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手术室多专业团队简报感知障碍:定性研究。

Perceived barriers to multiprofessional team briefings in operating theatres: a qualitative study.

机构信息

School of Psychological Science, The University of Western Australia, Crawley, Western Australia, Australia

Business School, The University of Western Australia, Crawley, Western Australia, Australia.

出版信息

BMJ Open. 2020 Feb 9;10(2):e032351. doi: 10.1136/bmjopen-2019-032351.

Abstract

OBJECTIVES

This study investigates perceived barriers towards the implementation of multiprofessional team briefings (MPTB) in operating theatres, as well as ways to overcome these perceived barriers. Previous research shows that MPTB can enhance teamwork and communication, but are underused in operating theatres. By adopting a multilevel systems perspective, this study examines perceived barriers and solutions for MPTB implementation.

DESIGN

Participants completed open-ended survey questions. Responses were coded via qualitative content analysis. The analysis focused on themes in the responses and the systems level at which each barrier and solution operates.

SETTING

Four tertiary hospitals in Australia.

PARTICIPANTS

103 operating theatre staff, including nurses, surgeons, anaesthetists, technicians and administrators.

RESULTS

Participants identified barriers and solutions at the organisational (15.81% of barriers; 74.10% of solutions), work group (61.39% of barriers; 25.09% of solutions) and individual level (22.33% of barriers; 0% of solutions). Of all the perceived barriers to MPTB occurrence, a key one is getting everyone into the room at the same time . Matching of perceived barriers and solutions shows that higher systems-level solutions can address lower level barriers, thereby showing the relevance of implementing such wider reaching solutions to MPTB occurrence (including work practices at occupational level and above) as well as addressing more local issues.

CONCLUSIONS

Successful MPTB implementation requires changes at various systems levels. Practitioners can strategically prepare and plan for systems-based strategies to overcome barriers to MPTB implementation. Future research can build on this study's findings by directly examining higher systems-level barriers and solutions via detailed case analyses.

摘要

目的

本研究调查了手术室多专业团队简报(MPTB)实施中存在的感知障碍,以及克服这些感知障碍的方法。先前的研究表明,MPTB 可以增强团队合作和沟通,但在手术室中未得到充分利用。通过采用多层次系统视角,本研究考察了 MPTB 实施的感知障碍和解决方案。

设计

参与者完成了开放式调查问题。通过定性内容分析对回答进行编码。分析重点是回答中的主题以及每个障碍和解决方案运作的系统级别。

设置

澳大利亚的四家三级医院。

参与者

103 名手术室工作人员,包括护士、外科医生、麻醉师、技术人员和管理人员。

结果

参与者确定了组织层面(15.81%的障碍;74.10%的解决方案)、工作小组层面(61.39%的障碍;25.09%的解决方案)和个人层面(22.33%的障碍;0%的解决方案)的障碍和解决方案。在 MPTB 发生的所有感知障碍中,一个关键障碍是让所有人同时进入房间。感知障碍和解决方案的匹配表明,更高层次的系统解决方案可以解决较低层次的障碍,从而表明实施这种更广泛的解决方案对于 MPTB 的发生(包括职业层面及以上的工作实践)以及解决更局部的问题具有相关性。

结论

成功实施 MPTB 需要在各个系统层面进行变革。从业者可以通过有策略地准备和规划基于系统的策略来克服 MPTB 实施的障碍。未来的研究可以通过通过详细的案例分析直接检查更高层次的系统障碍和解决方案,从而建立在本研究的发现基础上。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8cd/7044864/401fc98bd56b/bmjopen-2019-032351f01.jpg

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