Human factors
high workload for operating theatre teams. When there is not enough staff to meet these demands, the risk of patient harm can increase. This can lead to fatigue, stress, and burnout with an impact on the team’s effective care for patients or each other. When there is not enough staff, there is no time for supervision of junior staff, then the risk of errors increases. Junior staff may not have the experience or skills required to manage complex or critical situations and may be more prone to errors or mistakes. Delays in surgeries can also increase the risk of more complicated surgery in the future for a patient. To be effective and efficient, debriefing in
operating theatre should follow best practices – such as creating a supportive environment for all team members. Debriefing should take place in a space that is private and free from interruptions. All team members should be encouraged to speak their thoughts and feelings openly and honestly. The debrief should be without judgment and fear of reprisal – where everyone can feel like an equal team member. Each member of the team has a unique perspective on surgical intervention, and their insight and feedback should be valued and respected. The best practice for the debrief would be to make sure that all operating theatre teams are present – including a surgeon, anaesthetic team, scrub team, healthcare staff and sometimes management. To protect the safety and welfare of
operating theatre teams, new practices could be implemented to achieve the goal – for instance, the reassurance of a positive work environment by changing the culture and the hierarchy. Respecting each other’s experience can enhance team morale.15
Additionally, a
focus on the safety and welfare of healthcare professionals promotes retention and attracts new talents to the field, addressing workforce shortages. Therefore, sufficient staffing allows time for training, support to perform duties effectively, and reduces errors. Implementing protocols and standardising practice, with enhanced communication, will minimise misunderstanding. Encouraging team members to prevent errors by providing open dialogue builds important operating team trust. Moreover, providing emotional and psychological support with assistance programmes helps address mental well-being. A culture of well-being – encouraged through
stress management programmes, physical activity opportunities, and a realistic workload – can positively impact the health of operating theatre teams. By implementing strategies such as adequate staff levels, enhanced communication, psychological support and
10 Yeganeh S., Torabizadeh C., Bahmani T., Molazem Z., Dust H.Y & Dahavani S.D (2022). Examining the views of the operating theatre rooms nurses and physician on the relationship between professional values and professional communication. BMC Nursing.
www.ncbi.nlm.nih.gov/pmc/articles/ PMC8759190/
11 Health and Safety executive. (n.d). Introducing the key topic.
www.hse.gov.uk/humanfactors/top-ten.htm
well-being measures, operating theatres can become a safer and more positive places of work. In short, prioritising the safety and welfare of these professionals by highlighting the importance of the debriefing tool, not only improves outcomes for patients and the efficiency of operating theatres, but also contributes to a resolute workforce.
12 Health and Safety Executive (n.d). Human factors. Staffing levels.
www.hse.gov.uk/humanfactors/topics/ staffing-levels.htm
CSJ
References 1 Pupkiewicz, J., & Kitson, A., Perry, J. (2015). ‘What factors within the peri-operative environment influence the training of scrub nurses?’. Nurse education in Practice (15), 373-380.
2 Royal College of Nursing (2023). Sharp safety. RCN Guidance for the prevention and Management of sharps injuries in health and social care settings.
3 The Association for Perioperative Practice (2021). Vol. 31 (10)364-365.
4 Serou, N., Slight, P., Husband A.K., Forrest, S.P & Slight R.D. (2021) Surgical incidents and their impact on operating theatre staff: quality study. British Journal of Surgery.
5 Osingada, C.P. & Porta, C.M. (2020). Nursing and Sustainable Development Goals (SDGs) in a Covid-19 world: The state of the science and a call for Nursing to lead.
6 The World Health Organization (2020). Operational Guidelines for maintaining essential health services during the outbreak.
www.apps.who.int/iris/bitstream/ handle/10665/331561/WHO-2019-nCoV- essential_health_services-2020.1-eng.pdf
7 Lee H., Woodward-Kron R., Merry A. and Weller J. (2023). Emotions and team communication in the operating theatre room: a scoping review. Medical Education online.
www.ncbi.nlm.nih. gov/pmc/articles/PMC10064827/
8 The World Health Organization. Safe surgery saves lives, 2014.
www.who.int/news-room/questions-and- answers/item/safe-surgery-saves-lives- frequently-asked-questions
9 Nursing and Midwifery Council. (2018, updated 2020) Code of Practice. Professional Standards of practice and behaviour for Nurses and Midwives. London: NMC.
About the author
Dorota Maria Bilan is a Polish Registered Nurse and has lived in the UK for over 18 years. She has extensive experience in a variety of specialties including operating theatres, ITU, A&E, private healthcare, and nursing home care. Her current practice is within operating theatres, but in addition to her work as a scrub nurse, she is also currently undertaking an MSc degree.
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13 Usher, R. (2017). Nurses’ Standard English Communication Difficulties: Native Undergraduate and Non-Native. Pilgrims.
www.hltmag.co.uk/oct22/nurses-standard- english-communication-difficulties
14. Marshall, D.S., and Touzell, A. (2020). Human factors and the safety of surgical and anaesthetic care, Association of Anaesthesia.
www.associationofanaesthetistspublications.
onlinelibrary.wiley.com/doi/10.1111/anae.14830
15. Kirschbaum K., McAuliffe M.S., Swanson M., (2018). Team Communication in the Operating Room: A measure of Latent Factors Form a National Sample of Nurses Anesthetists. AANA Journal, 2018, vol. 86, No. 1
www.aana.com/docs/default-source/ aana-journal-web-documents-1/team- communication-in-the-operating-room- february-2018.pdf?sfvrsn=5f2d42b1_6
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