Dana Arad
- Health System Management Department, Bar-Ilan University, Ramat Gan, Israel,Patient Safety Division, Ministry of Health, Jerusalem, Israel,*Correspondence: Dana Arad ✉
| | - Adi Finkelstein
- Department of Nursing, Jerusalem College of Technology, Jerusalem, Israel
| | - Ronen Rozenblum
- Brigham and Women's Hospital, Boston, MA, United States,Harvard Medical School, Boston, MA, United States
| | - Racheli Magnezi
- Health System Management Department, Bar-Ilan University, Ramat Gan, Israel
| |
Collapse
|
7
|
Meizoso JP, Barrett CD, Moore EE, Moore HB. Advances in the Management of Coagulopathy in Trauma: The Role of Viscoelastic Hemostatic Assays across All Phases of Trauma Care. Semin Thromb Hemost 2022; 48:796-807. [DOI: 10.1055/s-0042-1756305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
AbstractUncontrolled bleeding is the leading cause of preventable death following injury. Trauma-induced coagulopathy can manifest as diverse phenotypes ranging from hypocoagulability to hypercoagulability, which can change quickly during the acute phase of trauma care. The major advances in understanding coagulation over the past 25 years have resulted from the cell-based concept, emphasizing the key role of platelets and their interaction with the damaged endothelium. Consequently, conventional plasma-based coagulation testing is not accurate in predicting bleeding and does not provide an assessment of which blood products are indicated. Viscoelastic hemostatic assays (VHA), conducted in whole blood, have emerged as a superior method to guide goal-directed transfusion. The major change in resuscitation has been the shift from unbridled crystalloid loading to judicious balanced blood product administration. Furthermore, the recognition of the rapid changes from hypocoagulability to hypercoagulability has underscored the importance of ongoing surveillance beyond emergent surgery. While the benefits of VHA testing are maximized when used as early as possible, current technology limits use in the pre-hospital setting and the time to results compromises its utility in the emergency department. Thus, most of the reported experience with VHA in trauma is in the operating room and intensive care unit, where there is compelling data to support its value. This overview will address the current and potential role of VHA in the seriously injured patient, throughout the continuum of trauma management.
Collapse
Affiliation(s)
- Jonathan P. Meizoso
- DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, Florida
| | - Christopher D. Barrett
- Center for Precision Cancer Medicine, Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
- Department of Surgery, Boston University Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Ernest E. Moore
- Department of Surgery, University of Colorado Denver, Aurora, Colorado
- Department of Surgery, Ernest E. Moore Shock Trauma Center at Denver Health, Denver, Colorado
| | - Hunter B. Moore
- Department of Surgery, University of Colorado Denver, Aurora, Colorado
| |
Collapse
|
8
|
Paige JT, Kerdolff KE, Rogers CL, Garbee DD, Yu Q, Cao W, Rusnak S, Bonanno LS. Improvement in student-led debriefing analysis after simulation-based team training using a revised teamwork assessment tool. Surgery 2021; 170:1659-1664. [PMID: 34330538 DOI: 10.1016/j.surg.2021.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 04/26/2021] [Accepted: 06/08/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Team debriefing is an important teamwork development intervention for improving team outputs in healthcare. Debriefing is a key component of experiential team training teamwork development interventions such as simulation-based training. Improving the quality of debriefing of healthcare teams, therefore, has multiple benefits. We investigated whether the quality of student-led debriefing improved using a shortened guide. METHODS Senior medical students, nurse anesthesia students, and senior undergraduate nursing students participated in student operating room team training at a health sciences center in the southeastern United States. Student teams participated in a dual-scenario simulation-based training session with immediate after-action debriefings after each scenario. In 2018, student teams conducted the second debriefing using as a guide the teamwork assessment scale, an 11-item, 3-subscale, 6-point Likert-type instrument. In 2019, they used a shortened, revised, 5-item version of the teamwork assessment scale, the quick teamwork assessment scale. Trained observers rated the quality of the student-led debriefings using the Objective Structured Assessment of Debriefing, an 8-item, 5-point instrument. The Wilcoxon-Mann-Whitney test was used to compare the teamwork assessment scale-guided and the quick teamwork assessment scale-guided mean item debriefing scores. RESULTS Two observers rated 3 student-led team debriefings using the teamwork assessment scales as a guide in 2018, and 6 such debriefings happened using the quick teamwork assessment scale as a guide in 2019. For each debriefing, observer scores were averaged for each Objective Structured Assessment of Debriefing item; these mean scores were then averaged with other mean scores for each year. The use of the quick teamwork assessment scale resulted in a statistically significant higher mean score for the Analysis Objective Structured Assessment of Debriefing item compared with the use of the teamwork assessment scale (4.92 [standard deviation 0.20] versus 3.83 [standard deviation 0.76], P = .023). CONCLUSION The use of a shortened teamwork assessment instrument as a debriefing guide for student teams in student operating room team training was more effective in analysis of actions than the original, longer tool. Next steps include determining the efficacy of the quick teamwork assessment scale in an actual clinical setting.
Collapse
Affiliation(s)
- John T Paige
- Department of Surgery, LSU Health New Orleans School of Medicine, New Orleans, LA.
| | - Kathryn E Kerdolff
- John P. Ische Library, LSU Health New Orleans School of Medicine, New Orleans, LA
| | | | | | - Qingzhao Yu
- Department of Biostatistics, LSU Health New Orleans School of Public Health, New Orleans, LA
| | - Wentao Cao
- Department of Biostatistics, LSU Health New Orleans School of Public Health, New Orleans, LA
| | - Sergeii Rusnak
- Department of Medicine, LSU Health New Orleans School of Medicine, New Orleans, LA
| | | |
Collapse
|