Erestam Sofia, Haglind Eva, Bock David, Andersson Annette Erichsen, Angenete Eva
Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
SSORG - Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital, SE-416 85 Gothenburg, Sweden.
Patient Saf Surg. 2017 Jan 31;11:4. doi: 10.1186/s13037-017-0120-6. eCollection 2017.
Inter-professional teamwork in the operating room is important for patient safety. The World Health Organization (WHO) checklist was introduced to improve intraoperative teamwork. The aim of this study was to evaluate the safety climate in a Swedish operating room setting before and after an intervention, using a revised version of the WHO checklist to improve teamwork.
This study is a single center prospective interventional study. Participants were personnel working in operating room teams including surgeons, anesthesiologists, scrub nurses, nurse anaesthetists and nurse assistants. The study started with pre-interventional observations of the WHO checklist use followed by education on safety climate, the WHO checklist, and non-technical skills in the operating room. Thereafter a revised version of the WHO checklist was introduced. Post-interventional observations regarding the performance of the WHO checklist were carried out. The Safety Attitude Questionnaire was used to assess safety climate at baseline and post-intervention.
At baseline we discovered a need for improved teamwork and communication. The participants considered teamwork to be important for patient safety, but had different perceptions of good teamwork between professions. The intervention, a revised version of the WHO checklist, did not affect teamwork climate. Adherence to the revision of the checklist was insufficient, dominated by a lack of structure.
There was no significant change in teamwork climate by use of the revised WHO checklist, which may be due to insufficient implementation, as a lack of adherence to the WHO checklist was detected. We found deficiencies in teamwork and communication. Further studies exploring how to improve safety climate are needed.
NCT02329691.
手术室中的跨专业团队合作对患者安全至关重要。世界卫生组织（WHO）清单被引入以改善术中团队合作。本研究的目的是使用修订版的WHO清单来改善团队合作，评估瑞典手术室环境在干预前后的安全氛围。
本研究是一项单中心前瞻性干预研究。参与者是手术室团队中的工作人员，包括外科医生、麻醉师、洗手护士、麻醉护士和护士助理。研究首先对WHO清单的使用情况进行干预前观察，随后开展关于安全氛围、WHO清单和手术室非技术技能的培训。此后引入了修订版的WHO清单。对WHO清单的执行情况进行了干预后观察。使用安全态度问卷在基线和干预后评估安全氛围。
在基线时，我们发现需要改善团队合作和沟通。参与者认为团队合作对患者安全很重要，但对不同专业间良好团队合作的认知存在差异。干预措施，即修订版的WHO清单，并未影响团队合作氛围。对清单修订的依从性不足，主要原因是缺乏条理。
使用修订版的WHO清单后，团队合作氛围没有显著变化，这可能是由于实施不足，因为发现对WHO清单的依从性不够。我们发现团队合作和沟通存在缺陷。需要进一步研究探索如何改善安全氛围。
NCT02329691。
