Operating Room Teams Display Acceptable Levels of Patient Safety Behaviors During Surgical Cases.

Autor: Mitchell C; University of North Carolina at Chapel Hill, Division of Healthcare Engineering, School of Medicine, Chapel HIll, North Carolina, USA., Butler L; University of North Carolina at Chapel Hill, Division of Healthcare Engineering, School of Medicine, Chapel HIll, North Carolina, USA., Holloway AD; University of North Carolina at Chapel Hill, Division of Healthcare Engineering, School of Medicine, Chapel HIll, North Carolina, USA., Ra JH; University of North Carolina at Chapel Hill, Division of Acute Care Surgery, Department of Surgery, School of Medicine, Chapel HIll, North Carolina, USA., Adapa K; University of North Carolina at Chapel Hill, Division of Healthcare Engineering, School of Medicine, Chapel HIll, North Carolina, USA., Greenberg C; University of North Carolina at Chapel Hill, Department of Surgery, Chapel HIll, North Carolina, USA., Marks LB; University of North Carolina at Chapel Hill, Department of Radiation Oncology, School of Medicine, Chapel HIll, North Carolina, USA; University of North Carolina at Chapel Hill, UNC Health, Chapel HIll, North Carolina, USA., Ivester T; University of North Carolina at Chapel Hill, UNC Health, Chapel HIll, North Carolina, USA., Tan X; University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Biostatistics, Chapel HIll, North Carolina, USA., Mazur L; University of North Carolina at Chapel Hill, Division of Healthcare Engineering, School of Medicine, Chapel HIll, North Carolina, USA; University of North Carolina at Chapel Hill, School of Information and Library Science, Chapel HIll, North Carolina, USA. Electronic address: lukasz_mazur@med.unc.edu.
Jazyk: angličtina
Zdroj: Journal of surgical education [J Surg Educ] 2024 Aug; Vol. 81 (8), pp. 1105-1109. Date of Electronic Publication: 2024 Jun 08.
DOI: 10.1016/j.jsurg.2024.05.005
Abstrakt: Introduction: Cornerstones of patient safety include reliable safety behaviors proposed by Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) practices. A better quantification of these behaviors is needed to establish a baseline for future improvement efforts.
Methods: At one large academic medical center, OR Teams were prospectively assigned to be observed during surgical cases, and patient safety behaviors were quantified using the Teamwork Evaluation of Non-Technical Skills (TENTS) instrument. Mean scores of each TENTS behavior were calculated with 95% confidence intervals and compared using a paired t-test with a false discovery rate (FDR) control. Using the TENTS instrument, one hundred one surgical cases were observed by purposefully trained medical student volunteers. The average with 95% confidence interval (CI) of observed safety behaviors quantified using the TENTS instrument (including 20 types of safety behaviors scored 0 = expected but not observed, 1 = observed but poorly performed or counterproductive, 2 = observed and acceptable, and 3 = observed and excellent).
Results: All safety behaviors averaged slightly above 2, and the lower bound of 95% CI was above 2 for all behaviors except one. Statistically significant differences (p < 0.05) were detected between a few safety behaviors, with the lowest-rated safety behavior being "employs conflict resolution" (2.07, 95% CI: 1.96-2.18) and the highest-rated behavior being "willingness to support others across roles" (2.36, 95% CI: 2.27-2.45). There were no significant differences (p > 0.05) based on the number of persons present during the case, case duration, or by surgical department.
Conclusions: Given the persistent patient safety incidents in ORs nationwide, it might be necessary to advance these behaviors from acceptable to exceptional to advance patient safety.
(Copyright © 2024 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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