Nina V, Mendes AG, Sevdalis N, Marath A, Mejia OV, Brandão CMA, Monteiro R, Mendes VG, Jatene FB. Applicability of the Disruptions in Surgery Index in the Cardiovascular Management Scenarios - A Marker for Developing Functionally Efficient Teams.
Braz J Cardiovasc Surg 2021;
36:445-452. [PMID:
34617425 PMCID:
PMC8522325 DOI:
10.21470/1678-9741-2020-0685]
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Abstract
Introduction
To support the development of practices and guidelines that might help to
reduce adverse events related to human factors, we aimed to study the
response and perception by members of a cardiovascular surgery team of
various error-driven or adverse features that might arise in the operating
room (OR).
Methods
A previously validated Disruptions in Surgery Index (DiSI) questionnaire was
completed by individuals working together in a cardiovascular surgical unit.
Results were submitted to reliability analysis by calculating the Cronbach’s
alpha coefficient. Non-parametric Kruskal-Wallis test and Dunn’s post-test
were performed to estimate differences in perceptions of adverse events or
outcomes between the groups (surgeons, nurses, anesthesiologists, and
technicians). P<0.05 was considered statistically
significant.
Results
Cronbach’s alpha reliability coefficients showed consistency within the
recommended range for all disruption types assessed in DiSI: an individual’s
skill (0.85), OR environment (0.88), communication (0.81), situational
awareness (0.92), patient-related disruption (0.89), team cohesion (0.83),
and organizational disruption (0.83). Nurses (27.4%) demonstrated
significantly higher perception of disruptions than surgeons (25.4%),
anesthetists (23.3%), and technicians (23.0%) (P=0.005).
Study participants were more observant of their colleagues’ disruptive
behaviors than their own (P=0.0001).
Conclusion
Our results revealed that there is a tendency among participants to hold a
positive self-perception position. DiSI appears to be a reliable and useful
tool to assess surgical disruptions in cardiovascular OR teams, identifying
negative features that might imperil teamwork and safety in the OR. And
human factors training interventions are available to develop team skills
and improve safety and efficiency in the cardiovascular OR.
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