Department of Surgery and Cancer, Imperial College London.
Br J Surg. 2013 Dec;100(13):1677-88. doi: 10.1002/bjs.9332.
Communication is extremely important to ensure safe and effective clinical practice. A systematic literature review of observational studies addressing communication in the operating theatre was conducted. The focus was on observational studies alone in order to gain an understanding of actual communication practices, rather than what was reported through recollections and interviews.
A systematic review of the literature for accessible published and grey literature was performed in July 2012. The following information was extracted: year, country, objectives, methods, study design, sample size, healthcare professional focus and main findings. Quality appraisal was conducted using the Critical Appraisal Skills Programme. A meta-ethnographic approach was used to categorize further the main findings under key concepts.
Some 1174 citations were retrieved through an electronic database search, reference lists and known literature. Of these, 26 were included for review after application of full-text inclusion and exclusion criteria. The overall quality of the studies was rated as average to good, with 77 per cent of the methodological quality assessment criteria being met. Six key concepts were identified: signs of effective communication, signs of communication problems, effects on teamwork, conditions for communication, effects on patient safety and understanding collaborative work.
Communication was shown to affect operating theatre practices in all of the studies reviewed. Further detailed observational research is needed to gain a better understanding of how to improve the working environment and patient safety in theatre.
沟通对于确保临床实践的安全和有效至关重要。我们对手术室沟通的观察性研究进行了系统的文献回顾。之所以将重点放在观察性研究上,是为了了解实际的沟通实践,而不是通过回忆和访谈来报告。
2012 年 7 月,我们对可获取的已发表文献和灰色文献进行了系统的文献回顾。提取了以下信息:年份、国家、目标、方法、研究设计、样本量、医疗保健专业人员关注的重点和主要发现。使用关键评估技能计划进行了质量评估。采用元民族学方法,根据关键概念进一步对主要发现进行分类。
通过电子数据库搜索、参考文献列表和已知文献检索到了 1174 条引文,其中 26 条在应用全文纳入和排除标准后被纳入审查。研究的总体质量被评为平均到良好,有 77%的方法学质量评估标准得到满足。确定了六个关键概念:有效沟通的迹象、沟通问题的迹象、对团队合作的影响、沟通的条件、对患者安全的影响以及对协作工作的理解。
所有审查的研究都表明沟通会影响手术室的实践。需要进一步进行详细的观察性研究,以更好地了解如何改善手术室的工作环境和患者安全。