What are surgical team members' attitudes towards the safety culture in the operating theatre and the WHO surgical safety checklist?

Background: Safety culture is the mutual values, attitudes, perceptions, and patterns of behaviour within a group with the aim of minimising patient harm (Profit et al. 2012). The literature search identified the following... [ view full abstract ]

Background: Safety culture is the mutual values, attitudes, perceptions, and patterns of behaviour within a group with the aim of minimising patient harm (Profit et al. 2012). The literature search identified the following themes: 1) communication and teamwork, 2) safety climate v’s safety culture and 3) patient safety and checklists. Multiple studies worldwide identified the effect of the WHO surgical safety checklist since its introduction in 2008. Little research was found on the measurement of attitudes towards safety culture and towards the WHO Surgical Safety Checklist in Ireland.

Aim: To examine anaesthetists, surgeons and nurses attitudes towards the safety culture and the WHO Surgical Safety Checklist within Irish operating theatres.

Method: Census sampling was used to recruit anaesthetists, surgeons and nurses. A total of 173 participants consisting of 133 nurses, 37 doctors and 3 unidentified. A descriptive quantitative approach was used. Questionnaires were distributed to four hospitals in Ireland. Data collected was coded and entered into SPSS version 23. Data was analysed using descriptive statistics, independent sample t-tests and chi-square tests were used to compare attitudes between nurses and doctors. Ethical approval was granted by each hospital and by the Faculty of Health Sciences Research Ethics Committee of Trinity College.

Results: Doctors rated their level of communication with other team members higher than nurses. Respondents generally displayed positive attitudes towards the safety culture and the WHO checklist. Doctors showed more positive attitudes than nurses for all domains of the safety culture. When compared against an international benchmark, scores were lower in four of the five safety culture domains. Attitudes to the WHO checklist were similar from both doctors and nurses.

Findings: Overall positive attitudes towards the safety culture were identified. Issues regarding communication, teamwork, management and checklist implementation and their effect on the level of safety in theatre were highlighted.

Conclusion: Emphasis was placed on the need for improved levels of communication and teamwork within theatre. This study highlighted the need for a culture change in the operating theatre, towards a more open and just culture. The researcher places importance on the need for continual measuring of the safety culture.