Discrepant Perceptions of Communication, Teamwork and Situation Awareness among Surgical Team Members

Department of Surgery, Erasmus University Medical Center, Post Box 2040, 3000 CA Rotterdam, The Netherlands.
International Journal for Quality in Health Care (Impact Factor: 1.76). 03/2011; 23(2):159-66. DOI: 10.1093/intqhc/mzq079
Source: PubMed


To assess surgical team members' differences in perception of non-technical skills.
Questionnaire design.
Operating theatres (OTs) at one university hospital, three teaching hospitals and one general hospital in the Netherlands.
Sixty-six surgeons, 97 OT nurses, 18 anaesthetists and 40 nurse anaesthetists.
All surgical team members, of five hospitals, were asked to complete a questionnaire and state their opinion on the current state of communication, teamwork and situation awareness at the OT.
Ratings for 'communication' were significantly different, particularly between surgeons and all other team members (P ≤ 0.001). The ratings for 'teamwork' differed significantly between all team members (P ≤ 0.005). Within 'situation awareness' significant differences were mainly observed for 'gathering information' between surgeons and other team members (P < 0.001). Finally, 72-90% of anaesthetists, OT nurses and nurse anaesthetists rated routine team briefings and debriefings as inadequate.
This study shows discrepancies on many aspects in perception between surgeons and other surgical team members concerning communication, teamwork and situation awareness. Future research needs to ascertain whether these discrepancies are linked to greater risk of adverse events or to process as well as systems failures. Establishing this link would support implementation and use of complex team interventions that intervene at multiple levels of the healthcare system.

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    • "In providing safe care staff professional competencies need to be constantly developed ( Gilje et al . 2007 , Priest et al . 2008 , Blegen & Severinsson 2011 , Cleary et al . 2011 , Wauben et al . 2011 , White 2012 ) . For patient safety , an important competency is communication ( Calleja et al . 2010 , Fallowfield 2010 , Fernandez et al . 2010 ) . It is also one of the core competencies in psychiatric care and plays an important role in structuring care and in establishing therapeutic relationships ( Gilje et al . 2007 , Timmons 201"
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    ABSTRACT: Communication is important for safe and quality health care. The study provides needed insight on the communication elements that support patient safety from the psychiatric care view.Fluent information transfer between the health care professionals and care units is important for care planning and maintaining practices. Information should be documented and implemented accordingly.Communication should happen in an open communication culture that enables discussion, the opportunity to have debriefing discussions and the entire staff can feel they are heard. For effective communication, it is also important that staff are active themselves in information collecting about the essential information needed in patient care.In mental health nursing, it is important to pay attention to all elements of communication and to develop processes concerning communication in multidisciplinary teams and across unit boundaries.
    Journal of Psychiatric and Mental Health Nursing 03/2015; 22(5):298-305. DOI:10.1111/jpm.12187 · 0.84 Impact Factor
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    • "Within the operating room environment, situation awareness of team members has been identified as a key attribute for communication and coordination of roles and responsibilities and subsequently, assurance of patient safety (Fioratou et al., 2010; Hazelhurst et al., 2007; Parush et al., 2011). Similarly, situation awareness for each team member is important to ensure patient safety in other areas where teams must work closely together (Mitchell et al., 2011; Parush et al., 2011; Wauben et al., 2011). There is evidence demonstrating that a range of individual and environmental factors can impair and distract a nurse's SA including stress, tiredness, noise, technology and heavy work demands requiring the nurse to multi-task (Bucknall, 2003). "
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    ABSTRACT: Nursing work often occurs in complex and potentially hazardous settings. Awareness of patient and practice environments is an imperative for nurses in practice. To explore nursing students' situation awareness while engaging in simulated patient deterioration scenarios. The educational process of FIRST(2)ACT was the model for the nurse intervention. Situation awareness was measured quantitatively using the Situation Awareness Global Assessment tool. Four domains were measured: physiological perception (patient parameters), global perception (surroundings), comprehension (interpretation of information), and projection (forecasting outcomes). Clinical laboratories at each of three participating universities. Ninety-seven nursing students from three Australian universities. Between March and July 2012, students participated in three video-recorded simulation events, in which a trained actor played patient roles and groups of three students worked as teams. To measure situation awareness, following the simulation each team leader was taken to a separate room and asked to report on a question set regarding the patient's vital signs, bedside setting and medical diagnosis. Overall, situation awareness was low (41%). Of the four domains, physiological perceptions scored the lowest (26%) and projection the highest (59%). Final year nursing students may not have well developed situation awareness skills, especially when dealing with these types of scenarios. Education providers need to consider ways to assist students to fully develop this attribute. Findings suggest that this is an aspect of undergraduate nursing education that requires significant consideration by curriculum developers.
    Nurse education today 01/2014; 34(6). DOI:10.1016/j.nedt.2013.12.013 · 1.36 Impact Factor
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    • "Even though patterns of communication in the OR are known to be complex and socially motivated [23], the aim of the checklist is nevertheless to reinforce accepted safety practices and to foster better communication and teamwork between clinical disciplines. However, discrepancies in perception of teamwork are known to exist in the OR. "
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    ABSTRACT: Background Even though the use of perioperative checklists have resulted in significant reduction in postoperative mortality and morbidity, as well as improvements of important information communication, the utilization of checklists seems to vary, and perceived barriers are likely to influence compliance. In this grounded theory study we aimed to explore the challenges and strategies of performing the WHO’s Safe Surgical Checklist as experienced by the nurses appointed as checklist coordinators. Methods Grounded theory was used in gathering and analyzing data from observations of the checklist used in the operating room, in conjunction with single and focus group interviews. A purposeful sample of 14 nurse-anesthetists and operating room nurses as surgical team members in a tertiary teaching hospital participated in the study. Results The nurses’ main concern regarding checklist utilization was identified as “how to obtain professional and social acceptance within the team”. The emergent grounded theory of “adjusting team involvement” consisted of three strategies; distancing, moderating and engaging team involvement. The use of these strategies explains how they resolved their challenges. Each strategy had corresponding conditions and consequences, determining checklist compliance, and how the checklist was used. Conclusion Even though nurses seem to have a loyal attitude towards the WHO’s checklist regarding their task work, they adjusted their surgical team involvement according to practical, social and professional conditions in their work environment. This might have resulted in the incomplete use of the checklist and therefore a low compliance rate. Findings also emphasized the importance of: a) management support when implementing WHO’s Safe Surgical Checklist, and b) interprofessional education approach to local adaptation of the checklists use.
    BMC Nursing 09/2012; 11(1):16. DOI:10.1186/1472-6955-11-16
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