ORIGINAL ARTICLE
Nurse’s perioperative care errors and related factors in the operating room
 
More details
Hide details
1
MSc student in Operating room, Student Research Committee, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
2
MSc in Nursing, Ulcer Repair Research Center, Department of Operating Room, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
3
Associate Professor, Nursing and Midwifery Care Research Center, Adult Health Nursing Department, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences Isfahan, Iran
Online publish date: 2018-08-12
 
KEYWORDS:
ABSTRACT:
Introduction:
Surgical cares are one of the most complex and costly health care services and optimizing them should be prioritized. Medical error as an adverse event can be considered as a threat to the safety of the patients. The revelation of errors is recognized as the basis for maintaining and improving the safety of patients; consequently, the present study aimed to investigate pre-, intra- and postoperative care errors in the operating rooms and their related factors.

Method:
This descriptive-analytic study was conducted in the operating rooms of selected hospitals of Isfahan University of Medical Sciences. The research instrument was a researcher-made questionnaire including demographic information, errors perioperative care and effective factors on these sorts of medical cares. Data were entered into SPSS software and analyzed by statistical tests.

Findings:
The mean error in the perioperative care was 25.33%, the highest error rate was related to preoperative care (31%) and then the error in postoperative care (25.24%) and the lowest level of error rate was seen in line with intraoperative care (20.75%); the results showed that the most effective factor in the occurrence of care errors in the operating room were environmental and structural factors (80.25%), then individual factors (75.27%) and management factors (61.75%).

Conclusion:
Regarding the lesser intraoperative cares error, it can be concluded that nurses are more focused on surgical procedures and surgical principles in line with the operation and are more likely to play a role of the assistant surgeon in the operating room and pay less attention to nursing care before and after the operation.

 
REFERENCES (30):
1. Ugur E, Kara S, Yildirim S, Akbal E. Medical errors and patient safety in the operating room. Age. 2016;33(6.53):19-50.
2. Hashemi F, Nikbakht Nasrabadi A, Asghari F. The obstacles of reporting nursing errors in Iran: a qualitative study. Journal of medical ethics and history of medicine. 2011;4(2):53-64.
3. Weerakkody RA, Cheshire NJ, Riga C, Lear R, Hamady MS, Moorthy K, et al. Surgical technology and operating-room safety failures: a systematic review of quantitative studies. BMJ Qual Saf. 2013;22(9):710-718. https://doi.org/10.1136/bmjqs-... PMid:23886892.
4. Hoffmann B, Rohe J. Patient safety and error management: what causes adverse events and how can they be prevented? Deutsches Arzteblatt International. 2010;107(6):92. https://doi.org/10.3238/arzteb....
5. Chiozza ML, Ponzetti C. FMEA: a model for reducing medical errors. Clinica Chimica Acta. 2009;404(1):75-8. https://doi.org/10.1016/j.cca.... PMid:19298799.
6. Candas B, Gürsoy A. Patient safety in operating room: Thoughts of surgery team members on implementing the Safe Surgery Checklist (An example from Turkey). Perioperative Care and Operating Room Management. 2016;5:1-6. https://doi.org/10.1016/j.pcor....
7. Barajas-Nava L, Solà I, Delgado-Noguera M, Gich I, Villagran CO, Bonfill X, et al. Quality assessment of clinical practice guidelines in perioperative care: a systematic appraisal. Qual Saf Health Care. 2010;19(6):e50-e.
8. Makary MA, Daniel M. Medical error-the third leading cause of death in the US. BMJ: British Medical Journal (Online). 2016;353.
9. Nabhan M, Elraiyah T, Brown DR, Dilling J, LeBlanc A, Montori VM, et al. What is preventable harm in healthcare? A systematic review of definitions. BMC health services research. 2012;12(1):128. https://doi.org/10.1186/1472-6... PMid:22630817 PMCid:PMC3405467.
10. Shanafelt TD, Balch CM, Bechamps G, Russell T, Dyrbye L, Satele D, et al. Burnout and medical errors among American surgeons. Annals of surgery. 2010;251(6):995-1000. https://doi.org/10.1097/SLA.0b... PMid:19934755.
11. Ehsani SR, Cheraghi MA, Nejati A, Salari A, Esmaeilpoor AH, Nejad EM. Medication errors of nurses in the emergency department. Journal of medical ethics and history of medicine. 2013;6.
12. de Vries EN, Prins HA, Crolla RM, den Outer AJ, van Andel G, van Helden SH, et al. Effect of a comprehensive surgical safety system on patient outcomes. New England Journal of Medicine. 2010;363(20):1928-37. https://doi.org/10.1056/NEJMsa... PMid:21067384.
13. Griffen FD, Stephens LS, Alexander JB, Bailey HR, Maizel SE, Sutton BH, et al. The American College of Surgeons’ closed claims study: new insights for improving care. Journal of the American College of Surgeons. 2007;204(4):561-9. https://doi.org/10.1016/j.jamc... PMid:17382214.
14. Greenberg CC, Regenbogen SE, Studdert DM, Lipsitz SR, Rogers SO, Zinner MJ, et al. Patterns of communication breakdowns resulting in injury to surgical patients. Journal of the American College of Surgeons. 2007;204(4):533-40. https://doi.org/10.1016/j.jamc... PMid:17382211.
15. de Vries EN, Hollmann MW, Smorenburg SM, Gouma DJ, Boermeester MA. Development and validation of the SURgical PAtient Safety System (SURPASS) checklist. BMJ quality & safety. 2009;18(2):121-.6.
16. Movahednia S, Partovishayan Z, Bastanitehrani M, Moradi F. Nurse Managers’ perspectives about Reasons for not reporting medical errors in Firoozgar Hospital: 2012. Razi Journal of Medical Sciences. 2014;21(125).
17. Chard R. How perioperative nurses define, attribute causes of, and react to intraoperative nursing errors. AORN journal. 2010;91(1):132-45. https://doi.org/10.1016/j.aorn... PMid:20102810.
18. Cohoon B. Causes of near misses: perceptions of perioperative nurses. AORN journal. 2011;93(5):551-65. https://doi.org/10.1016/j.aorn... PMid:21530704.
19. Gorji HA, Ravaghi H, Pirouzi M, Mansourzade A. Utilizing Integrated Prospective and Retrospective Risk Analysis Method on General Processes Patient Flow in Operating Room in Seyed Alshohada Hospital in Semirom, Iran. Health Inf Manage. 2013;10(3).
20. Somville F, Van Sprundel M, Somville J. Analysis of surgical errors in malpractice claims in Belgium. Acta Chirurgica Belgica. 2010;110(1):11-8. https://doi.org/10.1080/000154... PMid:20306903.
21. Stone S, Bernstein M. Prospective error recording in surgery: an analysis of 1108 elective neurosurgical cases. Neurosurgery. 2007;60(6):1075-82. https://doi.org/10.1227/01.NEU... PMid:17538382.
22. Chen Q, Rosen AK, Amirfarzan H, Rochman A, Itani KM. Improving Detection of Intraoperative Medical Errors (iMEs) and Intraoperative Adverse Events (iAEs) and their Contribution to Postoperative Outcomes. The American Journal of Surgery. 2018. https://doi.org/10.1016/j.amjs....
23. ElBardissi AW, Sundt TM. Human factors and operating room safety. Surgical Clinics. 2012;92(1):21-35. https://doi.org/10.1016/j.suc.... PMid:22269258.
24. Bizhani M, Kouhpayeh SA, Abadi R, Tavacool Z. Effective factors on the Incidence of medication errors from the nursing staff perspective in various department of Fasa Hospital. Journal of Fasa University of Medical Sciences. 2013;3(1):88-93.
25. Saki K, Khezri_Azar J, Mohebbi I. Nursing errors and its relationship with fatigue among nurses of the emergency ward. Journal of Nursing and Midwifery Urmia University of Medical Sciences. 2016;13(10):835-42.
26. Vidyarthi AR, Auerbach AD, Wachter RM, Katz PP. The impact of duty hours on resident self reports of errors. Journal of general internal medicine. 2007;22(2):205-9. https://doi.org/10.1007/s11606... PMid:17356987 PMCid:PMC1824755.
27. Ajri-Khameslou M, Abbaszadeh A, Borhani F, Farokhnezhad Afshar P. Contributing factors to nursing error in emergency department: A qualitative study. Hayat. 2017;23(1):17-32.
28. Eslamian J TF, Bahrami M, Mojdeh S. Assessing the nursing error rate and related factors from the view of nursing staff. Iranian Journal of Nursing and Midwifery Research. 2010;15(Suppl1):272-7. PMid:22069399 PMCid:PMC3208929.
29. Cramer H, Pohlabeln H, Habermann M. Factors causing or influencing nursing errors as perceived by nurses: findings of a cross-sectional study in German nursing homes and hospitals. Journal of Public Health. 2013;21(2):145-53. https://doi.org/10.1007/s10389....
30. Morey JC, Simon R, Jay GD, Wears RL, Salisbury M, Dukes KA, et al. Error reduction and performance improvement in the emergency department through formal teamwork training: evaluation results of the MedTeams project. Health services research. 2002;37(6):1553-81. https://doi.org/10.1111/1475-6... PMid:12546286 PMCid:PMC1464040.
eISSN:2516-3507