Knowledge of surgical counting practices of operating room nurses in provincial hospitals in the Cape Metropole

Beukes, Robertha Devona (2016-03)

Thesis (MCur)--Stellenbosch University, 2016.

Thesis

ENGLISH ABSTRACT: Background: Retained surgical items are a preventable medical error that leads to patient harm and increased hospital stay. Surgical safety has emerged as a significant global health concern to avoid preventable medical errors and deaths globally. The cost implications for the facility and severe patient complications are significant and safety procedures to prevent this occurring are vital. Methods: A descriptive, cross-sectional design with a quantitative approach utilising a selfadministered questionnaire was used for this study. Four public hospitals were included in this study, which are situated in the Cape Metropole district. The study was conducted in their operating theatres to gain more information about surgical counting practices as it occurs in the natural setting. The population size was N=164 therefore no sampling was required on advice of the statistician. All nurses meeting the inclusion criteria were invited to participate in this study. Permission to conduct the study was obtained from the Health Research Ethics Committee at Stellenbosch University and the National Health Research Board. Data collection occurred at each respondent’s place of employment after an information session was held and informed, written consent obtained. Data was analysed by a statistician and presented in frequencies, tables and histographs. The variables were compared using either the Pearson chi-square test for differences in nursing category or the Mann-Whitney U-test for differences in years of experience. Results: Findings indicate that there is a serious knowledge deficit of the fundamental surgical counting procedures further corroborated by the section of the survey on clinical practice. Overall the respondents identified the major factor impacting surgical counting practice is handover during change of shift. It is suggested that increased awareness and training regarding surgical counting practices needs to be implemented. Conclusion: Renewed accountability for correct surgical counts needs to be fostered amongst theatre personnel by re-enforcement of counting policy and identifying bestpractices. There should be zero tolerance for not adhering to policy and deviation from recommended practice that compromise patient safety. The time spent with perioperative staff to reinforce surgical count policy and ensure application is standardised, is more valuable compared to the financial implications of legal proceedings and disciplinary measures lodged against facility and staff.

AFRIKAANSE OPSOMMING: Metode: ᾽n Nie-eksperimentele, beskrywende, deursnee ontwerp met ’n kwantitatiewe benadering wat van n self-geadministreerde vraelys gebruik maak, is aangewend vir hierdie studie. Vier openbare hospitale is ingesluit in hierdie studie, wat geleë is in die Kaapse Metropool. Die studie is uitgevoer in die operasiekamer om meer inligting te bekom oor die chirurgiese telpraktyk soos dit voorkom in die natuurlike omgewing. Die grootte van die bevolking was N=164, eindig en bekend, dus was geen steekproefneming nodig op advies van die statistikus. Alle verpleegpersoneel wat voldoen het aan die insluitingskriteria is genooi om deel te neem aan die studie. Toestemming om die studie te doen is verkry van die Gesondheidsnavorsing-kommitee by Stellenbosch Universiteit en die Nasionale Gesondheids Navorsings Raad verkry. Data versameling was gedoen by die deelnemers se werksplek nadat n inligtingsessie gehou is en toestemming verkry is. Data is geanaliseer deur n statistikus en aangebied in frekwensies,tafels en histogramme. Die vergelykings was gedoen met behulp van die Pearson chi kwadraattoets vir veskille in verpleging kategorie of die Man-Whitney U – toets vir verskille in die jare van ervaring. Resultate: Bevindinge dui daarop dat daar ’n ernstige kennistekort is aan die basiese chirurgiese telprosedures, en is verder deur die afdeling van die vraelys oor kliniese praktyk onderstaun. In die algemeen het deelnemers die hoof faktor wat kliniese praktyk beïnvloed as oorhandiging gedurende skofveranderings geidentifiseer. Daar word voorgestel dat daar verhoogde bewustheid en opleiding ten opsigte van chirurgiese telpraktyke geïmplimenteer word. Slotsom: Hernude aanspreeklikheid vir korrekte chirurgiese telling moet onder die teaterpersoneel bevorder word deur die hertoepassing van die telbeleid en identifisering van goeie praktyke. Daar moet geen toleransie wees vir afwyking van die telbeleid en van aanbevole praktyk nie aangesien die veiligheid van pasiënte in gedrang kan wees. Die tyd saam met peri-operatiewe personeel om chirurgiese telbeleid te versterk en om standardisering te verseker, is ten opsigte van die finansiële implikasies van regs en dissiplinêre stappe teen fasiliteite en personeel meer waardevol

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