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Interprofessional team assessments of the patient safety climate in Swedish operating rooms: a cross-sectional survey.

ABSTRACT: BACKGROUND:A positive patient safety climate within teams has been associated with higher safety performance. The aim of this study was to describe and compare attitudes to patient safety among the various professionals in surgical teams in Swedish operating room (OR) departments. A further aim was to study nurse managers in the OR and medical directors' estimations of their staffs' attitudes to patient safety. METHODS:A cross-sectional survey with the Safety Attitudes Questionnaire (SAQ) was used to elicit estimations from surgical teams. To evoke estimations from nurse managers and medical directors about staff attitudes to patient safety, a short questionnaire, based on SAQ, was used. Three OR departments at three different hospitals in Sweden participated. All licensed practical nurses (n=124), perioperative nurses (n=233), physicians (n=184) and their respective manager (n=22) were invited to participate. RESULTS:Mean percentage positive scores for the six SAQ factors and the three professional groups varied, and most factors (safety climate, teamwork climate, stress recognition, working conditions and perceptions of management), except job satisfaction, were below 60%. Significantly lower mean values were found for perioperative nurses compared with physicians for perceptions of management (56.4 vs 61.4, p=0.013) and working conditions (63.7 vs 69.8, p=0.007). Nurse managers and medical directors' estimations of their staffs' ratings of the safety climate cohered fairly well. CONCLUSIONS:This study shows variations and some weak areas for patient safety climate in the studied ORs as reported by front-line staff and acknowledged by nurse managers and medical directors. This finding is a concern because a weak patient safety climate has been associated with poor patient outcomes. To raise awareness, managers need to support patient safety work in the OR.

SUBMITTER: Goras C

PROVIDER: S-EPMC5588952 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Interprofessional team assessments of the patient safety climate in Swedish operating rooms: a cross-sectional survey.

Göras Camilla C Unbeck Maria M Nilsson Ulrica U Ehrenberg Anna A

BMJ open 20170901 9

<h4>Background</h4>A positive patient safety climate within teams has been associated with higher safety performance. The aim of this study was to describe and compare attitudes to patient safety among the various professionals in surgical teams in Swedish operating room (OR) departments. A further aim was to study nurse managers in the OR and medical directors' estimations of their staffs' attitudes to patient safety.<h4>Methods</h4>A cross-sectional survey with the Safety Attitudes Questionnai ...[more]

PMID: 28864690

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Project description:BackgroundDistractions during surgical procedures are associated with team inefficiency and medical error. Little is published about the healthcare provider's perception of distraction and its adverse impact in the operating room. We aim to explore the perception of the operating room team on multiple distractions during surgical procedures.MethodsA 26-question survey was administered to surgeons, anesthesia team members, nurses, and scrub technicians at our institution. Respondents were asked to identify and rank multiple distractions and indicate how each distraction might affect the flow of surgery.ResultsThere was 160 responders for a response rate of 19.18% (160/834), of which 71 (44.1%) male and 82 (50.9%) female, 48 (29.8%) surgeons, 59 (36.6%) anesthesiologists, Certified Registered Nurse Anesthetists (CRNA), and 53 (32.9%) OR nurses and scrub technicians. Responders were classified into a junior group (< 10 years of experience) and a senior group (≥ 10 years). Auditory distraction followed by equipment were the most distracting factors in the operating room. All potential auditory distractions in this survey were associated with higher percentage of certain level of negative impact on the flow of surgery except for music. The top 5 distractors belonged to equipment and environment categories. Phone calls/ pagers/ beepers and case relevant communications were consistently among the top 5 most common distractors. Case relevant communications, music, teaching, and consultation were the top 4 most perceived positive impact on the flow of surgery. Distractors with higher levels of "bothersome" rating appeared to associate with a higher level of perceived negative impact on the flow of surgery. Vision was the least distracting factor and appeared to cause minimal positive impact on the flow of surgery.ConclusionsTo our knowledge, this is the first survey studying perception of surgery, anesthesia, and OR staff on various distractions in the operating room. Fewer unnecessary distractions might improve the flow of surgery, improve OR teamwork, and potentially improve patient outcomes.

Project description:BackgroundInterprofessional education (IPE) interventions are not always successful in achieving learning outcomes. Team-Based Learning (TBL) would appear to be a suitable pedagogical method for IPE, as it focuses on team performance; however, little is known about interprofessional TBL as an instructional framework for patient safety. In this pilot-study, we aimed to (1) describe participants' reactions to TBL, (2) observe their achievement with respect to interprofessional education learning objectives, and (3) document their attitudinal shifts with regard to patient safety behaviours.MethodsWe developed and implemented a three-day course for pre-qualifying, non-medical healthcare students to give instruction on non-technical skills related to 'learning from errors'. The course consisted of three sequential modules: 'Recognizing Errors', 'Analysing Errors', and 'Reporting Errors'. The evaluation took place within a quasi-experimental pre-test-post-test study design. Participants completed self-assessments through valid and reliable instruments such as the Mennenga's TBL Student Assessment Instrument and the University of the West of England's Interprofessional Questionnaire. The mean scores of the individual readiness assurance tests were compared with the scores of the group readiness assurance test in order to explore if students learned from each other during group discussions. Data was analysed using descriptive (i.e. mean, standard deviation), parametric (i.e. paired t-test), and non-parametric (i.e. Wilcoxon signed-rank test) methods.ResultsThirty-nine students from five different bachelor's programs attended the course. The participants positively rated TBL as an instructional approach. All teams outperformed the mean score of their individual members during the readiness assurance process. We observed significant improvements in 'communication and teamwork' and 'interprofessional learning' but not in 'interprofessional interaction' and 'interprofessional relationships.' Findings on safety attitudes and behaviours were mixed.ConclusionTBL was well received by the students. Our first findings indicate that interprofessional TBL seems to be a promising pedagogical method to achieve patient safety learning objectives. It is crucial to develop relevant clinical cases that involve all professions. Further research with larger sample sizes (e.g. including medical students) and more rigorous study designs (e.g. pre-test post-test with a control group) is needed to confirm our preliminary findings.

Project description:As team-based care continues to evolve, pharmacists have been included in general practice teams in many countries, to varying extents, to improve medication use and patient safety. However, evidence on interprofessional collaboration and team effectiveness of pharmacists in general practice is sparse. This study aimed to compare the extent of interprofessional collaboration and team effectiveness of general practice pharmacists in Australia with international sites (Canada and the UK), and identify the factors associated with interprofessional collaboration and team effectiveness. General practice pharmacists from Australia, Canada, and the UK were identified through professional organisations and networks, and invited to participate in an online survey, adapted from existing validated tools. The survey explored interprofessional collaboration through four sub-domains (professional interactions, relationship initiation, trust and role clarity, and commitment to collaboration) and team effectiveness of general practice pharmacists. Of the 101 respondents (26 from Australia, 44 from Canada and 31 from the UK), 79% were female and 78% were aged below 50 years. Interprofessional collaboration and team effectiveness appeared to be high and similar between countries. Total scores for collaboration of pharmacists were 86.1 ± 7.4 in Australia, 88.5 ± 7.5 in the UK, and 89.1 ± 7.3 in Canada (mean ± SD, where higher scores represent more advanced collaboration), while the team effectiveness scores of the pharmacists were 88.6 ± 14.6 in Canada, 91.8 ± 14.6 in Australia and 97.5 ± 14.0 in the UK. Pharmacists who had worked in general practice for a longer time showed advanced interprofessional collaboration while those who worked exclusively in general practice had higher scores for team effectiveness. Overall, general practice pharmacists in the three countries were highly collaborative with general practitioners. Long-term employment and longer work hours could enhance interprofessional collaboration and team effectiveness in general practice pharmacists by improving trust and working relationships over time.

Dataset Information

Interprofessional team assessments of the patient safety climate in Swedish operating rooms: a cross-sectional survey.

Publications

Interprofessional team assessments of the patient safety climate in Swedish operating rooms: a cross-sectional survey.

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