Nursing and patient safety in the operating room.
OBJECTIVE
This paper is a report of a study to identify what operating room nurses believe influences patient safety and how they see their role in enhancing patient safety.


BACKGROUND
Research in health care shows that work experience, communication and the organization of work are key factors in patient safety. This study draws on Reason's definitions of active and latent errors to conceptualize the complex issues that affect patient safety in the operating room.


METHODS
The study reported here is part of an action research project at a university hospital in Iceland. Semi-structured interviews were conducted in 2004 with eight nurses, followed by two focus groups of four nurses each in 2005. Data were analysed using interpretive content analysis.


RESULTS
Securing patient safety and preventing mistakes were described as key elements in operating room nursing by all survey participants. In the interviews, the nurses identified the existing culture of prevention and protection that characterizes operating room nursing as crucial in enhancing safety. The organization of work into specialty teams was considered essential. Increased speed of work in an environment where enhanced productivity is imperative, as well as imbalance in staffing, was identified as the main threats to safety.


CONCLUSIONS
Operating room nurses have a common understanding of the core of their work, which is to ensure patient safety during operations. The work environment is increasingly characterized by latent error, i.e. system-based threats to patient safety that can materialize at any time. Interventions to enhance patient safety in operating room nursing are needed.
Alfredsdottir
Herdis
H
H. Alfredsdottir MNSc RN CNOR Clinical Coordinator Operating Room, National University Hospital, Reykjavik, Iceland K. Bjornsdottir EdD RN Professor Faculty of Nursing, University of Iceland, Reykjavik, Iceland.
Bjornsdottir
Kristin
K
H. Alfredsdottir MNSc RN CNOR Clinical Coordinator Operating Room, National University Hospital, Reykjavik, Iceland K. Bjornsdottir EdD RN Professor Faculty of Nursing, University of Iceland, Reykjavik, Iceland.
D000328:Adult; D001291:Attitude of Health Personnel; D036262:Empirical Research; D017144:Focus Groups; D006801:Humans; D007055:Iceland; D019300:Medical Errors / Q000517:prevention & control; D008875:Middle Aged; D024802:Nurse's Role / Q000523:psychology*; D009741:Nursing Staff, Hospital / Q000523:psychology*; D009871:Operating Room Nursing; D009873:Operating Rooms / Q000592:standards; D010361:Patients; D012308:Risk Management; D012449:Safety; D017751:Safety Management