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The Evaluation of Patient Safety Culture and Use of the Surgical Safety Checklist in the Operating Room

Year 2017, Issue: 1, 16 - 23, 01.03.2017

Özgül Karayurt Hale Turhan Damar Özlem Bilik Saliha Özdöker Melike Duran

Abstract

Introduction and Objective: The Association of Perioperative Registered Nurses recommended cooperation between team members, an error reporting system, and simplification and standardization of the work process, to achieve patient safety culture. This study aims to determine the patient safety culture among staff in an operating room and to examine use of the surgical safety checklist SSC . Methods: The descriptive and cross-sectional study data were collected with the Hospital Survey on Patient Safety Culture and Surgical Safety Checklist Questionnaire in the operating room of a university hospital between March 2014-Jaunary 2015. The study sample included 96 doctors, nurses and anesthesia technicians. Results: Of participants, 36.5% were nurses, 31.3% were physicians, 32.3% were anesthesia technicians, 41.7% had ≤5-years experience in the operating room, 81.3% knew about SSC and 76% wanted to use it, 71.9% never reported an event, but 22.9% reported 1-2 events, 59.4% considered patient safety in the operating room acceptable. When the working years in the operating room of the employees were assessed according to the scale and subscale, there was a significant difference between “Teamwork within units”, “Feedback and communication about error”, “No-punitive response to error”,” and Hospital management support for patient safety” p = 0.017, p = 0.006, p = 0.031, p = 0.015 . Conclusion: The study results can help nurses in the operating room to learn about and use SSC, which may promote their reporting events threatening safety. The results will help with designing education programs about patient safety and improvement of patient safety culture.

Keywords

patient safety culture surgical safety checklist operating room

References

  • JCAHO. Sentinel Event Statistics, URL: ttp://www.jointcommission. org/Library/T M_hysicians/mp_11_06. htm. 2006. Erişim tarihi: 2016.
  • Berwick DM. Errors Today and Errors Tomorrow. The New England Journal of Medicine 2003;348:2570-2.
  • Henry L, Hunt S, Kroetch M, Yang YT. Evaluation of Patient Safety Culture: A Survey of Clinicians in A Cardiovascular Operating Room. Innovations (Phila) 2012;7:328-33.
  • Griffin FA, Classen DC. Detection of Adverse Events in Surgical Patients Using the Trigger Tool Approach. Quality & Safety in Health Care 2008;17:25-38.
  • Steelman VM, Graling PR. Top 10 Patient Safety Issues: What More Can We Do? AORN 2013;97:6.
  • Association of Perioperative Registered Nurses (AORN), Perioperative Standards and Recommended Practices. 2013th Edition, America 2013,pp:217-331
  • National Patient Safety Foundation. 2003, http://www.npsf.org. Erişim tarihi: 06.04.2016.
  • Azami-Aghdash S, Ebadifard Azar F, Rezapour A, Azami A, Rasi V, Klvany K. Patient Safety Culture in Hospitals of Iran: A Systematic Review and Meta-Analysis The Medical Journal of the Islamic Republic of Iran 2015;29:251.
  • Kaissi AA. An Organizational Approach to Understanding Patient Safety and Medical Errors. Health Care Manag 2006; 25(4); 292–305.
  • Mardon R, Khanna K, Sorra J, Dyer N, Famolaro T. Exploring Relationships Between Hospital Patient Safety Culture and Adverse Events. Journal of Patient Safety 2010;6:226–32.
  • Sile´ n-Lipponen M, Tossavainen K, Turunen H, Smith A. Potential Errors and Their Prevention In Operating Room Teamwork As Experienced By Finnish, British And American Nurses. International Journal of Nursing Practice 2005;11:21–32.
  • Hellings J, Schrooten W, Klazınga N, Vleugels A. Challenging Patient Safety Culture: Survey Results. International Journal of Health Care Quality Assurance 2007;20:620-32.
  • Scherer D, Fitzpatric JJ. Perception of Patient Safety Culture Among Physicians and Rns in The Perioperative Area. AORN Journal 2008;87:163-75.
  • Russ S, Rout S, Sevdalis N, Moothy K, Darzi A, Vincent C. Do Safety Checklist Improve Teamwork and Communication in Operating Room? A Systematic Review. Annual Surgical 2003;258:856-71.
  • Kawano T, Taniwaki M. Ogata K, Sakamato M, and Yokoyama M. Improvement of Teamwork and Safety Climate Following Implementation of the WHO Surgical Safety Checklist at a University Hospital in Japan. The Journal of Anesthesia 2013;30:25-35.
  • Haynes H, ve ark. A Surgical Safety Checklist to Reduce Morbidity and Mortality in A Global Population. The New England Journal of Medicine 2009;360:491-9.
  • Abbasoğlu A, Uğurlu Z, Işık S, Karahan A, Ünlü H, Elbaş N. Güvenli Cerrahi Kontrol Listesinin Etkin Kullanılma Durumu ve Hemşirelerin Güvenli Cerrahi Kontrol Listesine Yönelik Görüşleri. Uluslararası Katılımlı 8. Ulusal Cerrahi ve Ameliyathane Hemşireliği Kongresi; 2013 Kasım 21-24; Aydın, Türkiye.
  • Sorra JS, Nieva VF. Hospital Survey on Patient Safety Culture. Rockville, MD: AHRQ Publication No. 04-0041, 2004. http://www. ahrq.gov/qual/patientsafetyculture/hospcult.pdf.
  • Bodur S, Filiz E. Validity and Reliability of Turkish Version of ‘Hospital Survey on Patient Safety Culture’ and Perception of Patient Safety in Public Hospitals in Turkey. BMC Health Services Research 2010;10:28.
  • Gündoğdu S, Bahçecik N. Hemşirelerde Hasta Güvenliği Kültürü Algılamasının Belirlenmesi. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi 2012;15:2.
  • Çiftlik EE, Kesmezacar Ö, Kurt M. Eğitim ve Araştırma Hastaneleri ile Devlet Hastanelerinde Hasta Güvenliği Kültürü Algılaması. II. Uluslararası Sağlıkta Performans ve Kalite Kongresi, 28 Nisan-01 Mayıs 2010, Antalya. Kongre Bildiriler Kitabı 1. Cilt, 3.
  • Özmen S, Başol O. Hasta Güvenliği Kültürü: Bursa’da Özel Bir Hastane Uygulama Örneği. II. Uluslararası Sağlıkta Performans ve Kalite Kongresi, 28 Nisan-01 Mayıs 2010, Antalya. Kongre Bildiriler Kitabı 1. Cilt, 81-97.
  • Özata M, Altunkan H. Hemşirelikte Tıbbi Hataya Eğilim Ölçeğinin Geliştirilmesi ve Geçerlilik Güvenilirlik Analizinin Yapılması. II. Uluslararası Sağlıkta Performans ve Kalite Kongresi Kitabı 2010;1:417-9.
  • Al-Ishaq M. Nursing Perceptions of Patient Safety at Hamad Medical Corporation in The State of Qatar. Doctorate Thesis, Doctor of Philosophy School of Nursing, İndiana University, Qatar 2008.
  • Evans SM, Berry JG, Smith BJ, Esterman A, Selim P, O’Shaughnessy J, DeWit M. Attitudes and Barriers to Incident Reporting: A Collaborative Hospital Study. Quality and Safety in Health Care 2006;15:39-43.
  • Bognar A, Barach P, Johnson JK, Duncan RC, Birnbach D, Woods D, Holl JL, Bacha EA. Errors and The Burden of Errors: Attitudes, Perceptions, and The Culture of Safety in Pediatric Cardiac Surgical Teams. The Annals of Thoracic Surgery. 2008;85:1374-81.
  • Yang CC, Wang YS, Chang ST, Guo SE, Huang MF. A Study On the Leadeship Behavior, Safety Culture, and Safety Performance of the Healthcare Industry. World Academy of Science, Engineering and Technology 2009;53:1148-55.
  • Mills P, Neily J, Dunn E. Teamwork and Communication in Surgical Teams: Implications for Patient Safety. Journal of the American College of Surgeons 2008;206:107-12.
  • Kim J, An K, Kim MK, Yoon SH. Nurses’ Perception of Error Reporting and Patient Safety Culture in Korea. Western Journal of Nursing Research 2007;29:827-44.
  • Çelen Ö, Teke A, Cihangiroğlu N. Investigating The Patient Safety Culture Level in Gulhane Military Medical Faculty Training Hospital. Gulhane Medical Journal 2014;56:85-92.
  • Singer SJ, Gaba DM, Geppert JJ, Sinaiko AD, Howard SK, Park KC. The Culture of Safety: Results of an Organization-Wide Survey in 15 California Hospitals. Quality and Safety in Health Care 2003;12:112-8.
  • Fındık YÜ. Operating Room Nurses’ Burnout and Safety Applications. International Journal of Caring Sciences 2015;8:610.
  • Gürsoy AA, Çolak A. Danacı S. Ameliyathane Hemşirelerinde İş Doyumu, Anksiyete ve Tükenmişlik: Trabzon Örneği, Hemşirelikte Araştırma ve Geliştirme Dergisi 2007;9:28-37.
  • Paige JT, Aaron DL, Yang T, Howell DS, Hilton CW, Cohn I Jr, Chauvin SW. Implementation of A Preoperative Briefing Protocol Improves Accuracy of Teamwork Assessment in The Operating Room. The American Journal of Surgery 2008;74:817–23.
  • Lingard L, Regehr G, Orser B, Reznick R, Baker GR, Doran D, Espin S, Bohnen J, Whyte S. Evaluation of A Preoperative Checklist and Team Briefing Among Surgeons, Nurses, and Anesthesiologists to Reduce Failures in Communication. Arch Surg 2008;143:12–7.
  • Nagpal K, Vats A, Lamb B, Sevdalis V, Vincent C, Moorthy K. Information Transfer and Communication in Surgery: A Systematic Review. Annals of Surgery 2010;252:225–39.

Ameliyathanede Hasta Güvenliği Kültürünün ve Güvenli Cerrahi Kontrol Listesinin Kullanımının İncelenmesi

Year 2017, Issue: 1, 16 - 23, 01.03.2017

Özgül Karayurt Hale Turhan Damar Özlem Bilik Saliha Özdöker Melike Duran

Abstract

Giriş ve Amaç: Ameliyathanelerde hasta güvenli kültürünün sağlanmasında Amerikan Ameliyathane Hemşireler Derneği iş sürecinin basitleştirilmesi ve standardize edilmesinin yanı sıra ekip iş birliğini, hata rapor sisteminin kullanımını önermiştir. Bu çalışmanın amacı ameliyathane çalışanlarında hasta güvenliği kültürünün belirlenmesi ve güvenli cerrahi kontrol listesinin kullanımının incelenmesidir. Yöntem: Tanımlayıcı ve kesitsel araştırmanın verileri, Mart 2014-Ocak 2015 tarihleri arasında bir üniversite hastanesi merkezi ameliyathanesinde “Hasta Güvenliği Kültürü Hastane Anketi” ve “Güvenli Cerrahi Kontrol Listesi Anketi” kullanılarak toplanmıştır. Örneklemi, çalışmaya katılmayı kabul eden ameliyathanede hasta ile birebir çalışan, 96 hekim, hemşire ve anestezi ve ameliyathane teknikeri oluşturmuştur. Bulgular: Katılımcıların %36.5’i hemşire, %31.3’ü hekim, %32.3’ü anestezi teknikeri olup; %41.7’sinin ameliyathanede 5 yıl ve daha az süredir çalıştığı saptanmıştır. Ameliyathane çalışanların %81.3’ünün Güvenli Cerrahi Kontrol Listesi’ni bilmediği ancak %76’sının kullanmak istediği belirlenmiştir. Katılımcıların %71.9’nun hiç olay raporlamadığı, %22.9’nun 1-2 olay raporladığı saptanmıştır. Ameliyathanede çalışanların %59.4’nün ameliyathanenin hasta güvenliği düzeyini kabul edilebilir olarak değerlendirmiştir. Çalışanlarının ameliyathanede çalışma yılları ile ölçeğin, “Üniteler içerisinde ekip çalışması”, “Hatalar hakkında geribildirim ve iletişim”, “Hatalar hakkına cezalandırıcı olmayan tutum”, “Hasta güvenliği için hastane yönetiminin tutumu” alt boyutları arasında istatiksel olarak anlamlı bir fark saptanmıştır p = 0.017, p = 0.006, p = 0.031, p = 0.015 . Sonuç: Araştırma sonuçları ameliyathane hemşirelerinin Güvenli Cerrahi Kontrol Listesi’ni tanıması ve kullanmasına katkı sağlayabilir. Ayrıca hemşirelerin bu konudaki eğitimlerinin planlanmasına ve hasta güvenliği kültürünün geliştirmesine katkı sağlayabileceği öngörülmektedir.

Keywords

hasta güvenliği kültürü güvenli cerrahi kontrol listesi ameliyathane

References

  • JCAHO. Sentinel Event Statistics, URL: ttp://www.jointcommission. org/Library/T M_hysicians/mp_11_06. htm. 2006. Erişim tarihi: 2016.
  • Berwick DM. Errors Today and Errors Tomorrow. The New England Journal of Medicine 2003;348:2570-2.
  • Henry L, Hunt S, Kroetch M, Yang YT. Evaluation of Patient Safety Culture: A Survey of Clinicians in A Cardiovascular Operating Room. Innovations (Phila) 2012;7:328-33.
  • Griffin FA, Classen DC. Detection of Adverse Events in Surgical Patients Using the Trigger Tool Approach. Quality & Safety in Health Care 2008;17:25-38.
  • Steelman VM, Graling PR. Top 10 Patient Safety Issues: What More Can We Do? AORN 2013;97:6.
  • Association of Perioperative Registered Nurses (AORN), Perioperative Standards and Recommended Practices. 2013th Edition, America 2013,pp:217-331
  • National Patient Safety Foundation. 2003, http://www.npsf.org. Erişim tarihi: 06.04.2016.
  • Azami-Aghdash S, Ebadifard Azar F, Rezapour A, Azami A, Rasi V, Klvany K. Patient Safety Culture in Hospitals of Iran: A Systematic Review and Meta-Analysis The Medical Journal of the Islamic Republic of Iran 2015;29:251.
  • Kaissi AA. An Organizational Approach to Understanding Patient Safety and Medical Errors. Health Care Manag 2006; 25(4); 292–305.
  • Mardon R, Khanna K, Sorra J, Dyer N, Famolaro T. Exploring Relationships Between Hospital Patient Safety Culture and Adverse Events. Journal of Patient Safety 2010;6:226–32.
  • Sile´ n-Lipponen M, Tossavainen K, Turunen H, Smith A. Potential Errors and Their Prevention In Operating Room Teamwork As Experienced By Finnish, British And American Nurses. International Journal of Nursing Practice 2005;11:21–32.
  • Hellings J, Schrooten W, Klazınga N, Vleugels A. Challenging Patient Safety Culture: Survey Results. International Journal of Health Care Quality Assurance 2007;20:620-32.
  • Scherer D, Fitzpatric JJ. Perception of Patient Safety Culture Among Physicians and Rns in The Perioperative Area. AORN Journal 2008;87:163-75.
  • Russ S, Rout S, Sevdalis N, Moothy K, Darzi A, Vincent C. Do Safety Checklist Improve Teamwork and Communication in Operating Room? A Systematic Review. Annual Surgical 2003;258:856-71.
  • Kawano T, Taniwaki M. Ogata K, Sakamato M, and Yokoyama M. Improvement of Teamwork and Safety Climate Following Implementation of the WHO Surgical Safety Checklist at a University Hospital in Japan. The Journal of Anesthesia 2013;30:25-35.
  • Haynes H, ve ark. A Surgical Safety Checklist to Reduce Morbidity and Mortality in A Global Population. The New England Journal of Medicine 2009;360:491-9.
  • Abbasoğlu A, Uğurlu Z, Işık S, Karahan A, Ünlü H, Elbaş N. Güvenli Cerrahi Kontrol Listesinin Etkin Kullanılma Durumu ve Hemşirelerin Güvenli Cerrahi Kontrol Listesine Yönelik Görüşleri. Uluslararası Katılımlı 8. Ulusal Cerrahi ve Ameliyathane Hemşireliği Kongresi; 2013 Kasım 21-24; Aydın, Türkiye.
  • Sorra JS, Nieva VF. Hospital Survey on Patient Safety Culture. Rockville, MD: AHRQ Publication No. 04-0041, 2004. http://www. ahrq.gov/qual/patientsafetyculture/hospcult.pdf.
  • Bodur S, Filiz E. Validity and Reliability of Turkish Version of ‘Hospital Survey on Patient Safety Culture’ and Perception of Patient Safety in Public Hospitals in Turkey. BMC Health Services Research 2010;10:28.
  • Gündoğdu S, Bahçecik N. Hemşirelerde Hasta Güvenliği Kültürü Algılamasının Belirlenmesi. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi 2012;15:2.
  • Çiftlik EE, Kesmezacar Ö, Kurt M. Eğitim ve Araştırma Hastaneleri ile Devlet Hastanelerinde Hasta Güvenliği Kültürü Algılaması. II. Uluslararası Sağlıkta Performans ve Kalite Kongresi, 28 Nisan-01 Mayıs 2010, Antalya. Kongre Bildiriler Kitabı 1. Cilt, 3.
  • Özmen S, Başol O. Hasta Güvenliği Kültürü: Bursa’da Özel Bir Hastane Uygulama Örneği. II. Uluslararası Sağlıkta Performans ve Kalite Kongresi, 28 Nisan-01 Mayıs 2010, Antalya. Kongre Bildiriler Kitabı 1. Cilt, 81-97.
  • Özata M, Altunkan H. Hemşirelikte Tıbbi Hataya Eğilim Ölçeğinin Geliştirilmesi ve Geçerlilik Güvenilirlik Analizinin Yapılması. II. Uluslararası Sağlıkta Performans ve Kalite Kongresi Kitabı 2010;1:417-9.
  • Al-Ishaq M. Nursing Perceptions of Patient Safety at Hamad Medical Corporation in The State of Qatar. Doctorate Thesis, Doctor of Philosophy School of Nursing, İndiana University, Qatar 2008.
  • Evans SM, Berry JG, Smith BJ, Esterman A, Selim P, O’Shaughnessy J, DeWit M. Attitudes and Barriers to Incident Reporting: A Collaborative Hospital Study. Quality and Safety in Health Care 2006;15:39-43.
  • Bognar A, Barach P, Johnson JK, Duncan RC, Birnbach D, Woods D, Holl JL, Bacha EA. Errors and The Burden of Errors: Attitudes, Perceptions, and The Culture of Safety in Pediatric Cardiac Surgical Teams. The Annals of Thoracic Surgery. 2008;85:1374-81.
  • Yang CC, Wang YS, Chang ST, Guo SE, Huang MF. A Study On the Leadeship Behavior, Safety Culture, and Safety Performance of the Healthcare Industry. World Academy of Science, Engineering and Technology 2009;53:1148-55.
  • Mills P, Neily J, Dunn E. Teamwork and Communication in Surgical Teams: Implications for Patient Safety. Journal of the American College of Surgeons 2008;206:107-12.
  • Kim J, An K, Kim MK, Yoon SH. Nurses’ Perception of Error Reporting and Patient Safety Culture in Korea. Western Journal of Nursing Research 2007;29:827-44.
  • Çelen Ö, Teke A, Cihangiroğlu N. Investigating The Patient Safety Culture Level in Gulhane Military Medical Faculty Training Hospital. Gulhane Medical Journal 2014;56:85-92.
  • Singer SJ, Gaba DM, Geppert JJ, Sinaiko AD, Howard SK, Park KC. The Culture of Safety: Results of an Organization-Wide Survey in 15 California Hospitals. Quality and Safety in Health Care 2003;12:112-8.
  • Fındık YÜ. Operating Room Nurses’ Burnout and Safety Applications. International Journal of Caring Sciences 2015;8:610.
  • Gürsoy AA, Çolak A. Danacı S. Ameliyathane Hemşirelerinde İş Doyumu, Anksiyete ve Tükenmişlik: Trabzon Örneği, Hemşirelikte Araştırma ve Geliştirme Dergisi 2007;9:28-37.
  • Paige JT, Aaron DL, Yang T, Howell DS, Hilton CW, Cohn I Jr, Chauvin SW. Implementation of A Preoperative Briefing Protocol Improves Accuracy of Teamwork Assessment in The Operating Room. The American Journal of Surgery 2008;74:817–23.
  • Lingard L, Regehr G, Orser B, Reznick R, Baker GR, Doran D, Espin S, Bohnen J, Whyte S. Evaluation of A Preoperative Checklist and Team Briefing Among Surgeons, Nurses, and Anesthesiologists to Reduce Failures in Communication. Arch Surg 2008;143:12–7.
  • Nagpal K, Vats A, Lamb B, Sevdalis V, Vincent C, Moorthy K. Information Transfer and Communication in Surgery: A Systematic Review. Annals of Surgery 2010;252:225–39.
There are 36 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Özgül Karayurt

Hale Turhan Damar

Özlem Bilik

Saliha Özdöker

Melike Duran

Publication Date March 1, 2017
Published in Issue Year 2017Issue: 1

Cite

EndNote Karayurt Ö, Damar HT, Bilik Ö, Özdöker S, Duran M (March 1, 2017) Ameliyathanede Hasta Güvenliği Kültürünün ve Güvenli Cerrahi Kontrol Listesinin Kullanımının İncelenmesi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 1 16–23.