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Kalantari R, Zamanian Z, Hasanshahi M, Jamali J, Faghihi A, Niakan MH, Gheysari S. An observational study to assess circulating nurses' non-technical skills. J Perioper Pract 2023; 33:296-301. [PMID: 36062532 DOI: 10.1177/17504589221117673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Non-technical skills are cognitive and social skills that are necessary for safe and efficient practices in operating theatre. These skills are inseparable parts of circulating nurses' duties and help them have a good performance during surgical processes. Circulating nurses' non-technical skills have not been closely measured, and much uncertainty still exists about the quality of their skills. This study aimed to assess circulating nurses' non-technical skills. METHODS A cross-sectional study was conducted on 300 circulating nurses who worked in four public hospitals in Iran, during 2020. The data of demographics of the studied population were collected using a demographic questionnaire. Kalantari et al's Circulating Practitioner's List of Non-Technical Skills was used to assess the circulating nurses' non-technical skills. RESULTS The situational awareness domain had the highest score, while leadership was the domain with the lowest mean score. There was a moderate positive relationship between the mean score of non-technical skills and the number of working years as a circulating nurse. CONCLUSION Although the circulating nurses had a moderate level of non-technical skills, they had low scores in several behaviours. However, they did well in some other behaviours. Educational interventions and policymaking solutions can help improve circulating nurses' non-technical skills.
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Affiliation(s)
- Reza Kalantari
- Department of Ergonomics, Faculty of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Zamanian
- Department of Ergonomics, Faculty of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Hasanshahi
- Department of Operating Room, School of Nursing, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jamshid Jamali
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Aliakbar Faghihi
- Clinical Educational Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hadi Niakan
- Department of Surgery, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Somayeh Gheysari
- Department of Operating Room, School of Nursing, Shiraz University of Medical Sciences, Shiraz, Iran
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2
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Niu A, Ma H, Chen Z, Zhang S, Deng J, Luo Y. Exploring the competencies of Chinese critical care nurses in mobile medical teams based on the onion model: A qualitative study. Nurs Crit Care 2023. [PMID: 37743055 DOI: 10.1111/nicc.12981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 08/20/2023] [Accepted: 09/07/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND With frequent conflicts, natural disasters, and public health emergencies globally, mobile medical teams (MMTs) are becoming increasingly critical. Importantly, the competency of critical care nurses in MMTs can substantially affect the effectiveness and quality of its rescue efforts. Yet, these nurses' competencies are not well understood. AIM This study examined the competencies of critical care nurses in MMTs using the Onion Model. DESIGN A qualitative descriptive method was used to describe the competencies of Chinese MMT critical care nurses. METHODS From April to May 2022, a convenience sample of 18 participants (14 critical care nurses and 4 surgeons) from 10 MMTs was recruited for semi-structured interviews. Deductive and inductive coding methods were combined for content analysis. RESULTS In total, 29 competencies were identified, which were grouped into four major domains using the Onion Model. From the outer to inner layers, these domains were knowledge and skills, professional abilities, professional quality, and personal traits. Several novel competencies emerged, including field medical equipment operation skills, on-site hazard identification and safety prevention skills, triage knowledge, and field survival skills. CONCLUSIONS Using the Onion Model, this study furthers the understanding of the competency of critical care nurses in MMTs, especially by revealing the novel competencies. Further, the results can be used to recruit, evaluate, and train critical care nurses for MMTs. RELEVANCE TO CLINICAL PRACTICE Understanding MMT critical care nurses' competencies can help managers plan and provide relevant training and education before deployment, which can improve nurses' performance, and especially reduce the mortalities and disabilities from trauma.
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Affiliation(s)
- Aifang Niu
- School of Nursing, Third Military University/Army Medical University, Chongqing, China
| | - Huijuan Ma
- School of Nursing, Third Military University/Army Medical University, Chongqing, China
| | - Zhe Chen
- Army Health Service Training Base, Third Military University/Army Medical University, Chongqing, China
| | - Suofei Zhang
- School of Nursing, Third Military University/Army Medical University, Chongqing, China
| | - Jing Deng
- School of Nursing, Third Military University/Army Medical University, Chongqing, China
| | - Yu Luo
- School of Nursing, Third Military University/Army Medical University, Chongqing, China
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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.
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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.
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Hallet J, Sutradhar R, Jerath A, d’Empaire PP, Carrier FM, Turgeon AF, McIsaac DI, Idestrup C, Lorello G, Flexman A, Kidane B, Kaliwal Y, Chan WC, Barabash V, Coburn N, Eskander A. Association Between Familiarity of the Surgeon-Anesthesiologist Dyad and Postoperative Patient Outcomes for Complex Gastrointestinal Cancer Surgery. JAMA Surg 2023; 158:465-473. [PMID: 36811886 PMCID: PMC9947805 DOI: 10.1001/jamasurg.2022.8228] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/23/2022] [Indexed: 02/24/2023]
Abstract
Importance The surgeon-anesthesiologist teamwork and relationship is crucial to good patient outcomes. Familiarity among work team members is associated with enhanced success in multiple fields but rarely studied in the operating room. Objective To examine the association between surgeon-anesthesiologist dyad familiarity-as the number of times working together-with short-term postoperative outcomes for complex gastrointestinal cancer surgery. Design, Setting, and Participants This population-based retrospective cohort study based in Ontario, Canada, included adults undergoing esophagectomy, pancreatectomy, and hepatectomy for cancer from 2007 through 2018. The data were analyzed January 1, 2007, through December 21, 2018. Exposures Dyad familiarity captured as the annual volume of procedures of interest done by the surgeon-anesthesiologist dyad in the 4 years before the index surgery. Main Outcomes and Measures Ninety-day major morbidity (any Clavien-Dindo grade 3 to 5). The association between exposure and outcome was examined using multivariable logistic regression. Results Seven thousand eight hundred ninety-three patients with a median age of 65 years (66.3% men) were included. They were cared for by 737 anesthesiologists and 163 surgeons who were also included. The median surgeon-anesthesiologist dyad volume was 1 (range, 0-12.2) procedures per year. Ninety-day major morbidity occurred in 43.0% of patients. There was a linear association between dyad volume and 90-day major morbidity. After adjustment, the annual dyad volume was independently associated with lower odds of 90-day major morbidity, with an odds ratio of 0.95 (95% CI, 0.92-0.98; P = .01) for each incremental procedure per year, per dyad. The results did not change when examining 30-day major morbidity. Conclusions and Relevance Among adults undergoing complex gastrointestinal cancer surgery, increasing familiarity of the surgeon-anesthesiologist dyad was associated with improved short-term patient outcomes. For each additional time that a unique surgeon-anesthesiologist dyad worked together, the odds of 90-day major morbidity decreased by 5%. These findings support organizing perioperative care to increase the familiarity of surgeon-anesthesiologist dyads.
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Affiliation(s)
- Julie Hallet
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Odette Cancer Centre, Division of Surgical Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Rinku Sutradhar
- ICES, Toronto, Ontario, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Angela Jerath
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Department of Anesthesiology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Pablo Perez d’Empaire
- Department of Anesthesiology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
| | - François M. Carrier
- Department of Anesthesiology and Pain Medicine, Université de Montréal, Montréal, Québec, Canada
- Division of Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Université Laval, Québec City, Québec, Canada
| | - Alexis F. Turgeon
- CHU de Québec–Université Laval Research Centre, Population Health and Optimal Health Practices Research Unit, Trauma– Emergency–Critical Care Medicine, Université Laval, Québec City, Québec, Canada
- Departments of Anesthesiology & Pain Medicine, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Daniel I. McIsaac
- Department of Anesthesiology and The Wilson Centre, University Health Network–Toronto Western Hospital, Toronto, Ontario, Canada
| | - Chris Idestrup
- Department of Anesthesiology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Gianni Lorello
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alana Flexman
- Section of Thoracic Surgery, Departments of Surgery and of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Anesthesiology, St Paul’s Hospital/Providence Health Care, Vancouver, British Columbia, Canada
| | - Biniam Kidane
- Department of Anesthesiology, St Paul’s Hospital/Providence Health Care, Vancouver, British Columbia, Canada
| | | | | | - Victoria Barabash
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Natalie Coburn
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Odette Cancer Centre, Division of Surgical Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Antoine Eskander
- Odette Cancer Centre, Division of Surgical Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Department of Anesthesiology, St Paul’s Hospital/Providence Health Care, Vancouver, British Columbia, Canada
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Zhang Y, Zheng B. Familiarity of surgical teams: Impact on laparoscopic procedure time. Am J Surg 2022; 224:1280-1284. [DOI: 10.1016/j.amjsurg.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/21/2022] [Accepted: 06/01/2022] [Indexed: 11/30/2022]
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Kalantari R, Zamanian Z, Hasanshahi M, Faghihi SAA, Niakan MH, Jamali J, Gheysari S. An interview study to identify circulating nurses’ nontechnical skills. SURGICAL PRACTICE 2022. [DOI: 10.1111/1744-1633.12540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Reza Kalantari
- Department of Ergonomics, Faculty of Public Health Shiraz University of Medical Sciences Shiraz Fars Iran
| | - Zahra Zamanian
- Department of Ergonomics, Faculty of Public Health Shiraz University of Medical Sciences Shiraz Fars Iran
| | - Mehdi Hasanshahi
- Department of Operating Room, Faculty of Nursing Shiraz University of Medical Sciences Shiraz Fars Iran
| | | | - Mohammad Hadi Niakan
- Department of Surgery, Faculty of Medicine Shiraz University of Medical Sciences Shiraz Fars Iran
| | - Jamshid Jamali
- Department of Biostatistics, Faculty of Public Health Mashhad University of Medical Sciences Mashhad Khorasane razavi Iran
| | - Somayeh Gheysari
- Department of Operating Room, Faculty of Nursing Shiraz University of Medical Sciences Shiraz Fars Iran
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Hara K, Kuroki T, Fukuda M, Onita T, Kuroda H, Matsuura E, Sawai T. Effects of Simulation-based Scrub Nurse Education for Novice Nurses in the Operating Room: A Longitudinal Study. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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8
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Opportunities for nurse involvement in surgical antimicrobial stewardship strategies: a qualitative study. Int J Nurs Stud 2022; 128:104186. [DOI: 10.1016/j.ijnurstu.2022.104186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 10/19/2022]
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Naviaux AF, Rigot A, Janne P, Gourdin M. Understanding stress factors for scrub nurses in the perioperative period: A cross-sectional survey. J Visc Surg 2021; 159:273-278. [PMID: 34802950 DOI: 10.1016/j.jviscsurg.2021.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE OF THE STUDY To assess the stress factors affecting operating theater nurses during the perioperative period. PATIENTS AND METHODS The study was conducted as a cross-sectional survey by means of a specifically drawn-up questionnaire based on the data available in the literature. Stress was measured on a 0/100 visual analogue scale (VAS). RESULTS Six hundred and twelve (612) persons responded. Stress associated with an operation amounted to 31.8; it was higher at the time of the procedure (49.6) and immediately beforehand (39.4), particularly among the least experienced nurses. The most widely represented stress factors were associated with the surgical team (perceived incompetence, lack of confidence), relational problems with regard to the surgeon, and team members' disruptive behavior. By contrast, familiarity with the team or the procedure seemed to shield the nurses from stress. Feelings of stress had a relatively frequent impact on quality of life (33%), family and personal life (26%), with chronic (recurrent or constant) stress symptoms reported among 20% of respondents. CONCLUSION Among operating theater nurses, stress associated with an operation was particularly strong among the least experienced professionals, when the type of procedure or the other team members were unfamiliar, and in the event of disruptive behavior. Stress factor improvement should be a priority, the objective being to enhance professional and personal quality of life, while better ensuring patient safety.
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Affiliation(s)
- A-F Naviaux
- Faculté de médecine, Université catholique de Louvain, USERN, Avenue Emmanuel Mounier 50, B-1200 Woluwé-Saint-Lambert, Belgium; College of Psychiatrists of Ireland; Health Service Executive (HSE) Summerhill Community Mental Health Service, Summer Hill; USERN, Wexford, W35 KC58, Ireland.
| | - A Rigot
- Faculté de Psychologie, Université catholique de Louvain; USERN, Place Cardinal Mercier 10, 1348 Ottignies-Louvain-la-Neuve, Belgium
| | - P Janne
- Faculté de Psychologie, Université catholique de Louvain; USERN, Place Cardinal Mercier 10, 1348 Ottignies-Louvain-la-Neuve, Belgium
| | - M Gourdin
- Faculté de médecine, Université catholique de Louvain, USERN, Avenue Emmanuel Mounier 50, B-1200 Woluwé-Saint-Lambert, Belgium; Université catholique de Louvain, Département d'Anesthésiologie, CHU UCL Namur; USERN, Yvoir, Belgium
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Urpo M, Eskola S, Suominen T, Roos M. Teamwork: a perspective of perioperative nurses. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2021. [DOI: 10.15452/cejnm.2021.12.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Silveira Thomas Porto C, Catal E. A comparative study of the opinions, experiences and individual innovativeness characteristics of operating room nurses on robotic surgery. J Adv Nurs 2021; 77:4755-4767. [PMID: 34423468 DOI: 10.1111/jan.15020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/11/2021] [Accepted: 07/20/2021] [Indexed: 11/28/2022]
Abstract
AIM To compare and evaluate operating room nurses' opinions about robotic surgery with their individual innovativeness metric scores. The aim was also to identify the experiences, adaptation processes and influencing factors of operating room nurses working in robotic surgery rooms in Turkey. DESIGN This was a comparative descriptive study. METHODS The sample included 114 operating room nurses working in 12 institutions that performed robotic surgery in Turkey. Data were collected between January 2018 and September 2019 using the Demographic Characteristics of Nurses and Robotic Surgery Evaluation Form and the Individual Innovativeness Scale, and were analysed using a quantitative statistical approach (independent samples t-test, one-way analysis of variance and Kruskal-Wallis H test). The data obtained from the Robotic Surgery Evaluation section, which consisted of open-ended and closed-ended questions, were analysed with appropriate steps. In particular, answers to open-ended questions were grouped and coded according to their content. RESULTS Operating room nurses held positive opinions about robotic surgery. Only 35.8% of the nurses had received training before joining the robotic team, while 55.2% had individually searched for information. Operating room nurses with robotic surgery experience had significantly higher (p < .001) individual innovativeness scores. Over 85% of nurses who received training adapted to robotic surgery in 3 months or less, while nurses with higher individual innovativeness scores adapted in a statistically significantly (p < .05) shorter period. Training, teamwork, and practical experience were mentioned as facilitating factors; inadequate training and technical problems were reported as obstructing factors. CONCLUSION Operating room nurses hold positive opinions about robotic surgery; nurses with robotic surgery experience have higher levels of individual innovativeness; and nurses who have received training are significantly better adapted. IMPACT What problem did the study address? This study addresses the need for a better understanding of operating room nurses' opinions and experiences about robotic surgery and the influencing factors of adapting to it. This study also offers an evaluation and comparison of the nurses' individual innovativeness characteristics and the correlation with their adaptation processes to the new role. What were the main findings? The main findings show a correlation between specific education/training and nurses' adaptation to the new role of robotic surgery, the individual innovativeness characteristics metric of nurses with or without robotic surgery experience and the time frame of their adaptation. Where and on whom will the research have an impact? This research traces the profile of current operating room nurses working in the robotic surgery field and the factors influencing their experience. These findings and conclusions have a much broader impact than in Turkey alone. The findings raise awareness of the importance of educating and preparing operating room nurses before introducing them to the new roles and responsibilities inherent to robotic surgery.
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Affiliation(s)
- Cindy Silveira Thomas Porto
- Surgical Diseases Nursing Master's Program, Institute of Health Sciences, Akdeniz University, Antalya, Turkey
| | - Emine Catal
- Department of Surgical Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
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Stucky CH, De Jong MJ. Surgical Team Familiarity: An Integrative Review. AORN J 2021; 113:64-75. [PMID: 33377513 DOI: 10.1002/aorn.13281] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/02/2020] [Accepted: 05/26/2020] [Indexed: 11/05/2022]
Abstract
The dynamic nature of perioperative care often brings unfamiliar clinicians together yet requires them to collectively provide complex health care in a challenging environment. In this review, we comprehensively evaluated evidence regarding surgical team familiarity and its relationship to surgical team performance. Using a comprehensive and iterative search strategy, we searched PubMed, Web of Science, PsycInfo, and EMBASE for surgical team familiarity manuscripts. We identified 598 manuscripts, 16 of which met our inclusion criteria. We found that surgical team familiarity is associated with improved performance for many metrics, including shorter total operative time, team member safety, decreased surgical errors and disruptions, reduced miscommunication, and fewer patient readmissions. Although additional research would be helpful, surgical managers should consider team familiarity and consistency in team membership when assigning staff members to surgical teams to optimize surgical care, decrease inefficiencies, and promote safe patient outcomes.
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Bracq MS, Michinov E, Le Duff M, Arnaldi B, Gouranton V, Jannin P. Training situational awareness for scrub nurses: Error recognition in a virtual operating room. Nurse Educ Pract 2021; 53:103056. [PMID: 33930750 DOI: 10.1016/j.nepr.2021.103056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 02/12/2021] [Accepted: 04/12/2021] [Indexed: 11/29/2022]
Abstract
Virtual reality simulation provides interesting opportunities to train nurses in a safe environment. While the virtual operating room has proven to be a useful training tool for technical skills, it has been less studied for non-technical skills. This study aimed to assess "Error recognition in a virtual operating room", using a simulation scenario designed to improve situation awareness. Eighteen scrub-nurse students and 8 expert scrub-nurses took part in the experiment. They were immersed in a virtual operating room and reported any errors they observed. There were nineteen errors with various degrees of severity. Measures were retrieved from logs (number of errors, time for detection, movements) and from questionnaires (situation awareness, subjective workload, anxiety and user experience). The results showed that the participants who detected most errors had a higher level of situation awareness, detected high-risk errors faster and felt more immersed in the virtual operating room than those detecting fewer errors. They also felt the workload was lighter and experienced more satisfaction. Students explored the operating room more than experts did and detected more errors, especially those with moderate risk. Debriefings confirmed that virtual simulation is acceptable to trainees and motivates them. It also provides useful and original material for debriefings.
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Affiliation(s)
- Marie-Stéphanie Bracq
- Univ Rennes, LP3C (EA 1285), F-35000 Rennes, France; Univ Rennes, Inserm, LTSI - UMR 1099, F-35000 Rennes, France.
| | | | - Marie Le Duff
- Univ Rennes, Inserm, LTSI - UMR 1099, F-35000 Rennes, France.
| | - Bruno Arnaldi
- Univ Rennes, INSA Rennes, Inria, CNRS, IRISA, F-35000 Rennes, France.
| | - Valérie Gouranton
- Univ Rennes, INSA Rennes, Inria, CNRS, IRISA, F-35000 Rennes, France.
| | - Pierre Jannin
- Univ Rennes, Inserm, LTSI - UMR 1099, F-35000 Rennes, France.
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Dellefield ME, Verkaaik CA. Using the Observational Teamwork Assessment in Surgery Instrument to Measure RN Teamwork During Cardiac Surgery: Lessons Learned. J Nurs Care Qual 2021; 36:162-168. [PMID: 32568965 DOI: 10.1097/ncq.0000000000000497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Surgical teams aspire to be safe and avoid preventable deaths. A lack of teamwork has been associated with safety failures, including adverse events and errors. PURPOSE The purpose of the pilot study was to: (1) modify the Observational Teamwork Assessment in Surgery (OTAS) and the original data collection method to measure registered nurse (RN) teamwork during the intraoperative phase of 5 open heart surgical procedures and (2) recommend strategies to further test the reliability and validity of the modified OTAS. METHODS This was a pilot study of the OTAS using direct observation. RESULTS Although characterized as psychometrically rigorous in prior systematic reviews, using the OTAS to measure RN teamwork in the intraoperative phase of cardiac surgery revealed deficits in its content validity and reliability. The OTAS and its original data collection method were modified. CONCLUSION Recommendations for further use of the modified OTAS to increase its reliability and validity are given.
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Zhang C, Baalsrud Hauge J, Härenstam KP, Meijer S. Game Experience and Learning Effects of a Scoring-Based Mechanic for Logistical Aspects of Pediatric Emergency Medicine: Development and Feasibility Study. JMIR Serious Games 2021; 9:e21988. [PMID: 33704081 PMCID: PMC7995068 DOI: 10.2196/21988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/27/2020] [Accepted: 02/12/2021] [Indexed: 01/11/2023] Open
Abstract
Background Using serious games for learning in operations management is well established. However, especially for logistics skills in health care operations, there is little work on the design of game mechanics for learning engagement and the achievement of the desired learning goals. Objective This contribution presents a serious game design representing patient flow characteristics, systemic resource configurations, and the roles of the players based on a real Swedish emergency ward. The game was tested in a set of game-based learning practices in the modalities of a physical board game and an online multiplayer serious game that implemented the same game structure. Methods First, survey scores were collected using the Game Experience Questionnaire Core and Social Presence Modules to evaluate the experience and acceptance of the proposed design to gamify real processes in emergency care. Second, lag sequential analysis was applied to analyze the impact of the game mechanics on learning behavior transitions. Lastly, regression analysis was used to understand whether learning engagement attributes could potentially serve as significant predicting variables for logistical performance in a simulated learning environment. Results A total of 36 students from courses in engineering and management at KTH Royal Institute of Technology participated in both game-based learning practices during the autumn and spring semesters of 2019 and 2020. For the Core Module, significant differences were found for the scores for negative affect and tension compared with the rest of the module. For the Social Presence Module, significant differences were found in the scores for the psychological involvement – negative feelings dimension compared with the rest of the module. During the process of content generation, the participant had access to circulating management resources and could edit profiles. The standard regression analysis output yielded a ΔR2 of 0.796 (F14,31=2725.49, P<.001) for the board version and 0.702 (F24,31=2635.31, P<.001) for the multiplayer online version after the learning engagement attributes. Conclusions The high scores of positive affect and immersion compared to the low scores of negative feelings demonstrated the motivating and cognitive involvement impact of the game. The proposed game mechanics have visible effects on significant correlation parameters between the majority of scoring features and changes in learning engagement attributes. Therefore, we conclude that for enhancing learning in logistical aspects of health care, serious games that are steered by well-designed scoring mechanisms can be used.
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Affiliation(s)
- Cevin Zhang
- School of Media and Design, Beijing Technology and Business University, Beijing, China.,Department of Biomedical Engineering and Health Systems, Kungliga Tekniska Högskolan, Huddinge, Sweden
| | - Jannicke Baalsrud Hauge
- Department of Sustainable Production Development, Kungliga Tekniska Högskolan, Södertalje, Sweden
| | - Karin Pukk Härenstam
- Pediatric Emergency Department, Karolinska University Hospital, Stockholm, Sweden
| | - Sebastiaan Meijer
- Department of Biomedical Engineering and Health Systems, Kungliga Tekniska Högskolan, Huddinge, Sweden
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Mykkeltveit I, Bentsen SB. Den norske versjonen av SPLINTS (SPLINTS-no)- et instrument for å utvikle og vurdere ikke tekniske ferdigheter hos operasjonssykepleiere. ACTA ACUST UNITED AC 2020. [DOI: 10.18261/issn.1892-2686-2020-03-04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Non-technical skills and device-related interruptions in minimally invasive surgery. Surg Endosc 2020; 35:4494-4500. [PMID: 32886238 DOI: 10.1007/s00464-020-07962-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/27/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Device-related interruptions in the operating room (OR) may create stress among health care providers and delays. Although non-technical skills (NTS) of the OR teams, such as situational awareness and communication, are expected to influence device-related interruptions, empirical data on this relationship are limited. METHODS We performed a prospective cohort study of 144 consecutive elective laparoscopic operations during 13 months. A data capture system called the OR Black Box® was used to characterize device-related interruptions, NTS, and distractions. Device-related interruptions were classified according to a priori established categories. Positive and negative NTS instances were identified according to validated measurement tools specific for nurses and surgeons. We assessed the relationship between NTS and device-related interruptions after adjusting for potential confounders. RESULTS A total of 86 device-related interruptions occurred in 48 of 144 operations (33%). They were most frequently classified as device failure (54%) followed by improper assembly (19%) and disconnection (14%). Medians of 1 [interquartile range (IQR) 0-3] and 1 (IQR 0-2) negative NTS instance per operation were demonstrated by nurses and surgeons, respectively. Medians of 28 (IQR 15-38) and 40 (IQR 28-118) positive NTS instances per operation were demonstrated by nurses and surgeons. In a multivariable analysis, a higher frequency of negative NTS instances demonstrated by nurses was associated with device-related interruptions after risk adjustment (Odds Ratio 1.33, p = 0.02). CONCLUSIONS In elective laparoscopic operations, an increased likelihood of device-related interruptions in the OR was associated with more frequent negative NTS demonstrations by nursing teams.
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Bretonnier M, Michinov E, Le Pabic E, Hénaux PL, Jannin P, Morandi X, Riffaud L. Impact of the complexity of surgical procedures and intraoperative interruptions on neurosurgical team workload. Neurochirurgie 2020; 66:203-211. [PMID: 32416100 DOI: 10.1016/j.neuchi.2020.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 02/02/2020] [Accepted: 02/22/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Neurosurgical teams are exposed to various stressors: complexity of surgical procedures, environment, time pressure and interruptions contribute to increasing the perceived workload. OBJECTIVE This study aimed to evaluate the impact of interruptions and surgical complexity on neurosurgical team workload. METHODS A prospective observational study was conducted on thirty surgical procedures of graduated complexity recorded in our Department of Neurosurgery. A scale was created and used by neurosurgeons to evaluate the perceived complexity of the surgical procedure. Interruptions and severity of interruptions were noted. The workloads of the neurosurgeon, surgical assistant, scrub nurse and circulating nurse were measured on the Surgery Task Load Index (SURG-TLX) at the end of the procedure. RESULTS A mean 24.6 interruptions per hour were recorded. The mean interference level of the interruptions was 3.5/7. Mean surgical complexity was 4.3/10. Mean sterile team workload was 43.4/100. The multiple linear regression model showed that sterile team workload increased with surgical complexity (β=6.692, P=.0002) but decreased in spite of increases in the number of interruptions per hour (β=-0.855, P=.027). Neurosurgeon and surgical assistant workload increased with surgical complexity (β=11.53, P<0.0001 and β=7.42, P=0.0007, respectively). Scrub nurse workload decreased in spite of increases in the number of interruptions per hour (β=-1.11, P=.026). CONCLUSION Our study suggests positive effects of some interruptions during elective neurosurgical procedures with strong team familiarity.
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Affiliation(s)
- M Bretonnier
- Univ Rennes, INSERM, LTSI - UMR 1099, 35000 Rennes, France; Department of Neurosurgery, Pontchaillou University Hospital, 2 Rue Henri Le Guilloux, 35033 Rennes Cedex 9, France.
| | - E Michinov
- Univ Rennes, LP3C (Laboratoire de Psychologie : Cognition, Comportement, Communication) - EA 1285, 35000 Rennes, France
| | - E Le Pabic
- Clinical Data Center, Pontchaillou University Hospital, Rennes, France; INSERM, CIC 1414, 35000 Rennes, France
| | - P-L Hénaux
- Univ Rennes, INSERM, LTSI - UMR 1099, 35000 Rennes, France; Department of Neurosurgery, Pontchaillou University Hospital, 2 Rue Henri Le Guilloux, 35033 Rennes Cedex 9, France
| | - P Jannin
- Univ Rennes, INSERM, LTSI - UMR 1099, 35000 Rennes, France
| | - X Morandi
- Univ Rennes, INSERM, LTSI - UMR 1099, 35000 Rennes, France; Department of Neurosurgery, Pontchaillou University Hospital, 2 Rue Henri Le Guilloux, 35033 Rennes Cedex 9, France
| | - L Riffaud
- Univ Rennes, INSERM, LTSI - UMR 1099, 35000 Rennes, France; Department of Neurosurgery, Pontchaillou University Hospital, 2 Rue Henri Le Guilloux, 35033 Rennes Cedex 9, France
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Operating Room Culture and Interprofessional Relations: Impact on Nurse's Retention. Health Care Manag (Frederick) 2020; 38:301-310. [PMID: 31663870 DOI: 10.1097/hcm.0000000000000280] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this article is to describe interprofessional relations in order to better understand their impact on nurse retention, while considering the operating room culture and its specific context. A focused ethnography was performed between September and October 2017 at a university hospital in an urban center in the province of Quebec, Canada. This was a secondary analysis of 11 nurses' semistructured one-on-one interviews. Additional data were collected through 6 days of observations, informal conversations, field notes, and a journal. A thematic analysis followed. Interprofessional relations and the need for recognition are important for nurse retention. In addition, a nurse's personality appears to be an important aspect in the complex and specific context of the operating room. Nurse retention in the operating room is multifactoral, and like the need for recognition, interprofessional relations are important issues. Interventions to improve working relationships, recognition of nurses, and consideration of a nurse's personality during hiring appear to be promising avenues for improving retention in the operating room.
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McMullan RD, Urwin R, Sunderland N, Westbrook J. Observational Tools That Quantify Nontechnical Skills in the Operating Room: A Systematic Review. J Surg Res 2020; 247:306-322. [DOI: 10.1016/j.jss.2019.10.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 09/18/2019] [Accepted: 10/01/2019] [Indexed: 12/14/2022]
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Relationships Between Expertise, Crew Familiarity and Surgical Workflow Disruptions: An Observational Study. World J Surg 2019; 43:431-438. [PMID: 30280222 DOI: 10.1007/s00268-018-4805-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Teamwork is an essential factor in reducing workflow disruption (WD) in the operating room. Team familiarity (TF) has been recognized as an antecedent to surgical quality and safety. To date, no study has examined the link between team members' role and expertise, TF and WD in surgical setting. This study aimed to examine the relationships between expertise, surgeon-scrub nurse familiarity and WD. METHODS We observed a convenience sample of 12 elective neurosurgical procedures carried out by 4 surgeons and 11 SN with different levels of expertise and different degrees of familiarity between surgeons and SN. We calculated the number of WD per unit of coding time to control for the duration of operation. We explored the type and frequency of WD, and the differences between the surgeons and SN. We examined the relationships between duration of WD, staff expertise and surgeon-scrub nurse familiarity. RESULTS 9.91% of the coded surgical time concerned WD. The most frequent causes of WD were distractions (29.7%) and colleagues' interruptions (25.2%). This proportion was seen for SN, whereas teaching moments and colleagues' interruptions were the most frequent WD for surgeons. The WD was less high among expert surgeons and less frequent when surgeon was familiar with SN. CONCLUSIONS The frequency of WD during surgical time can compromise surgical quality and patient safety. WD seems to decrease in teams with high levels of surgeon-scrub nurse familiarity and with development of surgical expertise. Favoring TF and giving feedback to the team about WD issues could be interesting ways to improve teamwork.
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Neyens DM, Bayramzadeh S, Catchpole K, Joseph A, Taaffe K, Jurewicz K, Khoshkenar A, San D. Using a systems approach to evaluate a circulating nurse's work patterns and workflow disruptions. APPLIED ERGONOMICS 2019; 78:293-300. [PMID: 29609835 PMCID: PMC6165699 DOI: 10.1016/j.apergo.2018.03.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 02/28/2018] [Accepted: 03/26/2018] [Indexed: 06/08/2023]
Abstract
The physical environment affects how work is done in operating rooms (OR). The circulating nurse (CN), in particular, requires access to and interacts with materials, equipment, and technology more than other OR team members. Naturalistic study of CN behavior is therefore valuable in assessing how OR space and physical configuration influences work patterns and disruptions. This study evaluated the CNs' work patterns and flow disruptions (FD) by analyzing 25 surgeries across three different ORs. The OR layouts were divided into transitional and functional zones, and the work of CNs was categorized into patient, equipment, material, and information tasks. The results reveal that information tasks involve less movement than other types of work, while across all ORs, CNs were more likely to be involved in layout and environmental hazard FDs when involved in patient, material, or equipment-related tasks compared to information tasks. Different CN work patterns and flow disruptions between ORs suggest a link between OR layout and a CN's work. Future studies should examine how specific layout elements influence outcomes.
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Affiliation(s)
- David M Neyens
- Clemson University, Department of Industrial Engineering, 100 Freeman Hall, College of Engineering, Computing and Applied Sciences, Clemson, SC 29634, USA.
| | - Sara Bayramzadeh
- Clemson University, School of Architecture, Lee 2, Clemson University, Clemson, SC 29634, USA.
| | - Kenneth Catchpole
- Medical University of South Carolina, Department of Anesthesia and Perioperative Medicine, Charleston, SC 29425, USA.
| | - Anjali Joseph
- Clemson University, School of Architecture, Lee 2, Clemson University, Clemson, SC 29634, USA.
| | - Kevin Taaffe
- Clemson University, Department of Industrial Engineering, 100 Freeman Hall, College of Engineering, Computing and Applied Sciences, Clemson, SC 29634, USA.
| | - Katherina Jurewicz
- Clemson University, Department of Industrial Engineering, 100 Freeman Hall, College of Engineering, Computing and Applied Sciences, Clemson, SC 29634, USA.
| | - Amin Khoshkenar
- Clemson University, Department of Industrial Engineering, 100 Freeman Hall, College of Engineering, Computing and Applied Sciences, Clemson, SC 29634, USA.
| | - Dee San
- Medical University of South Carolina, 169 Ashley Avenue, Suite 638, Charleston, SC 29625, USA.
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Loh HP, De Korne DF, Yin SQ, Ang E, Lau Y. Assessment of Scrub Practitioners’ List of Intraoperative Non‐Technical Skills (SPLINTS) in an Asian Ambulatory Surgical Setting. AORN J 2019; 109:465-476. [DOI: 10.1002/aorn.12640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Falk-Brynhildsen K, Jaensson M, Gillespie BM, Nilsson U. Swedish Operating Room Nurses and Nurse Anesthetists' Perceptions of Competence and Self-Efficacy. J Perianesth Nurs 2019; 34:842-850. [PMID: 30738727 DOI: 10.1016/j.jopan.2018.09.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/07/2018] [Accepted: 09/23/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE To compare perceived competence and self-efficacy (SE) among Swedish operating room (OR) nurses and registered nurse anesthetists (RNAs), and to evaluate the relationship between SE and competence, gender, age, and years of experience. DESIGN Comparative cross-sectional survey. METHODS Two validated questionnaires, Perceived Perioperative Competence Scale-Revised and General Self-Efficacy Scale, were sent to members of the Swedish Association of Health Professionals (n = 2,902). FINDINGS The response rate was 39% (n = 1,033). OR nurses showed significantly higher scores on Perceived Perioperative Competence Scale-Revised subscale foundational knowledge and leadership as well as General Self-Efficacy Scale scores compared with RNAs. The RNA group showed significantly higher empathy scores compared with OR nurses. Among the OR nurses professional development made the strongest contribution to SE and proficiency among the RNAs. CONCLUSIONS These results suggest that there are differences in perceived competence and SE between OR nurses and RNAs. Gender may be an independent factor affecting SE.
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Implementing Medical Technological Equipment in the OR: Factors for Successful Implementations. JOURNAL OF HEALTHCARE ENGINEERING 2018; 2018:8502187. [PMID: 30245784 PMCID: PMC6136550 DOI: 10.1155/2018/8502187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 07/29/2018] [Indexed: 11/28/2022]
Abstract
Operating rooms (ORs) more and more evolve into high-tech environments with increasing pressure on finances, logistics, and a not be neglected impact on patient safety. Safe and cost-effective implementation of technological equipment in ORs is notoriously difficult to manage, specifically as generic implementation activities omit as hospitals have implemented local policies for implementations of technological equipment. The purpose of this study is to identify success factors for effective implementations of new technologies and technological equipment in ORs, based on a systematic literature review. We accessed ten databases and reviewed included articles. The search resulted in 1592 titles for review, and finally 37 articles were included in this review. We distinguish influencing factors and resulting factors based on the outcomes of this research. Six main categories of influencing factors on successful implementations of medical equipment in ORs were identified: “processes and activities,” “staff,” “communication,” “project management,” “technology,” and “training.” We identified a seventh category “performance” referring to resulting factors during implementations. We argue that aligning the identified influencing factors during implementation impacts the success, adaptation, and safe use of new technological equipment in the OR and thus the outcome of an implementation. The identified categories in literature are considered to be a baseline, to identify factors as elements of a generic holistic implementation model or protocol for new technological equipment in ORs.
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Müller P, Tschan F, Keller S, Seelandt J, Beldi G, Elfering A, Dubach B, Candinas D, Pereira D, Semmer NK. Assessing Perceptions of Teamwork Quality Among Perioperative Team Members. AORN J 2018; 108:251-262. [PMID: 30156726 DOI: 10.1002/aorn.12343] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
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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Redaelli I. Nontechnical skills of the operating theatre circulating nurse: An ethnographic study. J Adv Nurs 2018; 74:2851-2859. [DOI: 10.1111/jan.13800] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/26/2018] [Accepted: 06/08/2018] [Indexed: 12/22/2022]
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Roche F. Human factors and non-technical skills: Teamwork. J Perioper Pract 2018; 26:285-288. [PMID: 29328768 DOI: 10.1177/175045891602601205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 09/15/2016] [Indexed: 01/04/2023]
Abstract
Making mistakes is part of being human and human error is normal in all areas of life (Bromiley and Mitchell 2009). In some contexts this is of little consequence, but in environments where human safety and well-being are at stake it is vital that such error is minimised. The operating theatre is one such safety critical environment. Research suggests, however, that certain factors predispose to human error. Some or all of these factors may be present in the operating theatre and, therefore, have the potential to compromise patient safety.
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Affiliation(s)
- Fiona Roche
- Queen Elizabeth University Hospital, Glasgow, UK
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McClelland G. Factors that affect scrub practitioner non-technical skills: a qualitative analysis. J Perioper Pract 2018; 29:216-222. [PMID: 30062932 DOI: 10.1177/1750458918791112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Context Non-technical skills are the cognitive and affective behaviours that underpin clinical practice in surgery. The purpose of this study was to explore the factors that affect how scrub practitioners use non-technical skills during surgery and their behavioural responses to those factors. Methods Eight scrub practitioners participated in a qualitative semi-structured interview study. Results Five major categories were found to affect scrub practitioner non-technical skills. These categories were democratises surgery, learns from experiences, comprehends situations, comprehends behaviours and insidious threats. Key findings and implications: A scrub practitioner’s ability to use non-technical skills results from the interdependent relationship of intrinsic and extrinsic motivators that affect their own behaviours, and those of their colleagues, during surgery.
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Affiliation(s)
- Guy McClelland
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
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Abstract
Non-technical skills are the cognitive and interpersonal behaviours that compliment clinical competence in surgery. Effective use of non-technical skills is essential for scrub practice, because they facilitate anticipation of the surgeon's requirements and promote appropriate communication behaviours. This literature review analyses the factors that may influence a scrub practitioner's use of non-technical skills during surgery. Recommendations are made that are intended to improve their use by reducing behavioural variations during surgery.
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Affiliation(s)
- Guy McClelland
- Senior Lecturer in Operating Department Practice, Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
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Bayramzadeh S, Joseph A, San D, Khoshkenar A, Taaffe K, Jafarifiroozabadi R, Neyens DM. The Impact of Operating Room Layout on Circulating Nurse’s Work Patterns and Flow Disruptions: A Behavioral Mapping Study. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2018; 11:124-138. [DOI: 10.1177/1937586717751124] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim: To assess how the adjacencies of functionally different areas within operating rooms (ORs) can influence the circulating nurse’s (CN) workflow patterns and disruptions. Background: The CN plays a significant role in promoting patient safety during surgical procedures by observing, monitoring, and managing potential threats at and around the surgical field. Their work requires constant movement to different parts of the OR to support team members. The layout of the OR and crowded and cluttered environment might impact the CN’s workflow and cause disruptions during the surgery. Method: A convenience sample of 25 surgeries were video recorded and thematically coded for CN’s activities, locations, and flow disruptions. The OR layout was categorized into transitional zones and functional zones (workstations, supply zones, support zones, and sterile areas around the surgical table). CN’s activities were classified into patient-, equipment-, material-, and information-related activities. Flow disruptions included those related to environmental hazards and layout. Results: The CN traveled through multiple zones during 91% of the activities. The CN’s workstation acted as a main hub from which the CN made frequent trips to both sides of the surgical table, the foot of the OR table, supply zones, and support zones. Transitional zones accounted for 58.3% of all flow disruption that the CN was involved in whereas 28% occurred in areas surrounding the OR bed. Conclusion: The similarity of the movement and flow disruption patterns, despite variations in OR layout, highlighted the adjacencies required between major zones that CNs regularly visit. These optimum adjacencies should be considered while designing ORs such that they are more efficient and safer.
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Affiliation(s)
- Sara Bayramzadeh
- Center for Health Facilities Design and Testing, School of Architecture, Clemson University, Clemson, SC, USA
| | - Anjali Joseph
- Center for Health Facilities Design and Testing, School of Architecture, Clemson University, Clemson, SC, USA
| | - Dee San
- Medical University of South Carolina, Charleston, SC, USA
| | - Amin Khoshkenar
- Department of Industrial Engineering, Clemson University, Clemson, SC, USA
| | - Kevin Taaffe
- Department of Industrial Engineering, Clemson University, Clemson, SC, USA
| | - Roxana Jafarifiroozabadi
- Center for Health Facilities Design and Testing, School of Architecture, Clemson University, Clemson, SC, USA
| | - David M. Neyens
- Department of Industrial Engineering, Clemson University, Clemson, SC, USA
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Mundt AS, Spanager L, Lyk-Jensen HT, Østergaard D. Adaptation of a tool to assess non-technical skills of scrub practitioners in Denmark. J Perioper Pract 2018; 27:180-185. [PMID: 29328750 DOI: 10.1177/175045891702700901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 11/10/2016] [Indexed: 01/19/2023]
Abstract
The aim of this study was to adapt the Scottish tool, Scrub Practitioners List of Intraoperative Non-Technical Skills, to Danish organisation and culture. With an explorative and qualitative approach, four group interviews with scrub practitioners, surgeons and anaesthesia staff were conducted. The main differences found were related to communication and teamwork regarding scrub practitioners focus on the team and speaking up. Differences in the non-technical skills described in the behavioural markers are perhaps explained by cultural differences between Scotland and Denmark. A new tool for scrub practitioners in Denmark was adapted.
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Affiliation(s)
- Anna Sofie Mundt
- Copenhagen Academy for Medical Education and Simulation. Capital Region of Denmark
| | | | | | - Doris Østergaard
- Copenhagen Academy for Medical Education and Simulation. Capital Region of Denmark and University of Copenhagen
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Sonoda Y, Onozuka D, Hagihara A. Factors related to teamwork performance and stress of operating room nurses. J Nurs Manag 2017; 26:66-73. [DOI: 10.1111/jonm.12522] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Yukio Sonoda
- Department of Health Communication; Kyushu University Graduate School of Medicine; Fukuoka Japan
- Department of Acute Care and General Medicine; Saiseikai Kumamoto Hospital; Kumamoto Japan
| | - Daisuke Onozuka
- Assistant Professor; Department of Health Communication; Kyushu University Graduate School of Medicine; Fukuoka Japan
| | - Akihito Hagihara
- Professor; Department of Health Communication; Kyushu University Graduate School of Medicine; Fukuoka Japan
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Abstract
Situation awareness (SA) refers to the conscious awareness of the current situation in relation to one’s environment. In nursing, loss or failure to achieve high levels of SA is linked with adverse patient outcomes. The purpose of this integrative review is to examine various instruments and techniques used to measure SA among nurses across academic and clinical settings. Computerized database and ancestry search strategies resulted in 40 empirical research reports. Of the reports included in the review, 24 measured SA among teams that included nurses and 16 measured SA solely in nurses. Methods used to evaluate SA included direct and indirect methods. Direct methods included the Situation Awareness Global Assessment Technique and questionnaires. Indirect methods included observer rating instruments and performance outcome measures. To have a better understanding of how nurses’ make decisions in complex work environments, reliable and valid measures of SA is crucial.
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Affiliation(s)
- Sabrina B. Orique
- University of Missouri, Columbia, MO, USA
- Kaweah Delta Health Care District, Visalia, CA, USA
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Gillespie BM, Harbeck E, Kang E, Steel C, Fairweather N, Chaboyer W. Correlates of non-technical skills in surgery: a prospective study. BMJ Open 2017; 7:e014480. [PMID: 28137931 PMCID: PMC5293872 DOI: 10.1136/bmjopen-2016-014480] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Communication and teamwork failures have frequently been identified as the root cause of adverse events and complications in surgery. Few studies have examined contextual factors that influence teams' non-technical skills (NTS) in surgery. The purpose of this prospective study was to identify and describe correlates of NTS. METHODS We assessed NTS of teams and professional role at 2 hospitals using the revised 23-item Non-TECHnical Skills (NOTECHS) and its subscales (communication, situational awareness, team skills, leadership and decision-making). Over 6 months, 2 trained observers evaluated teams' NTS using a structured form. Interobserver agreement across hospitals ranged from 86% to 95%. Multiple regression models were developed to describe associations between operative time, team membership, miscommunications, interruptions, and total NOTECHS and subscale scores. RESULTS We observed 161 surgical procedures across 8 teams. The total amount of explained variance in NOTECHS and its 5 subscales ranged from 14% (adjusted R2 0.12, p<0.001) to 24% (adjusted R2 0.22, p<0.001). In all models, inverse relationships between the total number of miscommunications and total number of interruptions and teams' NTS were observed. CONCLUSIONS Miscommunications and interruptions impact on team NTS performance.
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Affiliation(s)
- Brigid M Gillespie
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia
- Gold Coast University Hospital, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia
- National Centre for Research Excellence in Nursing (NCREN), Menzies Health Institute Qld (MHIQ), Griffith University, Gold Coast, Queensland, Australia
| | - Emma Harbeck
- School of Applied Psychology, Griffith University, Gold Coast, Queensland, Australia
| | - Evelyn Kang
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia
| | - Catherine Steel
- Division of Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Nicole Fairweather
- Division of Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Wendy Chaboyer
- National Centre for Research Excellence in Nursing (NCREN), Menzies Health Institute Qld (MHIQ), Griffith University, Gold Coast, Queensland, Australia
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