Ziman Roxanne, Espin Sherry, Grant Rachel E, Kitto Simon
a Daphne Cockwell School of Nursing, Faculty of Community Services , Ryerson University , Toronto , Ontario , Canada.
b Faculty of Education , University of Ottawa , Ottawa , Ontario , Canada.
J Interprof Care. 2018 Sep;32(5):575-583. doi: 10.1080/13561820.2018.1459514. Epub 2018 Apr 9.
The Surgical Safety Checklist (SSC) has been adopted in operating rooms (OR) worldwide to reduce medical errors, increase patient safety and improve interprofessional communication. Despite often high compliance rates, recent studies suggested the SSC has not been associated with significant reductions in operative mortality or complications. This ethnographic study sought to understand this disconnection through approximately 50 hours of observation in the OR and 10 in-depth semi-structured interviews with surgeons, nurses, and anaesthesiologists in orthopaedic surgery. Inductive thematic analysis was used to analyse the data. By spending time in the OR and listening to the staff, this study was able to look beyond what "ought" to be happening in the OR and garner a deep understanding of the realities of OR work that acknowledges the complexities of surgical culture in which the SSC is being implemented. This study found SSC compliance was influenced by the perceived (un)importance of individual checklist items within the orthopaedic setting. Additionally, there remains a need to further explore patients' involvement in their operative experience.
手术安全核对表（SSC）已在全球手术室（OR）中采用，以减少医疗差错、提高患者安全性并改善跨专业沟通。尽管通常依从率很高，但最近的研究表明，SSC与手术死亡率或并发症的显著降低并无关联。这项人种志研究试图通过在手术室进行约50小时的观察以及对骨科手术的外科医生、护士和麻醉师进行10次深入的半结构化访谈来理解这种脱节现象。采用归纳主题分析法对数据进行分析。通过在手术室花费时间并倾听工作人员的意见，本研究能够超越手术室“应该”发生的事情，深入了解手术室工作的实际情况，认识到实施SSC的手术文化的复杂性。本研究发现，在骨科环境中，SSC的依从性受到对各个核对表项目感知到的（不）重要性的影响。此外，仍有必要进一步探讨患者在手术体验中的参与情况。
