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- Rydenfält, Christofer, et al.
(författare)
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Compliance with the WHO Surgical Safety Checklist: deviations and possible improvements.
- 2013
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Ingår i: International Journal for Quality in Health Care. - : Oxford University Press (OUP). - 1464-3677 .- 1353-4505. ; 25:2, s. 182-187
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: /st>Previous research suggests that the World Health Organization Surgical Safety Checklist time-out reduces communication failures and medical complications and supports development of better safety attitudes. Previous research also indicates that different values can affect the implementation of interventions. OBJECTIVE: /st>To investigate the actual usage of the checklist in practice and to catalogue deviations for the purpose of identifying improvements. DESIGN: /st>Twenty-four surgical procedures were video recorded. The time-out was analysed quantitatively assessing compliance with a predefined observational protocol based on the checklist and qualitatively to describe reasons for non-compliance. SETTING: /st>The operating unit of a Swedish county hospital. MAIN OUTCOME MEASURES: /st>Compliance with checklist items and the participation of different personnel groups. Activities were conducted during the time-out. RESULTS: /st>Highest compliance was associated with patient ID, type of procedure and antibiotics; the worst with site of incision, theatre nurse team reviews and imaging information. Team member introductions occurred in half of the operations. Surgeons and the anaesthesia team dominated the time-out. CONCLUSION: /st>The checklist is not always applied as intended. The components that facilitate communication are often neglected. The time-out does not appear to be conducted as a team effort. It is plausible that the personnel's conception of risk and the perceived importance of different checklist items are factors that influence checklist usage. To improve compliance and involve the whole team, the concept of risk and the perceived relevance of checklist items for all team members should be addressed.
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- Rydenfält, Christofer, et al.
(författare)
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Social structures in the operating theatre: how contradicting rationalities and trust affect work.
- 2012
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402. ; 68:4, s. 783-795
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Tidskriftsartikel (refereegranskat)abstract
- Aim. This article is a report of a study of how healthcare professionals involved in surgery orientate themselves to their common task, and how this orientation can be affected by the social and organizational context. Background. Previous research indicates that surgical teams are not as cohesive as could be expected and that communication failures frequently occur. However, little is known about how these problems are related to their social, cultural and organizational context. Methods. Semi-structured interviews were conducted with 15 healthcare professionals, representing all personnel categories of the surgical team. During the interview, a virtual model, visualizing a real operating theatre, was used to facilitate reflection. The interviews were conducted in 2009. Themes were created from the interviews, with a focus on similarities and differences. An activity analysis was conducted based on the themes. Findings. Poor team functionality and communication failures in the operating theatre can to some degree be explained by differences in activity orientation between professions and by insufficient support from social and organizational structures. Differences in activity orientation resulted in different views between professional groups in their perceptions of work activities, resulting in tension. Insufficient support resulted in communication thresholds that inhibited the sharing of information. Conclusion. Organizing work to promote cross-professional interaction can help the creation of social relations and norms, providing support for a common view. It can also help to decrease communication thresholds and establish stronger relations of trust. How this organization structure should be developed needs to be further investigated.
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