Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
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Effect of Patient Safety Training Program of Nurses in Operating Room

  • Zhang, Peijia (Department of Operating Room Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University) ;
  • Liao, Xin (Department of Operating Room Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University) ;
  • Luo, Jie (Department of Operating Room Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University)
  • Received : 2022.02.14
  • Accepted : 2022.08.11
  • Published : 2022.08.31
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Abstract

Purpose: This study developed an in-service training program for patient safety and aimed to evaluate the impact of the program on nurses in the operating room (OR). Methods: A pretest-posttest self-controlled survey was conducted on OR nurses from May 6 to June 14, 2020. An in-service training program for patient safety was developed on the basis of the knowledge-attitude-practice (KAP) theory through various teaching methods. The levels of safety attitude, cognition, and attitudes toward the adverse event reporting of nurses were compared to evaluate the effect of the program. Nurses who attended the training were surveyed one week before the training (pretest) and two weeks after the training (posttest). Results: A total of 84 nurses participated in the study. After the training, the scores of safety attitude, cognition, and attitudes toward adverse event reporting of nurses showed a significant increase relative to the scores before the training (p < .001). The effects of safety training on the total score and the dimensions of safety attitude, cognition, and attitudes toward nurses' adverse event reporting were above the moderate level. Conclusion: The proposed patient safety training program based on KAP theory improves the safety attitude of OR nurses. Further studies are required to develop an interprofessional patient safety training program. In addition to strength training, hospital managers need to focus on the aspects of workflow, management system, department culture, and other means to promote safety culture.

Keywords

Acknowledgement

This study was supported by the Xinya Fund of the West China Second University Hospital in KX140.

References

  1. World Health Organization (WHO). Global patient safety action plan 2021-2030: Towards eliminating avoidable harm in health care [Internet]. Geneva: WHO; 2021 [cited 2022 Jun 4]. Available from: https://apps.who.int/iris/handle/10665/343477.
  2. Rochefort CM, Buckeridge DL, Abrahamowicz M. Improving patient safety by optimizing the use of nursing human resources. Implementation Science. 2015;10:89. https://doi.org/10.1186/s13012-015-0278-1
  3. Nilsson L, Borgstedt-Risberg M, Soop M, Nylen U, Alenius C, Rutberg H. Incidence of adverse events in Sweden during 2013-2016: A cohort study describing the implementation of a national trigger tool. BMJ Open. 2018;8(3):e020833. https://doi.org/10.1136/bmjopen-2017-020833
  4. Slawomirski L, Klazinga N. The economics of patient safety: From analysis to action [Internet]. Paris: Organisation for Economic Cooperation and Development (OECD); 2020 [cited 2022 Jun 4]. Available from: https://www.oecd.org/health/health-systems/Economics-of-Patient-Safety-October-2020.pdf.
  5. Leong KBMSL, Hanskamp-Sebregts M, van der Wal RA, Wolff AP. Effects of perioperative briefing and debriefing on patient safety: A prospective intervention study. BMJ Open. 2017;7(12):e018367. https://doi.org/10.1136/bmjopen-2017-018367
  6. Kozusko SD, Elkwood L, Gaynor D, Chagares SA. An innovative approach to the surgical time out: A patient-focused model. AORN Journal. 2016;103(6):617-622. https://doi.org/10.1016/j.aorn.2016.04.001
  7. Nelson PE. Enhanced time out: An improved communication process. AORN Journal. 2017;105(6):564-570. https://doi.org/10.1016/j.aorn.2017.03.014
  8. Hempel S, Maggard-Gibbons M, Nguyen DK, Dawes AJ, Miake-Lye I, Beroes JM, et al. Wrong-site surgery, retained surgical items, and surgical fires: A systematic review of surgical never events. JAMA Surgery. 2015;150(8):796-805. https://doi.org/10.1001/jamasurg.2015.0301
  9. Kobiela J, Kobiela P. Emotional aspects of never events. JAMA Surgery. 2016;151(1):95. https://doi.org/10.1001/jamasurg.2015.3085
  10. Lozito M, Whiteman K, Swanson-Biearman B, Barkhymer M, Stephens K. Good Catch Campaign: Improving the perioperative culture of safety. AORN Journal. 2018;107(6):705-714. https://doi.org/10.1002/aorn.12148
  11. Bajpai S, Lindeman B. The trainee's role in patient safety: Training residents and medical students in surgical patient safety. The Surgical Clinics of North America. 2021;101(1):149-160. https://doi.org/10.1016/j.suc.2020.09.007
  12. Davies HT, Nutley SM, Mannion R. Organisational culture and quality of health care. Quality in Health Care. 2000;9(2):111-119. https://doi.org/10.1136/qhc.9.2.111
  13. Rajalatchumi A, Ravikumar TS, Muruganandham K, Thulasingam M, Selvaraj K, Reddy MM, et al. Perception of patient safety culture among health-care providers in a tertiary care hospital, South India. Journal of Natural Science, Biology, and Medicine. 2018;9(1):14-18. https://doi.org/10.4103/jnsbm.JNSBM_86_17
  14. Russ S, Rout S, Sevdalis N, Moorthy K, Darzi A, Vincent C. Do safety checklists improve teamwork and communication in the operating room? A systematic review. Annals of Surgery. 2013;258(6):856-871. https://doi.org/10.1097/SLA.0000000000000206
  15. Birkmeyer NJ, Finks JF, Greenberg CK, McVeigh A, English WJ, Carlin A, et al. Safety culture and complications after bariatric surgery. Annals of Surgery. 2013;257(2):260-265. https://doi.org/10.1097/SLA.0b013e31826c0085
  16. Rocha RC, Abreu IM, Carvalho REFL, Rocha SSD, Madeira MZA, Avelino FVSD. Patient safety culture in surgical centers: Nursing perspectives. Revista da Escola de Enfermagem da USP. 2021;55:e03774. https://doi.org/10.1590/S1980-220X2020034003774
  17. Pimentel MPT, Choi S, Fiumara K, Kachalia A, Urman RD. Safety culture in the operating room: Variability among perioperative healthcare workers. Journal of Patient Safety. 2021;17(6):412-416. https://doi.org/10.1097/PTS.0000000000000385
  18. Yu A, Flott K, Chainani N, Fontana G, Darzi A. Patient safety 2030 [Internet]. London: NIHR Imperial Patient Safety Translational Research Centre; 2016 [cited 2022 Jun 4]. Available from: https://www.imperial.ac.uk/media/imperial-college/institute-of-global-health-innovation/centre-for-health-policy/Patient-Safety-2030-Report-VFinal.pdf.
  19. Johnstone MJ, Kanitsaki O. Clinical risk management and patient safety education for nurses: A critique. Nurse Education Today. 2007;27(3):185-191. https://doi.org/10.1016/j.nedt.2006.04.011
  20. Ranjbar H, Emami Zeydi A. Patient safety: An important yet neglected issue in nursing education. Journal of Patient Safety. 2018;14(3):e35. https://doi.org/10.1097/PTS.0000000000000231 Erratum in: Journal of Patient Safety. 2018;14(4):246.
  21. Ameryoun A, Pakpour AH, Nikoobakht M, Saffari M, Yaseri M, O'Garo KN, et al. Effectiveness of an in-service education program to improve patient safety directed at surgical residents: A randomized controlled trial. Journal of Surgical Education. 2019;76(5):1309-1318. https://doi.org/10.1016/j.jsurg.2019.03.002
  22. Habahbeh AA, Alkhalaileh MA. Effect of an educational programme on the attitudes towards patient safety of operation room nurses. British Journal of Nursing. 2020;29(4):222-228. https://doi.org/10.12968/bjon.2020.29.4.222
  23. Lopez-Jeng C, Eberth SD. Improving hospital safety culture for falls prevention through interdisciplinary health education. Health Promotion Practice. 2020;21(6):918-925. https://doi.org/10.1177/1524839919840337
  24. Islami Vaghar M. The impact of an educational program on blood and blood products transfusion on nurses' level of knowledge and performance. Journal of Medicine and Life. 2018;11(3):238-242. https://doi.org/10.25122/jml-2018-0016
  25. Cleary A, Dowling M. Knowledge and attitudes of mental health professionals in Ireland to the concept of recovery in mental health: A questionnaire survey. Journal of Psychiatric and Mental Health Nursing. 2009;16(6):539-545. https://doi.org/10.1111/j.1365-2850.2009.01411.x
  26. Saraswathy T, Nalliah S, Rosliza AM, Ramasamy S, Jalina K, Shahar HK, et al. Applying interprofessional simulation to improve knowledge, attitude and practice in hospital-acquired infection control among health professionals. BMC Medical Education. 2021;21(1):482. https://doi.org/10.1186/s12909-021-02907-1
  27. Ahmadi M, Bagheri-Saweh MI, Nouri B, Mohamadamini O, Valiee S. Effect of interventional educational programs on intensive care nurses' perception, knowledge, attitude, and practice about physical restraints: A pre-/postclinical trial. Critical Care Nursing Quarterly. 2019;42(1):106-116. https://doi.org/10.1097/CNQ.0000000000000244
  28. Huang HT, Chuang YH, Chiang KF. Nurses' physical restraint knowledge, attitudes, and practices: The effectiveness of an in-service education program. The Journal of Nursing Research. 2009;17(4):241-248. https://doi.org/10.1097/JNR.0b013e3181c1215d
  29. Brunoni AR, Valiengo L, Baccaro A, Zanao TA, de Oliveira JF, Goulart A, et al. The sertraline vs. electrical current therapy for treating depression clinical study: Results from a factorial, randomized, controlled trial. JAMA Psychiatry. 2013;70(4):383-391. https://doi.org/10.1001/2013.jamapsychiatry.32
  30. Kwak YB, Kim JY. Development and evaluation of an integrated health management program for psychiatric patients with metabolic syndrome. Journal of Korean Academy of Nursing. 2022;52(3):261-277. https://doi.org/10.4040/jkan.21222
  31. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 2009;41(4):1149-1160. https://doi.org/10.3758/BRM.41.4.1149
  32. Liao X, Zhang P, Xu X, Zheng D, Wang J, Li Y, et al. Analysis of factors influencing safety attitudes of operating room nurses and their cognition and attitudes toward adverse event reporting. Journal of Healthcare Engineering. 2022;2022:8315511. https://doi.org/10.1155/2022/8315511
  33. Association of periOperative Registered Nurses (AORN). Guidelines for perioperative practice [Internet]. Denver: AORN; 2021 [cited 2022 Jun 4]. Available from: https://www.aorn.org/guidelines/about-aorn-guidelines
  34. World Health Organization (WHO). WHO guidelines for safe surgery 2009: Safe surgery saves lives [Internet]. Geneva: WHO; 2009 [cited 2022 Jun 4]. Available from: http://apps.who.int/iris/bitstream/handle/10665/44185/9789241598552_eng.pdf?sequence=1.
  35. Amiri M, Khademian Z, Nikandish R. The effect of nurse empowerment educational program on patient safety culture: A randomized controlled trial. BMC Medical Education. 2018;18(1):158. https://doi.org/10.1186/s12909-018-1255-6
  36. Guo X. [A preliminary study on the revised Chinese safety attitude questionnaire] [master's thesis]. Taiyuan: Shanxi Medical University; 2009. p. 1-63. Chinese.
  37. Modak I, Sexton JB, Lux TR, Helmreich RL, Thomas EJ. Measuring safety culture in the ambulatory setting: The safety attitudes questionnaire--ambulatory version. Journal of General Internal Medicine. 2007;22(1):1-5. https://doi.org/10.1007/s11606-007-0114-7
  38. Lian M. [Investigation and analysis of nurses' cognition and attitude towards adverse event report] [dissertation]. Nanjing: Nanjing University of Traditional Chinese Medicine; 2012. p. 1-60. Chinese.
  39. Wilson B, Bekker HL, Fylan F. Reporting of Clinical Adverse Events Scale: A measure of doctor and nurse attitudes to adverse event reporting. Quality & Safety in Health Care. 2008;17(5):364-367. https://doi.org/10.1136/qshc.2006.021691
  40. Carney BT, West P, Neily J, Mills PD, Bagian JP. Changing perceptions of safety climate in the operating room with the Veterans Health Administration medical team training program. American Journal of Medical Quality. 2011;26(3):181-184. https://doi.org/10.1177/1062860610380733
  41. Biglan A, Embry DD. A framework for intentional cultural change. Journal of Contextual Behavioral Science. 2013;2(3-4):10.1016/j.jcbs.2013.06.001. https://doi.org/10.1016/j.jcbs.2013.06.001
  42. Forte EC, Pires DE, Padilha MI, Martins MM. Nursing errors: A study of the current literature. Texto & Contexto - Enfermagem. 2017;26(2):e01400016. https://doi.org/10.1590/0104-07072017001400016
  43. Kwon E, Kim YW, Kim SW, Jeon S, Lee E, Kang HY, et al. A comparative study on patient safety attitude between nurses and doctors in operating rooms. The Journal of International Medical Research. 2020;48(4):300060519884501. https://doi.org/10.1177/0300060519884501
  44. Park YM, Kim SY. Impacts of job stress and cognitive failure on patient safety incidents among hospital nurses. Safety and Health at Work. 2013;4(4):210-215. https://doi.org/10.1016/j.shaw.2013.10.003
  45. Han Y, Kong Y, Yang S. [Analysis on the status and factors of patient's safety attitude of surgical nurses]. Nursing Journal of Chinese People's Liberation Army. 2017;34(4):1-5. Chinese. https://doi.org/10.3969/j.issn.1008-9993.2017.04.001
  46. Piscitelli A, Bevilacqua L, Labella B, Parravicini E, Auxilia F. A keyword approach to identify adverse events within narrative documents from 4 Italian institutions. Journal of Patient Safety. 2022;18(1):e362-e367. https://doi.org/10.1097/PTS.0000000000000783
  47. Kohn LT, Corrigan JM, Donaldson MS, editors. To err is human: Building a safer health system. Washington, D.C.: National Academy Press (US); 2000. p. 245-246.
  48. Bohnen JD, Mavros MN, Ramly EP, Chang Y, Yeh DD, Lee J, et al. Intraoperative adverse events in abdominal surgery: What Happens in the operating room does not stay in the operating room. Annals of Surgery. 2017;265(6):1119-1125. https://doi.org/10.1097/SLA.0000000000001906
  49. Throckmorton T, Etchegaray J. Factors affecting incident reporting by registered nurses: The relationship of perceptions of the environment for reporting errors, knowledge of the nursing practice act, and demographics on intent to report errors. Journal of Perianesthesia Nursing. 2007;22(6):400-412. https://doi.org/10.1016/j.jopan.2007.09.006
  50. Santiago TH, Turrini RN. Organizational culture and climate for patient safety in Intensive Care Units. Revista da Escola de Enfermagem da USP. 2015;49 Spec No:123-130. https://doi.org/10.1590/S0080-623420150000700018