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Nurse–surgeon object transfer: Video analysis of communication and situation awareness in the operating theatre

Nurse–surgeon object transfer: Video analysis of communication and situation awareness in the operating theatre

Korkiakangas, Terhi, Weldon, Sharon-Marie ORCID: 0000-0001-5487-5265, Bezemer, Jeff and Kneebone, Roger (2014) Nurse–surgeon object transfer: Video analysis of communication and situation awareness in the operating theatre. International Journal of Nursing Studies, 51 (9). pp. 1195-1206. ISSN 0020-7489 (doi:https://doi.org/10.1016/j.ijnurstu.2014.01.007)

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Abstract

Background:
One of the most central collaborative tasks during surgical operations is the passing of objects, including instruments. Little is known about how nurses and surgeons achieve this. The aim of the present study was to explore what factors affect this routine- like task, resulting in fast or slow transfer of objects.

Methods: A qualitative video study, informed by an observational ethnographic approach, was conducted in a major teaching hospital in the UK. A total of 20 general surgical operations were observed. In total, approximately 68 h of video data have been reviewed. A subsample of 225 min has been analysed in detail using interactional video-analysis developed within the social sciences.

Results:
Two factors affecting object transfer were observed: (1) relative instrument trolley position and (2) alignment. The scrub nurse’s instrument trolley position (close to vs. further back from the surgeon) and alignment (gaze direction) impacts on the communication with the surgeon, and consequently, on the speed of object transfer. When the scrub nurse was standing close to the surgeon, and ‘‘converged’’ to follow the surgeon’s movements, the transfer occurred more seamlessly and faster (<1.0 s) than when the scrub nurse was standing further back from the surgeon and did not follow the surgeon’s movements (>1.0 s).

Conclusions:
The smoothness of object transfer can be improved by adjusting the scrub nurse’s instrument trolley position, enabling a better monitoring of surgeon’s bodily conduct and affording early orientation (awareness) to an upcoming request (changing situation). Object transfer is facilitated by the surgeon’s embodied practices, which can elicit the nurse’s attention to the request and, as a response, maximise a faster object transfer. A simple intervention to highlight the significance of these factors could improve communication in the operating theatre.

Item Type: Article
Uncontrolled Keywords: Communication; operating theatre; Operating room; Teamwork; Video analysis; Nurses; Surgeons; Conversation analysis
Faculty / Department / Research Group: Faculty of Education & Health
Faculty of Education & Health > Department of Adult Nursing & Paramedic Science
Related URLs:
Last Modified: 08 Apr 2018 17:00
Selected for GREAT 2016: None
Selected for GREAT 2017: None
Selected for GREAT 2018: GREAT b
Selected for GREAT 2019: None
URI: http://gala.gre.ac.uk/id/eprint/17293

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