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佩戴手术帽后对姓名使用、角色识别和团队协作的看法。

Perceptions of Use of Names, Recognition of Roles, and Teamwork After Labeling Surgical Caps.

机构信息

Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California.

Department of Surgery, Stanford University School of Medicine, Stanford, California.

出版信息

JAMA Netw Open. 2023 Nov 1;6(11):e2341182. doi: 10.1001/jamanetworkopen.2023.41182.

Abstract

IMPORTANCE

Communication failures in perioperative areas are common and have negative outcomes for both patients and clinicians. Names and roles of teammates are difficult to remember or discern contributing to suboptimal communication, yet the utility of labeled surgical caps with names and roles for enhancing perceived teamwork and connection is not well studied.

OBJECTIVE

To evaluate the use of labeled surgical caps in name use and role recognition, as well as teamwork and connection, among interprofessional perioperative teammates.

DESIGN, SETTING, AND PARTICIPANTS: In this quality improvement study, caps labeled with names and roles were distributed to 967 interprofessional perioperative clinicians, along with preimplementation and 6-month postimplementation surveys. Conducted between July 8, 2021, and June 25, 2022, at a single large, academic, quaternary health care center in the US, the study comprised surgeons, anesthesiologists, trainees, and all interprofessional hospital staff who work in adult general surgery perioperative areas.

INTERVENTION

Labeled surgical caps were offered cost-free, although not mandatory, to each interested clinician.

MAIN OUTCOME AND MEASURE

Quantitative survey of self-reported frequency for name use and role recognition as well as postimplementation sense of teamwork and connection. The surveys also elicited free response comments.

RESULTS

Of the 1483 eligible perioperative clinicians, 967 (65%; 387 physicians and 580 nonphysician staff; 58% female) completed preimplementation surveys and received labeled caps, and 243 of these individuals (51% of physicians and 8% of staff) completed postimplementation surveys. Pre-post results were limited to physicians, due to the low postsurvey staff response rate. The odds of participants reporting that they were often called by their name increased after receiving a labeled cap (adjusted odds ratio [AOR], 13.37; 95% CI, 8.18-21.86). On postsurveys, participants reported that caps with names and roles substantially improved teamwork (80%) and connection (79%) with teammates. Participants who reported an increased frequency of being called by their name had higher odds for reporting improved teamwork (AOR, 3.46; 95% CI, 1.91-6.26) and connection with teammates (AOR, 3.21; 95% CI, 1.76-5.84). Free response comments supported the quantitative data that labeled caps facilitated knowing teammates' names and roles and fostered a climate of wellness, teamwork, inclusion, and patient safety.

CONCLUSIONS AND RELEVANCE

The findings of this quality improvement study performed with interprofessional teammates suggest that organizationally sponsored labeled surgical caps was associated with improved teamwork, indicated by increased name use and role recognition in perioperative areas.

摘要

重要性

围手术期的沟通失误很常见,会对患者和临床医生都产生负面影响。队友的姓名和角色很难记住或辨别,这导致沟通效果不佳,但带有姓名和角色的标记手术帽对于增强感知团队合作和联系的作用尚未得到充分研究。

目的

评估在围手术期的多专业团队中使用带有姓名和角色的标记手术帽对姓名使用和角色识别以及团队合作和联系的影响。

设计、地点和参与者:这是一项质量改进研究,在 2021 年 7 月 8 日至 2022 年 6 月 25 日期间,在美国的一家大型学术四级保健中心的成人普通外科围手术区,向 967 名多专业围手术期临床医生发放了带有姓名和角色的标记手术帽,并在实施前和实施后 6 个月进行了调查。研究包括外科医生、麻醉师、学员和所有在成人普通外科围手术区工作的医院工作人员。

干预措施

免费提供带有标记的手术帽,但并非强制要求每位感兴趣的临床医生使用。

主要结果和测量

对自我报告的姓名使用和角色识别频率以及实施后的团队合作和联系意识进行定量调查。调查还征集了自由回复意见。

结果

在 1483 名符合条件的围手术期临床医生中,967 名(65%;387 名医生和 580 名非医生工作人员;58%为女性)完成了实施前的调查并收到了标记手术帽,其中 243 名(51%的医生和 8%的工作人员)完成了实施后的调查。由于工作人员在实施后调查中的低回复率,仅对医生进行了前后比较。参与者报告说,他们经常被人叫到名字的可能性在收到标记手术帽后增加(调整后的优势比 [OR],13.37;95%CI,8.18-21.86)。在实施后的调查中,参与者报告说,带有姓名和角色的手术帽显著改善了与队友的团队合作(80%)和联系(79%)。报告姓名使用频率增加的参与者更有可能报告团队合作(OR,3.46;95%CI,1.91-6.26)和与队友的联系(OR,3.21;95%CI,1.76-5.84)有所改善。自由回复意见支持了定量数据,即带有标签的帽子有助于了解队友的姓名和角色,并营造出一种健康、团队合作、包容和患者安全的氛围。

结论和相关性

这项与多专业团队合作的质量改进研究结果表明,组织赞助的带有标记的手术帽与围手术期团队合作的改善有关,这表现为姓名使用和角色识别的增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a0c/10656635/932d6140a789/jamanetwopen-e2341182-g001.jpg

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