Staff Feelings Research Articles

It’s a battlefield! A thematic analysis of narratives shared in Cape Town emergency departments

BackgroundThe Emergency Department(ED) team need to make sense of an ever-changing dynamic environment. The stories people tell about everyday occurrences are central to how sense-making occurs. These stories also contribute...

Nurses’ Perceptions of the Factors Which Cause Violence and Ways of Preventions in the Emergency Department: A Qualitative Study

Background: Violence has been increasing worldwide. The prevalence of violence in the healthcare sector is continuously rising, and the most vulnerable places for violence is emergency departments due to the critical nature of the workplace environment. Aims: To explore the factors that contribute to violence experienced by nurses, the impact of workplace violence on nurses, and the preventive methods. understanding these issues could enhance the workplace environment and quality of healthcare. Method: A qualitative approach was used with purposive sampling of 15 emergency department nurses at hospitals in Palestine who experienced or witnessed workplace violence. Semi-structured, face-to-face individual interviews were conducted to gain in-depth information about nurses’ experience in relation to workplace violence at emergency departments. All the interviews were transcribed verbatim for thematic analysis. Results: Three major themes were found to present the factors that contribute to violence experienced by nurses. These themes are: Knowledge and attitude related-issues, External-related factors and System-related issues. Four major themes emerged relating to the staff feelings, which are: Feeling overwhelmed, feeling distressed, feeling indignity and feeling helpless and fearful. Study participants offered some prevention methods to decrease workplace violence, and some suggestions to handle violence. Conclusion: Numerous factors contribute to the prevalence of workplace violence in emergency departments. Hospital administrations have to ensure the safety of all employees by using suitable precautions. There is an extensive need for psychological support after violent. In addition, universities have to develop communication, violence and stress management-training courses.

Betrayal-Based Moral Injury and Mental Health Problems Among Healthcare and Hospital Workers Serving COVID-19 Patients

ABSTRACT One factor potentially driving healthcare and hospital worker (HHW)’s declining mental health during the COVID-19 pandemic is feeling betrayed by institutional leaders, coworkers, and/or others’ pandemic-related responses and behaviors. We investigated whether HHWs’ betrayal-based moral injury was associated with greater mental distress and post-traumatic stress disorder (PTSD) symptoms related to COVID-19. We also examined if these associations varied between clinical and non-clinical staff. From July 2020 to January 2021, cross-sectional online survey data were collected from 1,066 HHWs serving COVID-19 patients in a large urban US healthcare system. We measured betrayal-based moral injury in three groups: institutional leaders, coworkers/colleagues, and people outside of healthcare. Multivariate logistic regression analyses were performed to investigate whether betrayal-based moral injury was associated with mental distress and PTSD symptoms. Approximately one-third of HHWs reported feeling betrayed by institutional leaders, and/or people outside healthcare. Clinical staff were more likely to report feelings of betrayal than non-clinical staff. For all respondents, 49.5% reported mental distress and 38.2% reported PTSD symptoms. Having any feelings of betrayal increased the odds of mental distress and PTSD symptoms by 2.9 and 3.3 times, respectively. These associations were not significantly different between clinical and non-clinical staff. As health systems seek to enhance support of HHWs, they need to carefully examine institutional structures, accountability, communication, and decision-making patterns that can result in staff feelings of betrayal. Building trust and repairing ruptures with HHWs could prevent potential mental health problems, increase retention, and reduce burnout, while likely improving patient care.

Us and them: Individual and group perceptions and attitudes about Reach Out and Read implementation in one pediatric clinic

The primary objective of this study was to explore clinic group culture surrounding Reach Out and Read (ROaR) at a pediatric clinic recognized as successful in ROaR implementation. In ROaR-participating clinics, pediatricians give books and information to families at well child visits to promote daily read aloud practices deemed necessary by many experts to build early literacy skills. The program is known to be most effective when implementing clinics demonstrate positive group culture, yet additional understanding of cultural elements is needed. To explore clinic group culture, we collaborated with a ROaR regional representative and a pediatrician leading high-quality ROaR implementation to create a semi-structured interview protocol regarding staff perceptions and feelings surrounding ROaR. Then we conducted the semi-structured interview with twelve non-physician staff members in the pediatrician’s clinic. A two-phase grounded theory analysis revealed an ingroup/outgroup relationship that created two distinct cultural groups related to ROaR. Participants described themselves as ingroup members and the patients receiving ROaR as outgroup members. The ingroup included community organizations, doctors, and study participants, working together to give books and information to parents and medical students, who made up the outgroup. Ingroup members assumed that outgroup members needed their services. Participants’ descriptions of literacy resources in their own family cultures were different from their descriptions of the needs they perceived of members of the outgroup. Descriptions of outgroup members’ literacy needs included multiple stereotypes that could serve to perpetuate, rather than ameliorate, existing literacy inequities. Empathy promotion within ROaR-implementing clinics is discussed as a potential strategy to increase equity.

ESports Events Trend: A Promising Opportunity for Tourism Offerings

eSports events are a groundbreaking phenomenon worldwide. For this reason, this study aims to recognize the potential of eSports as an alternative for tourism events diversification in the city of Guayaquil, Ecuador. Within the methodological framework of an exploratory-descriptive scope, it was proposed to analyze the conditions of eSports events and the tourist perception of them in the selected city. A survey was applied to 384 participants of eSports events (potential tourists), using video game rooms and player community networks throughout Latin America. The instrument used to collect data was a questionnaire available online for six months for further analysis. The principal findings in terms of quality performance of the event, perception of the event, destination image, and satisfaction revealed four vital indicators associated. Event staff, event atmosphere, hospitality, and good feelings about live attendance must be taken into consideration while designing a satisfactory experience to integrate into eSports into the city’s tourism offerings. Attendees also expressed their willingness to return to the city in the future. These results contribute to expanding the scientific literature on the evaluation and management of eSports events for other developing cities and countries.

A Qualitative Evaluation of the Barriers and Enablers for Implementation of an Asymptomatic SARS-CoV-2 Testing Service at the University of Nottingham: A Multi-Site Higher Education Setting in England.

Asymptomatic testing for SARS-CoV-2 RNA has been used to prevent and manage COVID-19 outbreaks in university settings, but few studies have explored their implementation. The aim of the study was to evaluate how an accredited asymptomatic SARS-CoV-2 testing service (ATS) was implemented at the University of Nottingham, a multi-campus university in England, to identify barriers and enablers of implementation and to draw out lessons for implementing pandemic response initiatives in higher education settings. A qualitative interview study was conducted with 25 ATS personnel between May and July 2022. Interviews were conducted online, audio-recorded, and transcribed. Participants were asked about their experience of the ATS, barriers and enablers of implementation. Transcripts were thematically analysed. There were four overarching themes: (1) social responsibility and innovation, (2) when, how and why people accessed testing, (3) impact of the ATS on the spread of COVID-19, and (4) lessons learned for the future. In establishing the service, the institution was seen to be valuing its community and socially responsible. The service was viewed to be broadly successful as a COVID-19 mitigation approach. Challenges to service implementation were the rapidly changing pandemic situation and government advice, delays in service accreditation and rollout to staff, ambivalence towards testing and isolating in the target population, and an inability to provide follow-up support for positive cases within the service. Facilitators included service visibility, reduction in organisational bureaucracy and red tape, inclusive leadership, collaborative working with regular feedback on service status, flexibility in service delivery approaches and simplicity of saliva testing. The ATS instilled a perception of early ‘return to normality’ and impacted positively on staff feelings of safety and wellbeing, with wider benefits for healthcare services and local communities. In conclusion, we identified common themes that have facilitated or hindered the implementation of a SARS-CoV-2 testing service at a university in England. Lessons learned from ATS implementation will inform future pandemic response interventions in higher education settings.

Managing the Mental Health of Healthcare Professionals in Times of Crisis: The Aruban COVID-19 Experience.

: PurposeHospital workers in Aruba have been facing an increased demand for healthcare in the unique setting of a Small Island Developing State (SIDS). This study assessed the impact of the first wave of the SARS-CoV-2 pandemic on the mental health of staff at the major hospital in Aruba, examining the differences between employee groups, with the goal of providing recommendations for targeted support and coping strategies in future crises in a small island setting. Patients and methods: In a mixed-method cohort design, Dr. Horacio E. Oduber Hospital staff were asked to complete a 25-item questionnaire about their concerns and worries, organization of work, and general wellbeing; 24% of the hospital staff filled in the questionnaire (mean age 41 ± 11 years, 79% female). Alongside the needs assessment questionnaire, six focus groups were established to explore staff feelings on specific measures taken by hospital management during the COVID-19 crisis. Results: Questionnaire analysis (n = 231) revealed employees’ concerns about infecting their relatives and their financial stability. In particular, nurses were significantly more concerned than other staff groups. In the wellbeing section of the questionnaire, items regarding future security scored poorest, alongside increased levels of tiredness and nervousness. Focus groups discussions revealed frustrations of the hospital staff with the foreign staff brought in to help during the crisis and a need for better leadership and communication practices from hospital management. Conclusions: Comprehensive and holistic approaches should be implemented by the hospital management to prevent occupational burnout and demoralized work ethics and further emotional exhaustion.

Predictive variables for feelings of sadness and depression while working remotely in Brazil during the COVID-19 pandemic.

Remote work was evidenced in the pandemic and studies in this area increased. Most studies focus on professionals of companies or professors/students in the academic environment. At the same time, non-academic staff, that provide all the support required for the core activities of the institutions (research/teaching/extension activities) have been neglected. This article aims to exploratory analyse which variables (interruptions when working remotely (1), health concerns (2) and fear of contracting coronavirus (3), anxiety and concern about professional career (4), frustration to have cancelled plans and missed opportunities (5) and gender (6)) can impact feelings of sadness and depression experienced by non-academic staff of a university working remotely. Using a database on behaviour and feelings of non-academic staff from a Brazilian university working remotely during the COVID-19 pandemic, a binary logistic regression model was structured. In an exploratory manner, six independent variables (presented in the previous item) were analysed in terms of their ability to predict the dependent variable (feelings of sadness and depression). The results presented the prediction power of the independent variables for the dependent variable. The variables regarding concern with their health, increased anxiety and concern about their career presented Odds Ratios of 3.6 (1.4-8.5 -95% C.I.) and 3.3 (2.2-5.0 -95% C.I.), respectively, standing out from the other variables. These results focus on staff at one institution, but they can contribute to better understand feelings and behaviours experienced by professionals working remotely and provide information for debates on the field of COVID-19-related changes of work.

A comparison of student and staff perceptions and feelings about assessment and feedback using cartoon annotation

ABSTRACT Evidence suggests that many higher education institutions have difficulty in managing student expectations around assessment and feedback, particularly on the clarity of criteria and the fairness of outcomes. Because of its importance students also have strong emotions linked to the process, as do those who teach them. This research sought to explore how students and staff think and feel about assessment and feedback and the implications for assessment literacy. It adopted an interpretive methodology, using qualitative data from focus group interviews combined with an innovative technique of using cartoon illustrations, which were annotated by participants. The results revealed the wide range of emotions associated with assessment and feedback amongst both students and staff. Most emotions were negative. Students feel uncertain about the tasks set. The data also revealed a lack of dialogue between students and staff, with staff often actively avoiding it for fear of conflict. An underlying issue seemed to be that students did not understand many of the backroom processes and roles related to assessment and feedback, partly because of obscure terminology such as ‘moderation’ and ‘unfair means’. This points to deficits in assessment literacy, but the extent of existing staff emotional labour suggests that a literacy lens is inadequate in itself and we should consider the role of wider structures in creating failures of dialogue. The innovative cartoon annotation method was successful in bringing out aspects of both the emotional and cognitive experience of assessment, including hidden assumptions.

Paediatric teams in front of childhood obesity: A qualitative study within the STOP project

IntroductionUnderstanding the underlying factors that influence the approach to overweight and obesity in children is basic to best support families searching a solution to this important public health problem. ObjectiveTo assess attitudes and feelings of paediatric staff in addressing overweight and childhood obesity to parents, exploring perceived barriers and facilitators, for an effective care. Participants and methodQualitative study by means of individual semi-structured questionnaires of paediatric staff (paediatricians and paediatrician nurses; n = 57; 68% female) of primary health care centres and hospitals in Mallorca. Thematic analysis was done. ResultsThree themes emerged from the data: “Parents’ attitude in childhood obesity” (sub-themes “The conscience of parents”, “The parents ask for help”), “Paediatric staff and childhood obesity” (sub-themes “Approaching to the problem: The interview with parents”, “Looking together for the solution”), and “System barriers” (sub-themes “Improving teamwork and health policy”, “Family participation in addressing childhood obesity”). ConclusionsPaediatric staffs know how to treat childhood obesity, but demand training on motivation. Effectivity on therapy of childhood obesity will be obtained after parents/carers recognize the problem and establish a trustful relationship with paediatric staff. The health system is still a barrier to the activity of paediatric personnel.

Healthcare worker's emotions, perceived stressors and coping mechanisms during the COVID-19 pandemic.

Increasing cases, insufficient amount of personal protection equipment, extremely demanding workloads, and lack of adequate therapies to save lives can contribute to a psychological burden directly related to working during disease outbreaks. Healthcare workers (HCWs) are at a high risk of contracting COVID-19 due to its ability to spread efficiently through asymptomatic and symptomatic individuals. There are limited studies assessing the pandemic's psychological impact on HCWs, specifically those in close proximity to hospitalized patients with COVID-19. Our study explored the emotions, perceived stressors, and coping strategies of front-line HCWs at high risk of exposure to COVID-19 during the first surge at our community-based teaching hospital, the epicenter of COVID-19 in Connecticut. A validated comprehensive questionnaire derived and modified from previous epidemics was used to inquire about staff feelings, factors that caused stress and factors that mitigated stress. Personal coping strategies and factors that can increase staff's motivation to work during future events of similar nature were also asked. Emotional reactions, coping mechanisms, and stressors varied by healthcare role, while some experiences and reactions were similar among groups. Willingness to participate in a second wave of the pandemic or future outbreaks is strongly driven by adequate personal protective equipment, financial recognition, and recognition from management, similarly reported in previous disease outbreaks. All groups felt a reduction in stress due to a sense of camaraderie and teamwork, as well as when sharing jokes or humor with colleagues. Our HCWs at high risk of exposure experienced significant emotional distress during the first wave of the COVID-19 pandemic. By understanding the needs and experiences of our HCWs at highest risk, we can improve our psychological support using targeted interventions during future waves of this pandemic or similar devastating events.

Comparison of Chief Surgeons' and Assistants' Feelings of Fatigue Between Laparoendoscopic Single-site and Conventional Laparoscopic Adrenalectomy.

Our objective was to compare the surgical staff's feelings of fatigue between laparoendoscopic single-site adrenalectomy (LESS-A) and conventional laparoscopic adrenalectomy (CLA) before and after surgery. Data were collected for surgical procedures performed between June 2011 and September 2017 (57 LESS-A and 37 CLA). Each procedure in both groups was performed by the same chief surgeon. The subjective fatigue feelings of the key members of the surgical team (chief surgeon, scopist, assistant surgeon) were assessed using the "Jikaku-sho shirabe" questionnaire, which contained questions about work-related feelings of fatigue. It consisted of 25 subjective items for 5 factors drawn from factor analysis (drowsiness, instability, uneasiness, local pain or dullness, and eyestrain). For each item, the participants were requested to estimate the intensity of their feelings using a five-point rating scale before and after surgery. There was no significant difference in operative time (p = 0.231) between the LESS-A and CLA procedure groups. For the chief surgeon, local pain or dullness (p = 0.603) and eyestrain (p = 0.086) were similar between the LESS-A and CLA procedures. The scopists and assistant surgeons in the LESS-A group did not suffer local pain or dullness (p = 0.793 and p = 0.240, respectively). They did, however, suffer more eyestrain than those in the CLA group (p = 0.001 and p = 0.001, respectively). Although LESS-A is generally considered to be a technically difficult procedure, the results of this study demonstrate that the feelings of physical fatigue are roughly equivalent between LESS-A and CLA procedures.

Application of dementia care mapping (DCM) for one year in a geriatric health services facility: Effects of developmental evaluation based on collaboration by medical and welfare staff aimed at person-centred care

This study aimed to clarify the effects of dementia care mapping (DCM) for one year in a healthcare center for older adults. DCM was conducted between September 2016 and August 2017. The care staff include nurses and caregivers in a narrow sense, medical staff, such as a physician, physical therapists, and occupational therapists worked on DCM as care staff in this study. There were 24 participants, with an average work experience of 7.21 (±4.74) years. In comparison to the baseline evaluation, the final assessment of self-efficacy through person-centred care showed significant improvement in 'Forecasting and Problem Solving on the Job' within 'Perceived Job Competence of Care Workers'. Six main categories of content were extracted from focus group interviews: 'Awareness,' 'Change of Elderly People under the Care of Staff throughout the Development of Mapping', 'Affirmative Feelings of Care Staff for Mapping', 'Negative Feelings for Mapping', 'Need for the Efficacy and Efficiency of the Mapping', and 'Mapping Based on the Age of the Participant and Future Prospects for Mapping'. The results of person-centred care showed that both the older patients and the staff noticed changes through the development of mapping. The developmental evaluation, based on collaboration by medical and welfare staff can improve self-efficacy through the practice of person-centred care and improves the ability to solve problems during the provision of care.

Los equipos de pediatría ante la obesidad infantil: un estudio cualitativo dentro del proyecto STOP

IntroductionUnderstanding the underlying factors that influence the approach to overweight and obesity in children is basic to best support families searching a solution to this important public health problem. ObjectiveTo assess attitudes and feelings of paediatric staff in addressing overweight and childhood obesity to parents, exploring perceived barriers and facilitators, for an effective care. Participants and methodQualitative study by means of individual semi-structured questionnaires of paediatric staff (paediatricians and paediatrician nurses; n=57; 68% female) of primary health care centres and hospitals in Mallorca. Thematic analysis was done. ResultsThree themes emerged from the data: «Parents’ attitude in childhood obesity» (sub-themes «The conscience of parents», «The parents ask for help»), «Paediatric staff and childhood obesity» (sub-themes «Approaching to the problem: The interview with parents», «Looking together for the solution»), and «System barriers» (sub-themes «Improving teamwork and health policy», «Family participation in addressing childhood obesity»). ConclusionsPaediatric staffs know how to treat childhood obesity, but demand training on motivation. Effectivity on therapy of childhood obesity will be obtained after parents/carers recognize the problem and establish a trustful relationship with paediatric staff. The health system is still a barrier to the activity of paediatric personnel.

Based on in-depth interviews to analyze the real experience of front-line medical staff facing the new coronavirus pneumonia epidemic

Objective: From the perspective of front-line medical staff, to understand the real experience and feelings of front-line medical staff in the face of the new coronavirus pneumonia epidemic. On the one hand, the physical and mental conditions of medical staff are directly related to the results of epidemic prevention, and we also need to pay attention to the health of medical staff. Psychological experience, so as to provide a basis for later psychological intervention, improvement of emergency plans, and public health management. Methods: This article adopts the semi-structured in-depth interview qualitative research method to conduct in-depth interviews with 12 clinical medical staff who are directly exposed to the epidemic in our province, record the interview content, and use the Colaizzi 7-step analysis method to analyze and summarize the interview data. class. Result: After reading the interview transcripts carefully and analyzing it line by line, a total of 3 themes were generated. Theme group 1: Perceptual experience; Theme group 2: Body experience; Theme group 3: Life experience; Conclusion: For medical staff in COVID-19 In the epidemic, there are psychological feelings such as anxiety, fear, frustration, and fear of being infected. There are also problems such as high work intensity, insufficient supplies, and lack of respect and understanding. The focus should be on perception and experience and self-reported by frontline medical staff. Outcome is the evaluation dimension, providing comprehensive psychological guidance and humanistic care for clinical front-line medical staff.

Big Data Technology in Museum Exhibition Digitization

Today, museums have become a very important part of people’s lives. In the exhibition of cultural relics, the level of display technology is directly related to the development and service quality of museums. With the development of science and technology, the exhibition activities of museums are gradually developing towards intelligence, networking and digitization. Big data technology plays an important role in the digital construction of museums and is widely used in museum business. This paper studies the digital museum which uses digital technology to display cultural relics and the application of big data technology in digital museum. In order to better understand the application of big data technology in museum exhibitions and its help, this paper carried out a survey in a digital exhibition museum with big data technology, counted the flow of people in the museum before and after the application of big data technology, and formulated a questionnaire to investigate the feelings of museum staff and visitors on the application. The results show that big data technology can effectively improve the effect of Museum digital exhibition.

Facilitators and Barriers of a Health Department-based Mailed Fecal Testing Program.

BACKGROUND Mailed at-home stool testing offers a promising strategy for overcoming barriers to colorectal cancer (CRC) screening in vulnerable populations. This paper evaluates the facilitators and barriers of successful implementation of a mailed fecal testing program among Medicaid populations within a health department setting.METHOD Interviews were conducted with key informants involved in intervention start-up and implementation tasks. The Consolidated Framework for Implementation Research (CFIR) was used to design the interview guide and structure the analysis. Axial coding was used to connect the themes to each other under the major categories of facilitators and barriers.RESULTS Overall, the process evaluation suggests that with strong partnerships, effective champions, and existing infrastructure, a large county health department can successfully implement a mailed fecal testing program targeted at Medicaid beneficiaries. The identified facilitators and challenges to implementation provide important information for similar emerging programs.LIMITATIONS The sample size of this evaluation is small. Additionally, we are unable to discern whether participating stakeholders' responses represent the feelings of non-interviewed staff, program implementers, or participants. We were not able to collect data on patient perspectives of the intervention. The nursing staff and interns were not able to be included in the process evaluation. Lastly, the information taken from this process evaluation may not be applicable to organizations and systems with different attributes.CONCLUSION The process evaluation suggests strong partnerships, effective champions, and elegant program designs were key contributors to successful implementation of a CRC screening program targeted at Medicaid beneficiaries in a large county health department.

Evaluation of Academic Staff Job Satisfaction at Malaysian Universities in the Context of Herzberg’s Motivation-Hygiene Theory

Most academic staff don’t know what exactly makes them satisfy or dissatisfy at university and based on which effective factors they can improve and increase the level of their outcomes. Dissatisfaction occurred amongst academic staff when they don’t receive any basic motivational factors, versa job satisfaction happened when they obtained at least the fundamental facilities and considered via workplace (managers, leaders, and supervisors). There are numerous and effective factors that change attitudes and feelings of academic staff toward the job, likewise, change level of their outcomes; furthermore, recognizing these effective factors that rise level of job satisfaction among these group of staff; similarly, analyzing this factor as one of the important organizational factors in the context of Herzberg’s Motivation-Hygiene Theory determined as main objective of this literature review. Overall, in this research endeavors to finding brilliant points and motivational factors that influence job satisfaction and clarifies them in an educational situation such as the university.

Direct care nurses and support staff thoughts and feelings about the reasons patients fall at a cancer center

Extensive research addresses the prevalence and high fall risk for cancer patients related to age, diagnosis, treatment side effects, pharmacological side effects, and cognitive and/or motor deficits. The purpose of the study was to explore the thoughts and feelings that inpatient and outpatient oncology direct care nurses (registered nurses) and support staffs have about reasons patients fall; as well as their thoughts on what might be done to prevent falls. This descriptive qualitative study used focus groups as the method for discovery. Six themes were identified: Effect on Me, Guilt, Noncompliance, Poor Choices, Inconsistency, and No Authority. This study is significant and relevant because there is little previous research addressing staff thoughts and feelings about why patients fall and what additional interventions they think can be implemented to prevent falls. Findings from this study may be helpful in developing and/or refining current fall policies. Existing research suggests unlicensed patient care providers often have minimal participation in postfall reviews. This study suggests they can provide insight into why patients fall. Additionally, both registered nurses and unlicensed providers describe barriers that often impede their ability to work as a team to prevent patient falls. Findings from this study identified the need for the patient care team to strengthen collaborative work to create safer patient environments.

The work of sterile processing departments: An exploratory study using qualitative interviews and a quantitative process database

The sterile processing of surgical instruments and equipment is an essential part of surgical operations. Although clean instruments prevent infections, little is known about the departments that conduct this work. We sought to describe sterile processing departments (SPDs) and to identify factors impacting them. We analyzed data from 22 qualitative interviews of staff and managers and a quantitative benchmarking database. Qualitative results indicated 4 primary factors impacting sterile processing work: (1) role and visibility, (2) relationships and communication with other departments and vendors, (3) staffing and management, and (4) technical problems and solutions. Quantitative analysis revealed significant differences in SPD responsibilities and scope. Relationships with operating room staff were of paramount importance in the ability of the SPD to accomplish its job and in staff motivations and feelings. Differences in management practices, communication strategies, and problem-solving resources were also emphasized. Both quantitative and qualitative data showed concern for the role of the SPD in patient safety, particularly concerning practices such as the use of immediate-use steam sterilization. To more completely address adverse patient events and surgical patient safety, we must move toward examining the entire surgical process, including the vital role of SPDs.