Surgical Team Members Research Articles

The effect of interprofessional education on the surgical team members' self-efficacy perception of interprofessional communication in the healthcare system.

The current study aimed to assess the effect of interprofessional education on participants' self-efficacy perception of interprofessional communication at different levels of a healthcare system (relationships in the interpersonal, interprofessional, and administration levels). This is a sequential explanatory mixed-method study. Learners include surgical residents, surgical technology nurses, and anesthesia nurses (n = 130) who participated in the intervention and control groups. The quasi-experimental study was conducted in the first step. The educational strategy was interprofessional education and the main teaching method was case-based learning. The self-efficacy perception of the participants was assessed by a 26-item questionnaire before and 1 month after the intervention. The descriptive tests (mean, SD, percentage), student t-tests, and ANOVA were analyzed. The participants' experiences were explored through semi-structured interviews. Qualitative content was analyzed by Lundman and Graneheim's approach. The results showed that the scores of the learners in the intervention group (4.05 ± 0.31) improved significantly compared to the control group (3.35 ± 0.37) (p = 0.0001). In the present study, the experiences of the participants were categorized into a theme "explicit and implicit confrontations with perceived distrust in the system" which includes two categories "failure to internalize professionalism among team members" and "dominance of a paternalistic culture within the health care system". The results showed the positive impact of interprofessional education interventions on participants' self-efficacy perception of interprofessional communication. The results showed that interprofessional education, with the participation of different professionals and managers at different levels of a healthcare system, improved the participants' perception of self-efficacy regarding interprofessional communication. The results showed the improvement in the participants' communication with team members and managers required to solve the perceived explicit and implicit confrontations in the surgical departments. The implementation of an interprofessional education strategy focused on interprofessional professionalism and collaboration principles in clinical activities, formal and informal education in the surgical department is recommended.

Collaborative Surgical Team Formation: A Proposed Theoretical Framework Using Genetic Algorithm

The imbalance in surgical team composition has a significant impact on the increment of surgical failure and error. The crucial factors influencing the optimal surgical team members are experience, skills, trust, and leadership. Hence, this study aims to maximize surgical team formation effectiveness with a systematic and data-driven approach to team composition for minimizing human error, maximizing safety, and promoting active communication and reliability among team members that can result in successful surgeries. A theoretical framework has been proposed for optimizing surgical team formation using a Genetic Algorithm (GA). This proposed framework is predicted to assemble an effective collaborative surgical team that can perform a successful surgery based on the multi-objective function: the performance indicators and social-based ratings.

Bibliometric Analysis of Studies on Surgical Smoke: Bibliometric Analysis

PurposeThe aim of this study was to examine the studies on surgical smoke by bibliometric analysis and science mapping methods. DesignBibliometric analysis and science mapping methods study. MethodsData were obtained by searching the SCOPUS database. The keywords “surgical smoke,” “operating room,” “operating room staff,” and “nurse” were used. Due to the ongoing scientific flow to the database, the search was performed on December 25, 2023 as a single day. FindingsAs a result of the research, a total of 51 studies were reached. We found 49 research articles and 2 review publications in the field of nursing and medicine. Most publications related to surgical smoke were published in 2021 (21.5% n: 11), and the journals with the highest number of publications were the Journal of Perioperative Nursing (5.9% n: 3) and AORN Journal (5.9% n: 3). The most common keyword in the studies was “surgical smoke.” "Surgical smoke" was used in common with all other keywords, the most publications on the subject were made in the United States, the most publications were made in English (92% n: 47), and the most citations were made by Barrett and Garber in 2003 with 250 citations (25.4%). ConclusionsThis study provides a comprehensive overview of the current state of research on surgical smoke, highlighting its prevalence in recent literature. The findings underscore the need for continued investigation and awareness among health care professionals. The results obtained are important in terms of understanding the current situation in the relevant literature and will provide resources for new studies to be carried out by nursing and other surgical team members in the future.

Investigating the effect of video-based training on adherence of surgical positioning standards: a randomized controlled trial

BackgroundThe operating room is a high-risk environment where proper patient positioning is crucial for minimizing injury and ensuring optimal access to surgical sites. This process requires effective collaboration among surgical team members, particularly operating room nurses who play a vital role in patient safety. Despite advancements in technology, challenges such as pressure injuries persist, with a significant incidence rate. Video-based training (VBT) emerges as a promising educational tool, enhancing knowledge retention and fostering a learner-centered approach. This study aims to evaluate the impact of VBT on adherence to surgical positioning standards, highlighting its potential to improve safety protocols in the operating room.MethodsIn this clinical trial, 62 qualified operating room nurses (50 women, 12 men, average age: 28.90 ± 3.75 years) were randomly divided into control and intervention group (n = 31 in each group). The control group only received positioning recommendations, but in the intervention group, in addition to the recommendations, video-based surgical positioning training was performed for 1 month, at least 3 times a week. The performance of nurses in both groups was evaluated through a researcher-made checklist at baseline and post-intervention.ResultsBased on findings, there was no significant difference between the two groups in compliance with surgical positioning standards at baseline (p = 0.07). However, after the intervention, compliance scores significantly improved in the VBT group compared to the control group (p < 0.001). The VBT group showed a mean improvement of 62.12 points, while the control group improved by 10.77 points (p < 0.001).ConclusionsThis preliminary study demonstrated a notable improvement in compliance with surgical positioning standards among operating room nurses following VBT intervention. Despite the promising results, the small sample size and preliminary nature of the research necessitate further studies to confirm these findings and assess long-term outcomes. These initial insights highlight the potential of innovative training methods in enhancing surgical practices.

Improving the provision of emotional support for patients following major lower limb amputation

Major lower limb amputation (MLLA) is a lifesaving but life-altering surgical procedure. Psychological distress is common and typically heightened in the acute postoperative period. Despite the negative impact that poor...

INVESTIGATING THE RELATIONSHIP BETWEEN SURGICAL TEAM COMMUNICATION AND PATIENT OUTCOMES

Surgical team plays a vital role in the care of patients during the surgery. For safe patient outcomes, surgical team members must effectively communicate within the surgical site. Communication breakdowns in the complex operating room atmosphere can result in unfavorable outcomes. To reduce risks, avoid errors and provide the best possible care for patients, the surgical team must communicate clearly and effectively with one another. Enhancing the quality of surgical treatment requires an understanding of the connection between communication and patient results. Objective: The purpose of this study was to investigate the connection between patient satisfaction outcomes and surgical communication between teams focusing on how the improved communication practices can enhance the patient safety in terms of care quality and satisfaction level in surgical setting. Method: The study comprised of 187 health care providers between the ages of 18 and 65 who were examined for the association between surgical team communication and patient outcomes after ethical approval from Hospital ethical committee. Descriptive cross-sectional study was carried out in the District Headquarters Teaching Hospital, Kohat Development Authority Kohat from January 2022 to July 2022. Data was Analyzed on SPSS and shown in tables. Results: The analysis shows a strong positive correlation (.595) between team communication and patient outcomes, with healthcare professionals that rates the quality of communication at an average of 3.84 out of 5, which is closely linked to a decrease in surgical complications and an increase in patient satisfaction. Sticking and communicating according to communication protocols was rated at 3.76, underlining its importance in patient safety improvements. Conclusions: The study affirms the crucial impact of effective communication among surgical team members on improving patient outcomes and safety in the operating site. The enhanced communication directly relates with faster patient recovery, lesser complications and higher patient satisfaction.

Abbreviated in-situ inter-professional debriefing simulation training in peri-operative care environments: Minimizing the impact on clinical care using standardized videos

IntroductionOur facility leadership posed questions to the perioperative leadership team regarding the presence of collaborative communication during the reconciliation of events occurring in several perioperative care areas (operating rooms {OR}, clinic procedure areas, Intensive Care Unit {ICU}). Our team* collaborated to pilot a rapid cycle performance improvement project focused on improving the effectiveness of debriefings and handoffs that could conceivably lead to more effective after-action reviews following events which were complicated by multiple simultaneous unexpected factors. We proposed we could implement standardized abbreviated low-fidelity point of care (in-situ) inter-professional simulation training across the healthcare system with minimal impact on clinical schedules. We believed this would improve the perception of teamwork and collaboration among surgical team members. MethodsInter-professional in-situ simulation training exercises were designed and performed in perioperative care areas systemwide at our three major facilities (Main hospital and two Healthcare Community Centers [HCC]). Multiple iterations of styles of training were conceived and trialed. In the end, preconstructed videos were used to standardize the processes that framed the simulation role-playing of a debriefing after a complex situation. These videos contain the pre-simulation pre-briefings, the clinical situation that preceded the clinical debriefing and the simulation debriefing. Successful reconciliation of the multiple events required team members to exercise closed-loop communication, mutual trust, reengagement, and de-escalation of disengaged team members. Anonymous institutional review board reviewed, and Association of Federal Government Employees (AFGE) approved retrospective pre/post implementation surveys were made available to participants immediately after and sixty to ninety days following simulation exercises. ResultsBetween July 2023 and March 2024, one hundred and six staff in the perioperative care areas participated in twenty-two inter-professional simulation trainings (eleven OR, eight clinic, and three ICU simulations). Fourteen simulation scenarios in seven surgical disciplines were created. Eleven videos were produced covering cases in the O.R., clinic and ICU. Ultimately, the simulations were completed within twenty minutes in the three perioperative care clinical areas. Seventy-nine staff responded to the initial surveys after the simulation training. Eighty percent of the respondents gave favorable assessments regarding the effectiveness of the training in improving components of teamwork and agreed this program should continue. ConclusionsThe pilot program affirmed that we could implement simulations across the healthcare system in a format that minimally impacted the staffs’ clinical schedule. The process was standardized through the creation of multiple specialty specific videos. We proposed that perioperative team leadership could utilize these videos in the future to conduct spontaneously arranged simulations when they identified the presence of members naïve to this training and opportunities in the clinical schedule.*Refer to the acknowledgments for construct of our perioperative leadership simulation advisory team

SP9.5 - Peri-operative Comprehensive Geriatric Assessment (CGA): A new benchmark for Acute General Surgery patients

Abstract Aims More than 50% of patients undergoing emergency general surgery are over 65 years of age. NICE guidelines emphasise frailty assessment in acute surgical settings, particularly in the preoperative period. Similarly, the Emergency Laparotomy and Frailty (ELF) study showed associations between frailty (CFS ≥ 5) and 90-day mortality, increased complication and length of hospital stay in older emergency laparotomy patients. NELA best practice tariff (BPT) April 2023 heavily focuses on perioperative team involvement in frailer, older patients. This is an audit from a city teaching hospital, with a surgical liaison team against standards set by NELA. Methods Review of patients aged ≥ 65 undergoing emergency laparotomies between August and November 2023 (pre-intervention) then December and January 2024 (post-intervention). Data collected includes whether patients had a documented frailty score, a clearly documented CPR decision &amp; treatment escalation plan (TEP), pre- or post-operative medical review, and advanced-care planning (ACP) post-operatively. Intervention included dedicated members of surgical liaison team following patients throughout admission, weekly meetings to discuss laparotomy patients, older patient template being created capturing ceilings of care, frailty score, and social history. Results Post intervention, improvement in clear documentation regarding escalation, frailty level. Greater level of MDT collaboration with regards to older patients undergoing laparotomies. Conclusion Changes in NELA BPT emphasise the importance of comprehensive geriatric assessment in the management of older laparotomy patients. Even a basic surgical liaison service can achieve high levels of compliance with a few simple strategies, resulting in better outcomes for patients as well as financial benefits for Trusts.

Utilization of recurrent laryngeal nerve monitoring during thyroid surgery in china: a point prevalence survey (2015-2023).

The survey aimed to elucidate the complete range of national practices, including all technical and non-technical aspects, as well as surgical stratification and maturation, of the use of intraoperative neuromonitoring (IONM) during thyroid surgery in China. Six national questionnaires, developed by the Chinese Neural Monitoring Study Group (CNMSG) between 2015 and 2023, were used to collect and analyze data regarding the clinical application, education, and scientific research related to IONM in Chinese medical institutions. Among the surveyed hospitals, 45% reported an average annual surgical volume exceeding 3,000 cases, with 82.5% performing more than 80% of the surgeries for malignant thyroid tumors. Additionally, 97.5% of the hospitals reported a<3% incidence of postoperative hoarseness with IONM. Statistical analysis from 2011 to 2015 found that the incidence of postoperative hoarseness decreased by 30% in 2013 compared with 2011, when the technology was introduced. Preoperative and postoperative laryngoscopies were routinely performed by 82.5% and 15% of the hospitals, respectively. For 65% of the hospitals, the publication of the Chinese edition of neuromonitoring guidelines in 2013 prompted the utilization of IONM technology. An average annual number of IONM applications exceeding 500 cases (18.5% the average volume) was reported by 80% of the hospitals, while 62.5% reported a cumulative number of applications greater than 5,000 cases (47.1% the average cumulative volume). Regarding technical parameters, 75% of the hospitals reported an intraoperative V1 amplitude of >500µV, and 70% reported an intraoperative loss of signal (LOS) rate of<3%. 92.5% of the surveyed hospitals believed that IONM could help identify dissociated nerves, and 95% of the surveyed hospitals believed that IONM could reduce nerve damage. However, 72.5% of the respondents thought that cost was the main limitation. Furthermore, 67.5% of the hospitals reported that half of their thyroid surgical team members were trained in IONM, with 17.5% reporting that all team members were trained. Areas for reinforced training included IONM research methods and directions (72.5%), and analysis and treatment of abnormal EMG signals (72.5%). Research projects related to IONM were conducted by 42.5% of the hospitals, while 52.5% had published papers on neuromonitoring. IONM was independently and incrementally associated with the annual surgical volume. This survey emphasized the importance of national collaboration and/or a registry for the uptake, consolidation, and development of CNMSG consensus.

To speak or not to speak: Factors influencing medical students’ speech and silence in the operating room

PurposeThe surgical clerkship provides medical students with valuable hands-on experience. This study examined why medical students speak or remain silent in the OR to improve progression from novice to engaged surgical team member. MethodsUsing Constructivist Grounded Theory 37 interviews were conducted concerning expectations and behaviors that encourage or discourage students from speaking during their clerkship. Transcripts were coded, analyzed, and triangulated to develop a conceptual model. ResultsStudents’ decision to speak or remain silent was based on their perception of the OR as a safe learning space. Our findings suggest that better preparation, awareness of critical moments, and informal communication with team members encouraged student speech. ConclusionsMedical students remain conflicted about their speaking in the OR and their evaluation. Key to improving students’ psychological safety is establishment of interpersonal relationships, awareness of OR mood, and assignment of case-related tasks to assist with OR assimilation and improved learning.

Development and psychometric evaluation of a pneumatic tourniquet work standards scale

ObjectivePneumatic tourniquets are among the most essential equipment for controlling bleeding in orthopedic surgeries. However, incorrect application of pneumatic tourniquets is accompanied by many hazards and complications for patients. Evaluation of surgical teams’ use of pneumatic tourniquets and establishment of protocols can play an important role in improving patient safety, minimizing risks, and increasing the lifetime of this equipment. Accordingly, the present study was conducted to develop and assess the psychometric properties of a pneumatic tourniquet work standards scale.MethodsThe present study is a methodological work carried out in two stages. In the first stage, an initial version of the scale was developed based on existing research and panel reviews. In the second stage, the psychometric properties of the scale were tested in terms of face validity (measured qualitatively and quantitatively), content validity (measured qualitatively and quantitatively), item analysis, construct validity, and reliability (internal consistency and stability).ResultsThe initial version of the scale consisted of 91 items. After several meetings of the research team, the number of items decreased to 81. In the course of face and content validity testing, 40 items were eliminated, leaving 41 items on the scale when it entered the construct validity testing stage. For evaluation of construct validity, a sample of 300 operating room nurses was recruited. The Exploratory Factor Analysis (EFA) results showed a structure supported by seven factors and 41 items. The reliability of the scale was confirmed by internal consistency analysis, with a good Cronbach’s alpha (0.85), and test–retest analysis, with good values of ICC (0.95).ConclusionThe present instrument is a reliable and valid scale which fills the gap in assessment of surgical team members’ use of pneumatic tourniquets. The developed scale can be employed by researchers and managers of medical centers to identify hazards in applying pneumatic tourniquets and devise educational programs to eliminate or reduce the existing issues.

Constructing a User-Centric Visual Real-Time Surgical Dashboard.

The existing surgery timetable is very simple, not user-friendly, and has very limited information. This article outlines the creation of a surgical dynamic dashboard for users, using Microsoft Power BI. The dashboard was developed based on in-depth interviews with the surgical team members to determine their requirements. The outcome of dashboard was evaluated by 5-likert scale questionnaire to measure satisfaction of all surgical team members. All team members were very satisfied with the dashboard compared to the existing surgery timetable. In addition, with the function of auto-generated analytic reports through data criteria selection on the dashboard saved time on manually generating reports. This study supports to replace the existing surgery timetable by the user-centric and real time surgical dashboard.

Organizational learning in surgery in Tanzania's health system: a descriptive cross-sectional study.

Organizational learning is critical for delivering safe, high-quality surgical care, especially in low- and middle-income countries (LMICs) where perioperative outcomes remain poor. While current investments in LMICs prioritize physical infrastructure, equipment, and staffing, investments in organizational learning are equally important to support innovation, creativity, and continuous improvement of surgical quality. This study aims to assess the extent to which health facilities in Tanzania's Lake Zone perform as learning organizations from the perspectives of surgical providers. The insights gained from this study can motivate future quality improvement initiatives and investments to improve surgical outcomes. We conducted a cross-sectional analysis using data from an adapted survey to explore the key components of organizational learning, including a supportive learning environment, effective learning processes, and encouraging leadership. Our sample included surgical team members and leaders at 20 facilities (health centers, district hospitals, and regional hospitals). We calculated the average of the responses at individual facilities. Responses that were 5+ on a 7-point scale or 4+ on a 5-point scale were considered positive. We examined the variation in responses by facility characteristics using a one-way ANOVA or Student's t-test. We used univariate and multiple regression to assess relationships between facility characteristics and perceptions of organizational learning. Ninety-eight surgical providers and leaders participated in the survey. The mean facility positive response rate was 95.1% (SD 6.1%). Time for reflection was the least favorable domain with a score of 62.5% (SD 35.8%). There was variation by facility characteristics including differences in time for reflection when comparing by level of care (P = .02) and location (P = .01), and differences in trying new approaches (P = .008), capacity building (P = .008), and information transfer (P = .01) when comparing public versus faith-based facilities. In multivariable analysis, suburban centers had less time for reflection than urban facilities (adjusted difference = -0.48; 95% CI: -0.95, -0.01; P = .046). Surgical team members reported more positive responses compared to surgical team leaders. We found a high overall positive response rate in characterizing organizational learning in surgery in 20 health facilities in Tanzania's Lake Zone. Our findings identify areas for improvement and provide a baseline for assessing the effectiveness of change initiatives. Future research should focus on validating the adapted survey and exploring the impact of strong learning environments on surgical outcomes in LMICs. Organizational learning is crucial in surgery and further research, funding, and policy work should be dedicated to improving learning cultures in health facilities.

Non-technical skills training for Nigerian interprofessional surgical teams: a cross-sectional survey

IntroductionNon-technical skills (NTS) including communication, teamwork, leadership, situational awareness, and decision making, are essential for enhancing surgical safety. Often perceived as tangential soft skills, NTS are many times not included in formal medical education curricula or continuing medical professional development. We aimed to explore exposure of interprofessional teams in North-Central Nigeria to NTS and ascertain perceived facilitators and barriers to interprofessional training in these skills to enhance surgical safety and inform design of a relevant contextualized curriculum.MethodsSix health facilities characterised by high surgical volumes in Nigeria’s North-Central geopolitical zone were purposively identified. Federal, state, and private university teaching hospitals, non-teaching public and private hospitals, and a not-for-profit health facility were included. A nineteen-item, web-based, cross-sectional survey was distributed to 71 surgical providers, operating room nurses, and anaesthesia providers by snowball sampling through interprofessional surgical team leads from August to November 2021. Data were analysed using Fisher’s exact test, proportions, and constant comparative methods for free text responses.ResultsRespondents included 17 anaesthesia providers, 21 perioperative nurses, and 29 surgeons and surgical trainees, with a 95.7% survey completion rate. Over 96% had never heard of any NTS for surgery framework useful for variable resource contexts and only 8% had ever received any form of NTS training. Interprofessional teams identified communication and teamwork as the most deficient personal skills (38, 57%), and as the most needed for surgical team improvement (45, 67%). There was a very high demand for NTS training by all surgical team members (64, 96%). The main motivations for training were expectations of resultant improved patient safety and improved interprofessional team dynamics. Week-long, hybrid training courses (with combined in-person and online components) were the preferred format for delivery of NTS education. Factors that would facilitate attendance included a desire for patient safety and self-improvement, while barriers to attendance were conflicts of time, and training costs.ConclusionsInterprofessional surgical teams in the Nigerian context have a high degree of interest in NTS training, and believe it can improve team dynamics, personal performance, and ultimately patient safety. Implementation of NTS training programs should emphasize interprofessional communication and teamworking.

Enhancing Team Performance in Surgical Operations: A Case Study at a Private Cancer Hospital and Research Centre in Thrissur District

Purpose: The purpose of this study is to evaluate the existing team dynamics within the surgical crew; to gain insights into the perceptions of different team members regarding team effectiveness and potential areas for improvement; to investigate factors crucial to successful teamwork in the operation theatre, and to analyze successful practices that have positively impacted team performance and patient outcomes. Design/methodology/approach: Quantitative data was gathered through a validated questionnaire distributed among surgical team members at a private cancer hospital and research center in Thrissur District, Kerala. Descriptive research was adapted for this study. The population for the study includes the members of the surgical team. A sample size of 120 members including doctors, nurses, technicians, and other supportive members who participated in various surgeries, were selected using a random sampling technique for the data purpose. Findings: The findings of the study disclosed that the challenges included occasional communication breakdowns and role ambiguity that seriously influenced the team performance of a surgical crew. Successful practices involved structured communication protocols, regular team training, and a collaborative leadership approach. Stakeholders accentuated the need for continuous improvement in strategies premeditated to the operation theatre’s unique demands. Research limitations/implications: The study’s inferences underscore the necessity for targeted intermediations focusing on the factors manipulating the surgical teams. Implementing structured training programs, refining communication protocols, and fostering a collaborative leadership culture can notably improve team performance. Additionally, modifying these interventions to suit the specific demands of the operation theatre is essential for sustaining and augmenting positive changes in teamwork dynamics, ultimately elevating the quality of patient care and outcomes. Social Implications: The empirical research contributed to enhancing the quality of surgical care, improving patient safety, and refining the overall performance of surgical teams in specialized healthcare settings through enhanced team performance for societal well-being by improving patient outcomes and reducing healthcare disparities. A more cohesive surgical team fosters a safer environment, positively impacting patient satisfaction, trust in healthcare, and overall community health. Additionally, it promotes a culture of collaboration and excellence, setting a precedent for improved healthcare practices within society. Originality / Value: The originality of the study lies in its broad examination of team dynamics within a specialized setting, the operation theatre of a private cancer hospital, and a research center. The study offers insights into specific challenges, successful practices, and context-specific interventions, to enhance team performance and patient care in this distinct healthcare environment.

The Factors Affecting Surgical Room Nurse's Compliance in Performing Sterile Handwashing in the Central Surgery Installation of RSUD Banyumas

Background: Surgical site infection, as a part of Healthcare-Associated Infections (HAIs), can be prevented by proper handwashing among the surgical team members. Compliance with handwashing has been proven to reduce healthcare associated infections. Method: This was quantitative research with a descriptive correlation design using a cross sectional approach. A total sampling technique was used with a sample size of 35 surgical room nurses’s in the central surgery installation of RSUD Banyumas who met the inclusion and exclusion criteria. The research instrument was aquestionnare. Data analysis was conducted using the chi-square test. Results: The study result show that the majority of nurses have good knowledge (45,7%), high motivation (77,1%), perceive good supervision (74,3%) and are compliant in performing sterile handwashing (71,4%). There is a correlation between knowledge, motivation and supervision with the compliance of surgical room nurses in performing sterile handwashing in the central surgery installation of RSUD Banyumas. Conclusion: Factor such as nurses knowledge and motivation in the surgical room and supervision from the department head are related to the compliance of surgical room nurses in performing sterile handwashing.

An investigation on the compliance of perioperative practices using ERAS protocols and barriers to the implementation of the ERAS protocols in colorectal surgery

Background Although ERAS protocols have many benefits, there are some deficiencies in their understanding and implementation by healthcare professionals. The present study was conducted to investigate the compliance of the current perioperative practices of healthcare professional with the ERAS protocols and to assess barriers to the implementation of ERAS protocols in colorectal surgery. Methods This cross-sectional descriptive study conducted in the surgical clinics and operating rooms of a training and research hospital between January 2020 and September 2020 included 110 physician and nurse members of surgical teams. Data were collected using the Questionnaire for Evaluating the Use of the ERAS Protocol and Identifying Barriers to Implementation in Colorectal Surgery. Results The compliance of the current perioperative practices by healthcare professionals with the ERAS protocols ranged between 15.5% (routinely leaving nasogastric tubes in situ following colorectal resection) and 61.8% (being aware of the concept of balanced analgesia). Variables such as the healthcare professional’s profession, title, years in practice and colorectal surgery experience led to a difference between them in terms of their compliance of the practices with the ERAS protocols (p < 0.05). Based on the healthcare professionals’ comments about barriers to the implementation of the ERAS protocol, themes such as education, teamwork, communication and lack of resources were created. Conclusion Healthcare professionals’ compliance level of the current perioperative practices with the ERAS protocols was mostly low. Barriers to the implementation of the ERAS protocols had a multi-factor structure that concerns the multidisciplinary team.

The effects of hierarchical relationship on well-being of surgical team members in operating theaters: Prospective cohort study.

Although there are many studies about wellbeing on healthcare professionals, the relationship between hierarchy and well-being has not been studied much. In this study, we focused on surgical branch professionals (anesthesiologists, surgeons, nurses) as organized in a strict hierarchy. We explored the association between the position within the organizational hierarchy in operating theaters and well-being. Data were collected in 2 parts as cross-sectional (baseline) and daily surveys (for 15 days). A total of 226 participants participated in the baseline study and 156 participants in the daily surveys. How hierarchical positions, in-group identification and personality traits were related to the well-being and experiences of surgical team members were investigated. System justification, social dominance orientation, and personality theories were used to investigate personality traits. Emotional stability and identification with other healthcare professionals were positively associated with positive experience and well-being. Daily hierarchical relationship when the team members were in a superior position was positively associated with that day's well-being, positive experience, enjoying working, and motivation to work on the following day. Conversely, the negative effects of daily hierarchical relationships on outcomes were not seen when the participants were in a subordinate position. Our findings were parallel to the literature that perceived autonomy in the workplace has positive impacts on the well-being. Furthermore, we found that in-group identification can protect surgical branch professionals from the adverse effects of the organizational hierarchy. We suppose our findings can contribute to the literature to evaluate organizational structure of operating theaters.

Surgical team member's application of personal protective equipment: an observational study.

Personal protective equipment (PPE) is a term used to refer to clothing or equipment that creates a barrier to protect an individual from work-place hazards, thereby protecting the worker against work-related injuries and illnesses. This study was aimed at determining the compliance of application of personal protective equipment against the standards. One hundred surgical personnel were included in this study from 21 March 2023 to 23 April 2023. Data were collected through direct observation. The standards were directly changed into question forms with two integral checking components, "Yes", and "No". Data were entered and analyzed by statistical package of social sciences (SPSS) version 25. A total of 100 surgical personnel involved in surgical procedures were assessed for how they applied PPE. Majority of healthcare workers, 61.2%, were compliant with the communicable disease control standard on the application of PPE. The highest compliance rate was observed for the put-on gloves over the gown, while the lowest compliance rate was observed for wearing eye protection. The practice of PPE usage by surgical personnel was suboptimal. Healthcare facilities can better protect their staff and patients from the spread of infections and other hazards through PPE use protocols. Donning and doffing must always be methodical and supervised by another staff member, especially during surgical emergencies. PPE should be used in accordance with infection prevention and control guidelines and the level of risk involved in the specific procedure.

Difficulties Experienced by Surgical Team Members with Operating Room COVID-19 Personal Protective Equipment

Difficulties Experienced by Surgical Team Members with Operating Room COVID-19 Personal Protective Equipment