Disruptive behavior in the operating room

Villafranca, Alexander; Fast, Ian; Jacobsohn, Eric

doi:10.1097/aco.0000000000000592

Cited by 31 publications

(19 citation statements)

References 52 publications

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“…Pertaining to reporting culture of DBs by radiographers, our ndings are also similar to those found in literature, notwithstanding in other healthcare professions, which indicate that these behaviours go unreported for various reasons (7-9). Villafranca et al (34), in their study, reveal that DBs were underreported by 96.5% of their respondents, and never reported by 30.9% of respondents. Some health workers accept DBs, especially nonphysical, as part of the job (35)(36)(37).…”

Section: Discussionmentioning

confidence: 79%

Factors Leading to Disruptive Behaviours Involving Radiographers: A Qualitative Study

Chinene

Nkosi

Sibiya

2022

Preprint

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Background The negative consequences of disruptive behaviours involving healthcare workers threatens the institution’s image, staff morale, finances, and patient safety. While all kinds of health organisations or settings are potentially exposed to disruptive behaviours, some are at higher risk than others because of both environmental and cultural factors. Such risk should be assessed having regard to the specific situation and conditions in which each healthcare organization operates. International regulatory best-practice standards now require healthcare institutions to develop policies and plans at specific workplaces to combat DBs and establish the required monitoring mechanisms and a range of sanctions. The purpose of this study was to explore the environmental and cultural factors leading to DBs involving radiographers at central hospitals in Harare Metropolitan Province so that tailor-made strategies for addressing these behaviours can be formulated. Methods An exploratory qualitative study employing face to face, one-on-one in-depth interviews was carried out between March and April 2021. Eleven radiography managers at central hospitals in Harare Metropolitan Province (HMP) were selected by criterion purposive sampling. The interview data were analysed using Tesch's method of qualitative analysis. The data was first manually coded and then entered into Nvivo (QSR International Version 11) for further analysis. This study was assessed using the four criteria for developing the trustworthiness of qualitative research as suggested by Lincoln and Guba, namely credibility, dependability, conformability and transferability. Results The key environmental and cultural factors identified included three themes: power hierarchy, work environment and reporting framework. Power hierarchy comprised categories, superiority, professional boundaries and representation. The work environment incorporated categories, trust in leadership, burnout and fatigue and remuneration. Lastly, reporting framework included categories, lack of protocol and reporting culture. Conclusions This study highlights that environmental factors play a bigger role in provoking disruptive behaviours involving radiographers at central hospitals in HMP. This underscores the need for hospital and radiography managers to pay particular emphasis on these when formulating policies and procedures to address these behaviours. Addressing DBs ensures that healthy work environments are promoted which in turn ensures that patients receive optimum and safe care.

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Section: Discussionmentioning

confidence: 79%

Factors Leading to Disruptive Behaviours Involving Radiographers: A Qualitative Study

Chinene

Nkosi

Sibiya

2022

Preprint

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“…Unfortunately, tolerance of such behavior is not without consequence and cost to those on the receiving end. Therefore, it is important for the organization to have a comprehensive, fair, and consistent process for prevention, remediation, and accountability for psychologically unsafe behaviors 12,29,30 . The pillars of such a program are as follows.…”

Section: Ensuring a Health Care Environment Of Psychological Safetymentioning

confidence: 99%

Patient Safety/Quality Improvement Primer, Part IV: Psychological Safety—Drivers to Outcomes and Well‐being

Jamal

Young

Shapiro³

et al. 2022

Otolaryngol.--head neck surg.

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Psychological safety is the concept that an individual feels comfortable asking questions, voicing ideas or concerns, and taking risks without undue fear of humiliation or criticism. In health care, psychological safety is associated with improved patient safety outcomes, increased clinician engagement, and greater creativity. A culture of psychological safety is imperative for physician well-being and satisfaction, which in turn directly affect delivery of care. For health care professionals, psychological safety creates an environment conducive to trust and openness, enabling the team to focus on high-quality care. In contrast, unprofessional behavior reduces psychological safety and threatens the culture of the organization. This patient safety/quality improvement primer considers the barriers and facilitators to psychological safety in health care; outlines principles for creating a psychologically safe environment; and presents strategies for managing conflict, microaggressions, and lapses in professionalism. Individuals and organizations share the responsibility of promoting psychological safety through proactive policies, conflict management, interventions for microaggressions, and cultivation of emotional intelligence.

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“…En stor del av forskningen som omhandler kirurgisk telling beskriver hvilke redskap som gjenglemmes i pasientens kropp og ved hvilke type operasjoner faren for dette er størst (5,8,19). Ifølge studier av pasientsikkerhet har sykehusets arbeidskultur betydning for resultater etter kirurgi (26)(27)(28). Støy og forstyrrelser på operasjonsstuen, samarbeidsutfordringer og menneskelige faktorer kan også forårsake at kirurgiske redskaper blir gjenglemt (8).…”

Section: Forskningsoversiktunclassified

Kirurgisk telling som verktøy for sikker pasientbehandling ved kirurgi: En kvalitativ studie av operasjonssykepleieres erfaringer

Oksavik

Heen

Heggdal

2021

inspira

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Bakgrunn: Forskning viser at gjenglemte fremmedlegemer i pasienters kropp etter kirurgi er et betydelig problem som forårsaker pasientskader, menneskelige lidelser og i enkelte tilfeller død. Operasjonssykepleiere har et viktig ansvar for å gjennomføre korrekt kirurgisk telling og forebygge uønskede hendelser. Hensikt: Hensikten med denne studien var å få innsikt i hvordan operasjonssykepleiere praktiserer kirurgisk telling, deres erfaringer med prosedyren og hvordan de reflekterer rundt pasientsikkerhet. Metode: En kvalitativ tilnærming ble valgt for denne studien. Feltobservasjoner av 12 kirurgiske team, etterfulgt av intervju med sterilt utøvende operasjonsstuesykepleiere ble gjennomført ved 3 sykehus i Norge i 2017. Datamaterialet ble analysert i tråd med prinsipper for innholdsanalyse. Resultater: Resultatene ble oppsummert i tre hovedtemaer: «Variasjon i gjennomføring av prosedyren », «Sansende tilstedeværelse og situasjonsforståelse» og «Respektløs holdning og nestenuhellene ». Analysen viser at det er variasjon i gjennomføring av prosedyren, og usikkerhet når det gjelder eksistens og bruk av retningslinjer. Samtidig var operasjonssykepleierne sansende til stede og tilpasset sin praksis i tråd med egen situasjonsforståelse. De gav eksempler på respektløs holdning fra andre teammedlemmer angående tellingsprosedyren og beskriver at nesten-uhell forekommer. Funnene er motsetningsfulle. Operasjonssykepleierne gir uttrykk for usikkerhet når det gjelder utførelse av prosedyren, og observasjonene viste stor variasjon. Instrumenter kom på avveie ved 2 av de 12 observerte operasjonene. Konklusjon: Studien gir grunnlag for å forsterke utdanning av operasjonssykepleiere i tråd med anbefalte retningslinjer for kirurgisk telling. Videre å veilede operasjonssykepleiere til å være tydelige når det gjelder praktisering av tellingsprosedyren, og tørre å varsle om hendelser som kan true pasientsikkerheten.

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Disruptive behavior in the operating room

Abstract: Disruptive intraoperative behavior is prevalent and harms multiple parties in the operating room. Institutions require comprehensive measures to prevent the behavior and to mitigate consequences.

Cited by 31 publications

References 52 publications

Factors Leading to Disruptive Behaviours Involving Radiographers: A Qualitative Study

Factors Leading to Disruptive Behaviours Involving Radiographers: A Qualitative Study

Patient Safety/Quality Improvement Primer, Part IV: Psychological Safety—Drivers to Outcomes and Well‐being

Kirurgisk telling som verktøy for sikker pasientbehandling ved kirurgi: En kvalitativ studie av operasjonssykepleieres erfaringer

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