可视化绘制手术室团队动态和交流图,促进反思反馈和手术实践优化

S. Surendran, C. Bonaconsa, V. Nampoothiri, O. Mbamalu, Anu George, Swetha Mallick, Sudheer Ov, Alison Holmes, M. Mendelson, Sanjeev Singh, Gabriel Birgand, E. Charani
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引用次数: 0

摘要

有效的手术室(OT)沟通和团队合作对于取得最佳手术效果至关重要。我们采用可视化方法绘制了手术室团队动态和感染控制实践图,以指导反思反馈和优化围手术期实践。 我们通过观察、社会图(沟通图绘制工具)和焦点小组讨论(FGDs)从印度一家三级医院的成人胃肠道手术团队收集数据。我们的方法旨在绘制团队沟通图、感染相关实践中的角色和责任以及开门情况。对定性数据进行了专题分析。定量数据采用描述性统计进行分析。 数据来自 10 个手术过程(超过 51 个小时),使用了 16 张社会图、15 张交通流图和 3 次 FGD。资深外科医生直接影响着团队的等级、动态和沟通。在手术过程中,外科医生、麻醉住院医师和技师领导着大部分任务,而擦洗护士则充当着协调角色扮演者之间跨层级活动的中间人。如果不能向擦洗护士提供手术计划的完整细节,就会导致多次开门取设备和一次性用品。在 15 分钟间隔内观察到的人流量相当于平均每小时开门 56 次(最少:16 次;最多:108 次),这对感染控制产生了影响。世界卫生组织手术安全清单的执行情况在各路径中并不一致,与报告的合规数据也不相符。 人为因素研究对于优化外科团队合作非常重要。使用可视化方法为围术期团队的沟通模式和行为提供反馈,为根据具体情况加强感染预防和控制实践提供了机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Visual Mapping of Operating Theater Team Dynamics and Communication for Reflexive Feedback and Surgical Practice Optimization
Effective operating theater (OT) communication and teamwork are essential to optimal surgical outcomes. We mapped the OT team dynamics and infection control practices using visual methods to guide reflexive feedback and optimize perioperative practices. Data were gathered from adult gastrointestinal surgical teams at a tertiary hospital in India using observations, sociograms (communication mapping tool), and focus group discussions (FGDs). Our methods aimed to map team communication, roles and responsibilities in infection-related practices, and door openings. Qualitative data were thematically analyzed. Quantitative data were analyzed using descriptive statistics. Data were gathered from 10 surgical procedures (over 51 hours) using 16 sociograms, 15 traffic flow maps, and 3 FGDs. Senior surgeons directly influence team hierarchies, dynamics, and communication. While the surgeons, anesthetic residents, and technicians lead most tasks during procedures, the scrub nurse acts as a mediator coordinating activity among role players across hierarchies. Failing to provide the scrub nurse with complete details of the planned surgery leads to multiple door openings to fetch equipment and disposables. Traffic flow observed in 15-minute intervals corresponds to a mean frequency of 56 door openings per hour (min: 16; max: 108), with implications for infection control. Implementing the World Health Organization surgical safety checklist was inconsistent across pathways and does not match reported compliance data. Human factors research is important in optimizing surgical teamwork. Using visual methods to provide feedback to perioperative teams on their communication patterns and behaviors, provided an opportunity for contextualized enhancement of infection prevention and control practices.
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