Patient safety culture in the operating room: a cross-sectional study using the Hospital Survey on Patient Safety Culture (HSOPSC) Instrument

Abstract

Background Credible evidence has established a link between the level of patient safety culture in healthcare environments and patient outcomes. Patient safety culture in the operating room has received scant attention despite the burden of adverse events among surgical patients. We aimed to evaluate the safety culture in our operating rooms and compare with existing data from other operating room settings. Methods We investigated the patient safety culture in the operating rooms of our hospital as perceived by the surgeons, nurse anaesthetists and perioperative nurses using the Hospital Survey on Patient Safety Culture (HSOPSC) instrument. IBM Statistical Package for Social Science software, version 25, was used for data entry and analysis. Differences were considered significant when p < 0.05. Results Only 122 completed surveys were returned out of a survey population of 132 frontline staff, yielding a response rate of 92.4%. The overall average composite score was 47%. The average composite scores ranged from 17–79.6% across the 12 dimensions of the HSOPSC, with teamwork within units being the only dimension with demonstrable strength. Non-punitive response to error, communication openness, feedback and communication about error”, frequency of events reported”, handoffs and transition and staffing need improvement. The perceived safety culture varied according to work areas and professional roles with nurse anaesthetists having the highest perception and the surgeons the least. Conclusion Patient safety culture in our operating rooms is adjudged to be weak, with only one of the twelve dimensions of HSOPSC demonstrating strength. This is notwithstanding its comparative strengths relative to other operating room settings.

Patient and Operational Factors Do Not Substantively Affect the Annual Departmental Quality of Anesthesiologists’ Clinical Supervision and Nurse Anesthetists’ Work Habits

“…These earlier study results [4,50,51] are consistent with the finding that time and hospital are important but not patient-related factors. The consistency shows the importance of our current article because, unlike these earlier studies [4,50,51], our sample size of tens of thousands was sufficient to test reliably the validity of the assumption.…”

“…Themes of importance included who performed the evaluations (i.e., analogous to raters being anesthesiologists or trainees) and the hospital type, but not the characteristics of the patients receiving the care [ 50 ]. Similarly, Nwosu et al measured safety climate in operating rooms [ 51 ]. Principal factors were who performed the evaluations and the hospital [ 51 ].…”

“…Similarly, Nwosu et al measured safety climate in operating rooms [ 51 ]. Principal factors were who performed the evaluations and the hospital [ 51 ]. Gillespie et al examined the non-technical skills of surgical teams before and after hospital relocation and a substantial increase in workload [ 4 ].…”

Awareness of the culture of patient safety among medical staff in neurosurgery departments from Moldova

“…According to AHRQ the Highest Scoring Composite Measures "Teamwork" where 82% of respondents "strongly agreed" or "agreed" that "staff work together as an effective team, help each other during busy times, and are respectful" [18]. Nwosu et al ( 2022) described in their study on patient safety culture in operating room that the "teamwork within units" had the highest average percentage positive score and was the only area of demonstrable strength (composite score ˃75%), with a score of 79.6% [19].…”

Determinants of Patient Safety Culture: The Role of Safety Leadership Interactions

“…Based on information obtained from the head of the hospital quality department in January 2023, several unexpected incidents occurred, namely 6 cases of bracelets not being installed. patient identity, 12 cases of postponement of surgery and 15 cases of not marking the operating side in 2022, and unexpected events in the operating room are forms of weak discipline of health workers towards the patient safety culture system (Nwosu et al, 2022). Not having an identity bracelet on will result in surgical procedures that are not in accordance with the patient's medical data and records, and this reflects an ineffective interprofessional collaboration system and leads to patient safety incidents (Arad et al, 2022), Marking the surgical site is the most important part before carrying out surgical procedures, if this is not done, it reflects the non-compliance of the doctor responsible for implementing the surgical safety checklist which impacts the risk of patient injury (Hou et al, 2021), Delays in operating times cause patients to experience psychological disorders and delays in medical treatment, and this shows a weak supervisory system from the leadership (Maine et al, 2019).…”