Tag Archives: #ODP

Operating Room, Patient Safety

Communication in the OR

Leave a comment

The operating room is a culturally diverse background with various levels of multidisciplinary professionals working collaboratively to deliver optimized care.

 

 

A study by the British Journal of Anaesthesia, identifies;

 

 

 

  • Failures in peri-operative communication contributed to patient injury in 43% of 910 anaesthesia malpractice claims

 

 

  • The most common root cause of communication failure was insufficient or inaccurate information, occurring in 30% of procedures

 

 

As part of a team that assessed RCA’s and near misses, communication was highlighted as a contributing factor in a majority of cases. Nurses stated they did not feel heard and confident, especially as a novice.

 

 

Surgeons may also feel unsupported by staff they are unfamiliar with or who are unfamiliar with the flow of surgery.

 

 

We need to empower all operating room professionals to work collaboratively, but we also need to empower and provide knowledge and support to our clinicians, in order to support, and deliver enhanced patient care.

 

 

The annual cost of medical errors likely exceeds $17 billion, with 35% being surgery related

 

 

 

A recent publication, Towards the Future of Surgery, 2024 has highlighted the need for surgeons to further develop their soft skills.

 

 

This is something we should all consider. Here’s a little insight.

 

 

 

“It is clear how patient outcomes are becoming less and less dependent on technical skills (however, this is always essential) and increasingly dependent on non-technical skills. Surgeons have the potential to improve patient outcomes, reduce medical errors, and improve patient satisfaction through their leadership on the multidisciplinary team.”

 

 

“Leadership in surgery entails many non-technical skills, including professionalism, technical competence, motivation, innovation, teamwork, communication skills, decision making, business acumen, ethics, emotional competence, resilience and effective teaching.”

 

 

“Surgeons have the potential to improve patient outcomes, reduce medical errors, and improve patient satisfaction through their leadership on the multidisciplinary team.”

 

 

 

I believe we all have the ability to improve patient outcomes.

 

 

Our use of checklists, such as the Surgical Safety Checklist has reduced errors by 30%.

 

 

Research shows we can improve patient outcomes by developing a team culture by easily identifying surgical team members, via scrub or cap identification.

 

 

Team huddle has also improved team collaboration and work flow.

 

 

Effective communication aims to streamline practices and utilizing resources to share information is key when stakes and patient lives are at risk.

 

 

 

Lets all aim to improve communication, empower clinicians and share our clinical expertise.

 

 

 

 

 

 

ttps://www.bjanaesthesia.org.uk/article/S0007-0912(21)00349-4/fulltext

 

 

Towards the Future of Surgery, 2024

 

https://link.springer.com/book/10.1007/978-3-031-47623-5

Operating Room, Patient Safety

Situational Awareness in the OR

Leave a comment

The OR is an environment where the room for error in minimal, time is critical and perfection is expected 100% of the time.

 

 

Situational Awareness that can have a significant impact on the flow of surgery, time & costs.

 

 

Situational awareness encompasses the ability to observe, listen, absorb and act swiftly. 

 

 

A change in the environment can be sudden and simultaneous. Eg, a surgeon may have an uncontrolled bleeding vessel, whilst the anaesthetist is having problems securing a dislodged airway.

 

 

Distractions are the costly, which is why 100% attention should be focused on the patient and care delivery.

 

 

Each OR nurse/tech/ODP, should be aware of the environment in order to work as a team, prioritise and support the care required, in order to stabilise a situation.

 

 

Demonstrating situational awareness is critical to patient safety and team cohesiveness.

 

 

Recognising a change in the environment, and troubleshooting or prioritising a task prior to verbal direction can save time. An instrument nurse/tech/ODP may only need to move their eyes, in a certain direction, in order to communicate a task, to the circulator.

 

A circulator may use verbal and non-verbal communication to the instrument nurse/tech/ODP if there is an observation that is of concern, such as low irrigation fluids, especially if the surgeon has a bleeding vessel.

 

 

 

 

Timing is key and costly.

 

 

 

 

If the need to obtain a bag of fluids is required by the circulator, it is important they obtain direction by the instrument nurse/tech/ODP, as they may prefer the circulator to stay in the OR, due to the case going ‘open’, thus, requiring additional instrumentation & equipment.

 

Situational awareness requires assertiveness, listening to cues and observing minute changes, by all team members.

 

 

 

It can take years to develop & evolve these astute, efficient & life saving skills. 

 

 

 

 

Many senior OR staff have developed these astute skills over the years. Which is why experience and expertise should never be under valued or under estimated.

 

 

 

What does one minute of operating room time cost your organisation?

 

 

Patient Safety, Policies, Technology

Implications of Equipment Failure During Surgery

Leave a comment

Research states that, ‘Implications of equipment failure during surgery’, occurred in 92% of surgical cases.

According to research,’equipment failures occurred in 76.9% of surgical cases. Equipment availability was impacted by 37.3% of surgical cases.

Unfortunately this is not surprising to those in the industry. I have witnessed first hand the lack of operating room checks, due to, time poor staff, who are already overloaded with paperwork and surgical setups.

When I first started working in the operating room as an instrument and circulating nurse, one of the first things I was taught, was to check the OR environment. This involved turning wall switches on and off, increasing/decreasing hardware settings.

Fast forward twenty plus years and there is more equipment to check, that is more technical and complex.

Staff are not given time to check equipment and the environment, which leads to intra-operative delays, stress and tension. Surgical time is impacted, patient safety is impacted, the waitlist is impacted and costs increase.

I hope that as we engage in more specialised practices that time is spent on checking the surgical environment and hard ware prior to the start of a surgical case load, or that specialised technical support is available to take the load off our already time poor health care professionals.

If you are a facility that provides your staff with additional time to setup and check equipment or has a technical support person. I would love to hear from you.

Contact Us

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9685966/

 

https://qualitysafety.bmj.com/content/22/9/710

 

 

Patient Safety, Scrub

Communication in the OR & Valuing Senior OR Staff

Leave a comment

The operating room is an environment where the room for error is minimal and time is always critical.
Surgery is becoming more complex, technical & challenging, which is why, communication & experience should be valued, especially when it comes to operating room professionals.

Effective verbal, observation & listening skills are qualities all surgical team members must demonstrate. Rothrock (2011) states that, “ improved communication is imbedded in human factors, culture, and social systems, all of which are more complex than checklists, mnemonics, and acronyms”.

A senior and experienced OR nurse, ST or ODP is able to recognise a change in the environment, they are able to ‘read the room’ & assess where attention should be focused.

They are able to ask concise questions at pivotal moments.

Example, does the laparoscopic or robotic case need to be ‘opened’? If so what trays & equipment do I require? Is there a bleeding vessel, are more fluids required for irrigation, are additional clips, ties, endoloops required?

Senior staff are able to think ahead because of their experience and surgical exposure especially if they are skilled across multiple surgical specialties.

Time can be critical during these intense moments and cohesive teamwork is vital in reducing surgical time. Surgical errors and complications arise when there is tension.

Time and experience matter, and there is usually a higher cost for these skilled clinicians, is the money worth it? Yes indeed!

Experienced OR staff  bring a wealth of experience, they have trouble shooting skills & clinical knowledge, they are able to think quickly and prioritize the needs of the surgical team.

Surgical time can have a direct impact on a patient, leading to longer post-op recovery which can impact on reduced bed availability and increased hospital costs.

Thank you to all the senior operating room professionals who have a wealth of skills and experience. Never forget how valuable you are.