NYEE Perioperative Nurses: Communication and Teamwork in the Operating Room

By Christina Walker, RN, MA

Communication and Teamwork in the Operating RoomNovember 9 through 13, 2015 marks the celebration of PeriOperative Nurses Week, an annual commemoration of the surgical nurses’ important role and commitment to safe patient care.

At NYEE, our perioperative nursing team works in collaboration with other healthcare professionals, including surgeons, anesthesia providers, surgical assistants, and other clinical personnel.

This large team must work together to provide the safest, most efficient care to all of our patients undergoing surgical procedures and one of the most important tools we have in this collaboration is our ability to communicate with one another.

Recently, a team of NYEE perioperative nursing researchers conducted a study to find new ways improve teamwork and communication amongst the operating room staff at our hospital. The research was presented at the 2015 Association of Perioperative Registered Nurses (AORN) Meeting.

In order to find new and innovative ways to improve our communication skills, we first had to understand how we were already performing. To do this, we deployed an observer to evaluate real-time surgical procedures over a two-year period. The observer used the Communication and Teamwork Skills Tool (CATS), an assessment tool that captures both the quantity and quality of teamwork behaviors. The CATS instrument examined specific behavior markers in four categories (Coordination, Situational Awareness, Cooperation, and Communication). CATS scoring allows the observer to mark each time a specific behavior occurs and grade their quality. Three columns are provided on the tool Observed adequate = 1 point; Observed Inadequate = .5 point and Expected but not observed = 0 point. The weighted score is divided by the number of observations, which is expressed in a 100 point scale. Total the number of points and divide by the total number of observations.

At the end of the evaluation, we learned that we had some areas that needed improvement relating to coordination, briefing /time outs, and cooperation. These results have led us to look into the concept of “social capital” and how it may be able to help our OR teams boost communication and team work.

Social Capital, defined “as those features of a social organization that facilitate coordination and cooperation for mutual benefit.” The term social capital emphasizes that investment in interpersonal connections are needed to produce improved returns. The elements required for this kind of investment are:

  • High level of trust
  • Robust networks
  • Shared understandings
  • A sense of equitable participation in a joint enterprise

All elements that individuals in a group, from doctors to nurses to OR techs, need in the operating room. We are also presently researching the literature for a tool to measure trust within the team of the operating room.

We feel that this investment in research and will ultimately help us to perform our jobs better as a perioperative nursing team, increase patient safety, and improve the overall care that NYEE is able to offer our wide range of patients, from infants to adults.

Christina Walker, RN, MA, is the Nursing Care Coordinator in Perioperative Services at The New York Eye and Ear Infirmary of Mount Sinai (NYEE).

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