Background
Methods
Setting and participants
Study design
Baseline measurements
Baseline WHO checklist
Baseline Safety Attitudes Questionnaire (SAQ)
Baseline structured observations
The intervention
Focus groups
Inadequate structure concerning the WHO checklist
Benefits of improved description of the surgical procedure
Educational settings
The revised WHO checklist
Post-intervention
Structured observations during use of the revised WHO checklist
Post-intervention Safety Attitude Questionnaire (SAQ)
Analysis methods
Qualitative analysis
Statistical analysis
Results
Baseline Safety Attitudes Questionnaire (SAQ)
Domaina
| Baseline (n) | Baseline | Post-inter-vention (n) | Post-intervention | (n) b
| Mean Change | SEM’ |
P-value |
---|---|---|---|---|---|---|---|---|
Mean (SD) | Mean (SD) | |||||||
Teamwork climate | 106 | 65 (15.2) | 88 | 64 (13.2) | 63 | 0.3 | 1.4 | ns |
Job satisfaction | 114 | 75 (15.2) | 94 | 72 (14.2) | 65 | −2.2 | 1.3 | ns |
Perception of management | 106 | 58 (16.3) | 86 | 53 (16.1) | 59 | −5.4 | 2.2 | 0.016 |
Safety climate | 97 | 62 (14.9) | 81 | 61 (13.9) | 52 | 1.8 | 2.0 | ns |
Stress recognition | 118 | 70 (19.6) | 93 | 72 (17.7) | 66 | 1.9 | 2.0 | ns |
Working conditions | 95 | 64 (15.0) | 74 | 61 (14.4) | 47 | −1.2 | 1.8 | ns |
Domain | Profession | Baseline | Post-intervention | Change | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
(n) | Mean | (SD) |
p-value | (n) | Mean | (SD) |
p-value | (n) a
| Mean | SEM |
P-value | ||
Team work climate | Doctors | 34 | 72 | 10.0 | 0.001 | 27 | 69 | 11.2 | 0.006 | 16 | −1.8 | 1.6 | 0.700 |
Nurses | 72 | 62 | 16.2 | 61 | 61 | 13.2 | 47 | 1.0 | 2.8 | ||||
Job satisfaction | Doctors | 42 | 75 | 14.6 | 0.856 | 37 | 73 | 12.3 | 0.551 | 22 | −1.2 | 2.1 | 0.498 |
Nurses | 71 | 75 | 15.7 | 57 | 71 | 15.3 | 43 | −2.7 | 1.7 | ||||
Perception of management | Doctors | 37 | 63 | 17.9 | 0.023 | 31 | 57 | 16.3 | 0.081 | 18 | 1.4 | 2.2 | 0.005 |
Nurses | 69 | 56 | 14.9 | 55 | 51 | 15.7 | 41 | −8.4 | 2.9 | ||||
Safety Climate | Doctors | 30 | 66 | 14.9 | 0.056 | 30 | 63 | 14.0 | 0.307 | 14 | −1.8 | 3.4 | 0.907 |
Nurses | 67 | 60 | 14.6 | 51 | 60 | 13.9 | 38 | 3.1 | 2.4 | ||||
Stress recognition | Doctors | 44 | 76 | 16.8 | 0.013 | 36 | 73 | 14.0 | 0.690 | 23 | −2.2 | 3.3 | 0.638 |
Nurses | 73 | 66 | 20.6 | 57 | 71 | 19.8 | 43 | 4.1 | 2.5 | ||||
Working Conditions | Doctors | 30 | 70 | 15.2 | 0.005 | 26 | 65 | 15.6 | 0.072 | 11 | 2.3 | 4.4 | 0.132 |
Nurses | 65 | 61 | 14.1 | 48 | 59 | 13.4 | 36 | −2.3 | 2.0 |
Teamwork Climate Items | Overall Baseline | Post-intervention | Surgeons Baseline | Post- intervention | Anestha Baseline | Post- intervention | Scrub nurses Baseline | Post-intervention | Nurse anb Baseline | Post-intervention | Nurse assc Baseline | Post-intervention |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Nurse input is well received in this clinical area | 3.75 (0.8); 66 | 3.75 (0.82); 66 | 4.04 (0.56); 71 | 3.95 (0.79); 61 | 4.31 (0.7); 78 | 4.4 (0.7); 90 | 3.41 (0.85); 50 | 3.47 (0.96); 55 | 3.57 (0.74); 64 | 3.58 (0.78); 71 | 3.63 (0.82); 67 | 3.67 (0.66); 67 |
Disagreements in this clinical area are appropriately resolved | 2.81 (0.96); 26 | 2.88 (0.84); 21 | 3.41 (0.8); 39 | 3.38 (0.59); 32 | 3.31 (0.7); 39 | 3.5 (0.53); 50 | 2.27 (0.83); 9 | 2.16 (0.76); 5 | 2.59 (0.8); 10 | 2.75 (0.74); 16 | 2.67 (1.13); 33 | 2.89 (0.83); 14 |
I have the support I need from other personnel to care for our patients | 4.07 (0.74); 85 | 3.97 (0.73); 82 | 4.29 (0.46); 100 | 3.89 (0.83); 82 | 4.12 (0.86); 78 | 4.1 (0.57); 90 | 3.73 (0,7); 68 | 3.6 (0.82); 60 | 4.11 (0.69); 90 | 4.21 (0.51); 96 | 4.04 (0.95); 83 | 4.11 (0.68); 81 |
It is easy for personnel in this clinical area to ask questions when there is something that they do not understand | 3.99 (0.79); 81 | 3.79 (0.79); 65 | 4.11 (0.51); 89 | 3.92 (0.74); 71 | 4.18 (0.53); 89 | 4.2 (0.42); 100 | 3.68 (0.89); 63 | 3.75 (0.85); 60 | 3.79 (0.88); 75 | 3.42 (0.78); 50 | 4.25 (0.9); 88 | 3.89 (0.83); 62 |
The doctors and nurses here work together as a well-coordinated team | 3.62 (0.86); 68 | 3.58 (0.86); 66 | 3.42 (0.9); 50 | 3.41 (0.93); 54 | 4 (0.71); 83 | 4 (0.47); 90 | 3.27 (0.89); 59 | 3.35 (1.04); 60 | 3.68 (0.67); 71 | 3.71 (0.69); 75 | 3.83 (0.87); 83 | 3.67 (0.84); 67 |
In this clinical area it is difficult to speak up if I perceive a problem with patient care (reversedscored) | 3.5 (1.03); 57 | 3.49 (0.93); 57 | 3.63 (1.01); 61 | 3.92 (0.8); 75 | 3.83 (0.92); 78 | 3.7 (0.48); 70 | 3.05 (0.95); 32 | 3.26 (0.99); 45 | 3.61 (0.96); 68 | 3.38 (1.01); 63 | 3.39 (1.2); 46 | 3.2 (0.95); 33 |
Profession | Surgeons | Anesthesiologists | Scrub nurses | Nurse anaesthetists | Nurse assistants | ||
---|---|---|---|---|---|---|---|
Consultants Attendings | Residents Interns | Consultants Attendings | Residents Interns | ||||
Surgeons (n = 28) |
93
|
64
| 50 | 50 | 64 | 46 | 36 |
Anesthesiologists (n = 18) | 33 | 33 |
56
|
67
| 56 | 83 | 61 |
Scrub nurses (n = 22) | 36 | 27 | 23 | 18 |
77
| 77 | 59 |
Nurse anaesthetists (n = 28) | 29 | 14 | 75 | 71 | 68 |
82
| 50 |
Nurse assistants (n =24) | 42 | 17 | 46 | 42 | 75 | 71 |
71
|