Human factors
Protecting the welfare of operating theatre teams
In this article, Dorota Maria Bilan highlights the importance of good communication and debriefing in the operating theatre to protect the safety and welfare of the team.
Operating theatre teams are highly skilled medical professionals who work under pressure, in environments that are stressful and highly demanding.1
In addition, challenges arising from
the pandemic period and associated backlog have exacerbated these pressures further. The responsibility for the safety and well-being of the patient during surgical procedures lies with those who are working in operating theatres. However, the welfare of surgeons, nurses, and healthcare professionals in the operating theatre is often put in second place. Team members often neglect their own safety, welfare, and mental health – just to provide the service required. Operating theatre teams are at high risk of
exposure to bodily fluids, blood, sharp injuries2 and musculoskeletal injuries3
to these physical risks, mental health can be impacted by anxiety, stress, depression or even post-traumatic stress disorder.4
The
literature provides information about the use of personal protective equipment (PPE), and its importance was particularly highlighted during the pandemic of COVID-19, but there has been very little information on how to protect the wellbeing and mental health of operating theatre teams. The pandemic period proved that changes are needed to protect teams5
and operating
theatres implemented World Health Organization6
guidelines to reduce the risk
of transmission of COVID-19 within operating theatres. This included the use of negative pressure rooms, installing barriers/zone areas, and using an air filtration system. However, consideration also needs to be given to the increase in stress levels due to the growth in workload and decrease in staff levels. Implementing support, such as counselling services or peer support groups, in many healthcare facilities, helps enhance the mental health of healthcare professionals. In fact, operating theatres recognised the importance of the debriefing sessions after difficult procedures or events, to help the team process the emotional impact of their work.
Performance, effectiveness and efficiency is disturbed when the emotional welfare of the team or the individual member of the team shows an increase in stress, fear, or anxiety.7 The World Health Organization8
surgical
checklist is designed to protect patients from harm during surgery and decrease mistakes and near misses or even patient death. It should also give medical staff a voice, if needed, so they can be an advocate for the patient, while they are in such a vulnerable place. Patients place all their trust in the operating team to ensure their health is restored after the procedure. Ensuring the safety of patients in the operating room is always a priority.9
However,
team members are always conscious of time management, the effectiveness of the working day, and efficiency to avoid cancellation of the surgery. Therefore, the turnover of the procedure must be well managed and supported with great communication between management, team members in operating theatres, and post-operative care for patients. Good communication as a professional tool can lower the risk of mistakes and increase professional trust. Communication that is led
by arrogance, conflicts, stress and incivility can directly harm patients. This can lead to medical errors defined as ‘never events’ (e.g. operating on the wrong side of surgery, falling off the operating table or retaining surgical items).10
Patient safety and overwhelmed theatre teams The wellbeing of operating theatre teams is critical to the success of the surgical intervention and the satisfaction of patients, as well as to the overall health of the healthcare system. Discussing the welfare and wellbeing of the operating theatre team should be as important as patient safety. Staff shortages, level of skills, and overworked and overwhelmed staff can be improved by highlighting the role of the debriefing in maintaining a healthy and effective operating theatre team.11,12 The welfare and well-being of the operating
theatre team are essential for several reasons. Firstly, a healthy and motivated team is providing safe and effective surgical intervention with good time management, communication and respect for each other.10
Surgical procedures can be very complex, long, and demanding and September 2023 I
www.clinicalservicesjournal.com 67 – but, in addition
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