Table 2.
Manuscript purpose and select methods
| Manuscript | Purpose/ Intervention/Initiatives | Instruments/Measures | Setting | Participants |
|---|---|---|---|---|
| Barr et al. (2020) | Assess safety culture, ICU team collaboration, and work environment Determine whether organizational characteristics were associated with ICU Liberation (ABCDEF) Bundle implementation Determine level of agreement between physician and nurse leaders around ICU organizational characteristics and bundle implementation |
Survey domains with respondent, ICU, and hospital characteristics; organizational characteristics of work environment (collaboration, safety culture); and bundle implementation phases Safety Organizing Scale (SOS) |
43 of 72 acute care hospitals with adult ICUs in Michigan | 28 ICU physicians 45 ICU nurses |
| Carney et al. (2010) | After team training and implementation of the Surgical Safety checklist: Assess teamwork differences between perioper. nurses and surgeons Examine implications of differences for improving practice patterns in the OR |
Safety Attitudes Questionnaire | 34 Veterans Health Administration hospitals | 312 surgeons 378 perioper. nurses |
| Falcone et al. (2021) | Assess perioperative safety initiatives: Pulse surveys with feedback for safety concerns; Multidisciplinary safety training; Safety culture champion team; New safety processes with standard training; Missions and tenets; Intraoperative huddle process; Pathways for resolution of safety concerns; Time-out and prevention of retained foreign object process |
Two question custom survey: Climate of trust in work area Others responding with grace and gratitude Process adherence and engagement Training feedback |
Urban, >600 bed pediatric academic medical center | 230 survey respondents from “selected staff” |
| Goldhaber-Fiebert et al. (2016) | Assess perspectives on OR safety culture regarding emergency manual (cognitive aid) use before and after implementation Describe emergency manual use during critical events. |
Custom pre/post-implementation surveys | Dept. of Anesth., Perioper. and Pain Medicine at Stanford Univ. School of Medicine | Anesth. residents Pre: 34 Post:42 |
| Halvorson et al. (2016) | Assess design of an ideal transfer process for transfers from ICUs to acute care units and associated structured handoff tool (checklist) | Adherence to standard workflow; Average time to transfer completion; Percentage of transfers completed in time period; Percentage of transfers with receiving provider notified of patient arrival; Staff survey assessing adequacy of transfer communication |
550-bed academic, tertiary care center with 13 medical and surg. ACUs + 80 adult critical care beds across 4 adult ICUs | Pre-survey: 41 physicians 2 PAs 115 nurses Post-survey: 43 physicians 123 nurses |
| Hemingway et al. (2015) | Assess Perioper. Services safety initiatives: Changing processes for safety reporting and performance improvement plans Adding resources and nurses’ roles, Creating communication strategies around adverse safety events |
Custom staff survey to understand OR safety culture | Massachusetts General Hospital, Boston | 79 RNs, surg. technologist, OR assistants, operational associates |
| Lozito et al. (2018) | Assess a Good Catch Campaign designed to improve perioperative safety culture including: Formal education about good catch reporting; Standardized event reporting; Debriefing sessions for interprofessional discussions of actual events or near misses |
Number of good catch reports Participation in and scores from AHRQ Hospital Survey on Patient Safety Culture |
249-bed acute care community teaching hospital in Pennsylvania | Nurses, surg. technologists, anesth. care providers, PAs, quality director and coordinator, surgeons and others: 2014: 58; 2015:35; 2016: 71 |
| Odell et al. (2019) | Assess safety culture and its associations with surgical outcomes after: Participation in the American College of Surgeons’ NSQIP Engaging surgeon champions Supporting QI team with formal QI education, external QI coaches, and surgeon mentors Sharing outcomes benchmark data |
Modified Safety Attitudes Questionnaire Postoperative patient outcomes |
49 adult Illinois Surgical Quality Improvement Collaborative (ISQIC) hospitals | 103 hospital administrators 131 physicians 17 PA/nurse practitioner 460 nurses 108 quality improvement team members |
| Pimentel et al. (2021) | Identify variability in safety climate between groups of perioperative staff, if any existed | AHRQ Hospital Survey on Patient Safety Culture | Brigham and Women’s Hospital, a academic tertiary medical center, 793 beds | 78 surgery attendings 46 surgery residents 68 anesth. attendings 46 anesth. residents 141 nurses 23 surgery techs |
| Putnam et al. (2014) | Develop and assess interventions to improve safety culture, local engagement of stakeholders, and comprehension of the WHO’s Surgical Safety checklist: Modified WHO’s Surgical Safety checklist Pediatric OR safety council Safety workshops: Culture of safety and high-reliability organizations Error identification and effective communication Stakeholder audit and feedback |
Safety Attitudes Questionnaire Checklist adherence |
Children’s Memorial Hermann Hospital academic, 240-bed children’s hospital within tertiary center | Unspecified number of perioper., direct care providers completed Safety Attitudes Questionnaire |
| Putnam et al. (2015) | Compare safety culture, teamwork, and metrics of speaking up between two groups: Surgeons, anesthesiologists, and perioper. nurses in workshops addressing communication & safety culture Surg. residents completing safety curriculum |
Safety Attitudes Questionnaire | University of Texas Health Science Center at Houston (Children’s hospital) | 48 surg. residents 63 perioper. staff (surgeons, anesthesiologist, ‘direct care providers’) |
| Scherer & Fitzpatrick (2008) | Compare physician and RN perceptions of patient safety after implementing the Joint Commission’s patient safety recommendations for verification of correct patient, procedure, side, and site for patients undergoing surgery | AHRQ Hospital Survey on Patient Safety Culture | 174-bed community hospital/ perioper. area | 40 surgeons + anesthesiologists 43 nurses |
| Wright, Polivka, & Abusalem (2021) | Examine relationships between perioper. nurse experience, engagement, and OR safety culture Examine if perioper. nurse experience and engagement predict OR safety culture Determine if OR culture of safety scores differ based on CNOR certification status |
Utrecht Work Engagement Scale – 9 item version; Modified Safety Attitudes Questionnaire −41 of 60 items |
Eligible perioperative nurses from local AORN chapter | 96 perioper. nurses |
| Wright, Polivka, & Clark (2022) | Explore normalization of deviance in OR Identify reasons for normalization of deviance Identify factors that protect against normalization of deviance. |
Custom interview questions about normalization of deviance | Perioper. Nurses in midwestern metropolitan area | 10 perioperative nurse |
| Zingiryan et al. (2017) | Implementation of WHO Surgery Safety Checklist to decrease 9 complications in perioper. morbidity/morality (mortality, wound dehiscence, sepsis, respiratory failure, venous thromboembolism, postoper. hemorrhage or hematoma, retained foreign body, transfusion reaction, and death among surg. inpatients with serious treatable complications) | Custom questions to assess attitudes towards the WHO Surgery Safety Checklist Complication rates for 9 complications |
University of Vermont Medical Center | 59 surgeons 33 surg. residents 37 anesthesiologists 13 anesth. residents 9 nurse anesthetists 54 OR nurse 5 scrub technicians 19 OB/GYN attendings 9 OB/GYN resident 17 other |
Abbreviations: AHRQ, Agency for Healthcare Research and Quality; anesth., anesthesia; CNOR, Certified Perioperative Nurse; ICU, intensive care unit; NSQIP, National Surgical Quality Improvement Program; OB/GYN, obstetrics and gynecology; OR, operating room; pa, perioperative; perioper, perioperative; surg, surgery; Univ, university.