Development and Evaluation of a Teamwork Improvement Program for Perioperative Patient Safety

Abstract

Background: Effective teamwork in healthcare teams improves quality of care, which positively impacts on patient safety. Teamwork is especially crucial for perioperative nurses because they provide care as a team in the operating room. Previous research on teamwork training has principally addressed the general aspects of healthcare settings and focused on interdisciplinary teamwork and has rarely considered operative settings and nursing teamwork.

Purpose: The aim of this study was to develop a teamwork improvement program for perioperative patient safety and to evaluate the effectiveness of this program.

Methods: A quasi-experimental design was applied. We developed a teamwork improvement program based on teamwork competencies that focused on the perioperative nursing practice. This research was conducted at two operating centers in a tertiary hospital in South Korea, and a total of 60 perioperative nurses participated, including 28 nurses from the cancer operating center (experimental group) and 32 nurses from the main operating center (control group). The program consisted of four sessions and was delivered to the experimental group for a period of 2 weeks. Following the intervention, the effectiveness of the intervention was measured using a self-report questionnaire, focus group interviews, and program evaluation survey. Data were analyzed using chi-square test, t test, Fisher's exact test, and content analysis.

Results: Nearly all (96.4%) of the participants were satisfied with the overall content of the teamwork improvement program. Statistically significant differences were found between the experimental and control groups with regard to teamwork knowledge, teamwork attitudes, communication self-efficacy, and teamwork skills and behaviors. Three themes were elicited from the qualitative analysis, including "recognizing the importance and content of teamwork," "improving teamwork competencies," and "contributing to safe surgery." No significant difference in the incidence of surgical nursing errors was identified between the experimental and control groups within a 4-week period.

Conclusions/implications for practice: The teamwork improvement program developed in this study was demonstrated as effective in improving perioperative nurses' utilization of teamwork competencies in nursing practice and positively changing teamwork. The findings of this study provide evidence that teamwork training increases nurses' teamwork competencies. The clinical application of teamwork tools using competency-based teamwork training may contribute to patient safety and safe nursing practice.