ROLE OF CONTINUOUS TRAINING IN IMPROVING COMPLIANCE TO SAFE SURGICAL PRACTICES ON ESTABLISHED STANDARD OPERATING PROTOCOLS IN A TERTIARY CARE HOSPITAL AT NATIONAL CAPITAL REGION IN INDIA

Arun Verma, Vijay Kumar Tadia

Abstract


Background

One of the most common interventions used in healthcare to improve safety and reliability is to formalize framework of activity based on Standard Operating Protocols (SOPs). The primary goal of SOPs is to structure and standardize work with predefined plans, minimizing errors which occur through failure of human memory and attention

Methods

A prospective observational study was conducted from January 2017 to June 2017 in a tertiary care hospital at National Capital Region in India. A sample size of 60 was taken based on a previous study. All Operation Theatre (O.T.) personnel with consent for the study were subjected to Pre-training evaluation based on WHO/NABH/Standard safe surgical practices & protocols for assessment of knowledge. Training of half an hour daily for 4 weeks was imparted to the O.T. personnel. Training was given with standard WHO/NABH material on safe surgical practices in the form of lectures, presentations, group discussions, audio-visuals etc. O.T. personnel participated in training were re-evaluated immediately on completion of training and after 3 months with the same Pre- training evaluation process and material.

Results

 Overall pre-training safe surgical practices compliance score for O.T. staff was 70.60%, which increased to 94.33% immediate post-training and persisted to 86.78% three months post-training. Difference in compliance after training was statistically significant.

Conclusions

 It seems that training increases compliance of healthcare providers on safe surgical practices related to preoperative, operative, postoperative, anaesthesia related, surgical attire related and infection control related practices.

Keywords


Standard Operating Protocols, Training, Compliance, Safe Surgery

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References


Aspden P, Corrigan J, W. J. (2004). Patient safety: achieving a new standard for care. Washington, DC: National Academies Press.

Bliss, L. A., Ross-Richardson, C. B., Sanzari, L. J., Shapiro, D. S., Lukianoff, A. E., Bernstein, B. A., & Ellner, S. J. (2012). Thirty-day outcomes support implementation of a surgical safety checklist. Journal of the American College of Surgeons, 215(6), 766–776. https://doi.org/10.1016/j.jamcollsurg.2012.07.015

Butterworth, P., Gilheany, M. F., & Tinley, P. (2010). Postoperative infection rates in foot and ankle surgery: A clinical audit of Australian podiatric surgeons, January to December 2007. Australian Health Review, 34(2), 180–185. https://doi.org/10.1071/AH08687

Diekema, D. J., Schuldt, S. S., Albanese, M. A., & Doebbeling, B. N. (1995). Universal precautions training of preclinical students: Impact on knowledge, attitudes, and compliance. Preventive Medicine, 24(6), 580–585. https://doi.org/10.1006/pmed.1995.1092

Friedland, L. R., Joffe, M., Wiley, J. F., Schapire, A., & Moore, D. F. (1992). Effect of Educational Program on Compliance With Glove Use in a Pediatric Emergency Department. American Journal of Diseases of Children, 146(11), 1355–1358. https://doi.org/10.1001/archpedi.1992.02160230113030

Goudra, B., Singh, P. M., & Galvin, E. (2014). Comparison of compliance of glove use among anesthesia providers: a prospective blinded observational study. AANA Journal, 82(5), 363–367. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25842651

Haynes, A. B., Weiser, T. G., Berry, W. R., Lipsitz, S. R., Breizat, A. H. S., Dellinger, E. P., … Gawande, A. A. (2009). A surgical safety checklist to reduce morbidity and mortality in a global population. New England Journal of Medicine, 360(5), 491–499. https://doi.org/10.1056/NEJMsa0810119

Jeong, I., Cho, J., & Park, S. (2008). Compliance with standard precautions among operating room nurses in South Korea. American Journal of Infection Control, 36(10), 739–742. https://doi.org/10.1016/j.ajic.2008.04.253

Kim, L. E., Jeffe, D. B., Evanoff, B. A., Mutha, S., & Freeman, B. (2001). Improved compliance with universal precautions in the operating room following an educational intervention Recommended Citation. In Infection Control and Hospital Epidemiology: The Official Journal of the Society of Hospital Epidemiologists of America (Vol. 22). Retrieved from http://digitalcommons.wustl.edu/ohs_facpubs

Mcculloch, P., Morgan, L., Flynn, L., Rivero-Arias, O., Martin, G., Collins, G., & New, S. (2016). Safer delivery of surgical services: a programme of controlled before-and-after intervention studies with pre-planned pooled data analysis. https://doi.org/10.3310/pgfar04190

Morgan, L., New, S., Robertson, E., Collins, G., Rivero-Arias, O., Catchpole, K., … McCulloch, P. (2015). Effectiveness of facilitated introduction of a standard operating procedure into routine processes in the operating theatre: A controlled interrupted time series. BMJ Quality and Safety, 24(2), 120–127. https://doi.org/10.1136/bmjqs-2014-003158

Morgan, L., Pickering, S. P., Hadi, M., Robertson, E., New, S., Griffin, D., … McCulloch, P. (2015). A combined teamwork training and work standardisation intervention in operating theatres: Controlled interrupted time series study. BMJ Quality and Safety, 24(2), 111–119. https://doi.org/10.1136/bmjqs-2014-003204

Mukti, A. G., Treloar, C., Suprawimbarti, Asdie, A. H., D’Este, K., Higginbotham, N., & Heller, R. (2000). A universal precautions education intervention for health workers in Sardjito and PKU Hospital Indonesia. The Southeast Asian Journal of Tropical Medicine and Public Health, 31(2), 405–411. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11127348

Pittet, D., & Boyce, J. M. (2001, April 1). Hand hygiene and patient care: pursuing the Semmelweis legacy. The Lancet Infectious Diseases, Vol. 1, pp. 9–20. https://doi.org/10.1016/S1473-3099(09)70295-6

Schwartz, R. J., Jacobs, L. M., & Juda, R. J. (1992). Evaluating the compliance of universal precautions by aeromedical personnel before and after an educational seminar on infectious diseases. Connecticut Medicine, 56(1), 3–5. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/1547631

Talan, D. A., & Baraff, L. J. (1990). Effect of education on the use of universal precautions in a university hospital emergency department. Annals of Emergency Medicine, 19(11), 1322–1326. https://doi.org/10.1016/s0196-0644(05)82295-4

Taylor, R. E. (2015). The role of message strategy in improving hand hygiene compliance rates. American Journal of Infection Control, 43(11), 1166–1170. https://doi.org/10.1016/j.ajic.2015.06.015

Tillman, M., Wehbe-Janek, H., Hodges, B., Smythe, W. R., & Papaconstantinou, H. T. (2013). Surgical care improvement project and surgical site infections: Can integration in the surgical safety checklist improve quality performance and clinical outcomes? Journal of Surgical Research, 184(1), 150–156. https://doi.org/10.1016/j.jss.2013.03.048

To err is human: building a safer health system. (2000). Washington, DC: National Academy Press.

WHO | Safe Surgery. (2014). WHO. Retrieved from https://www.who.int/patientsafety/safesurgery/en/

WHO Guidelines on Hand Hygiene in Health Care First Global Patient Safety Challenge Clean Care is Safer Care. (2009). Retrieved from https://apps.who.int/iris/bitstream/handle/10665/44102/9789241597906_eng.pdf?sequence=1

Zgonis, T., Jolly, G. P., & Garbalosa, J. C. (2004). The efficacy of prophylactic intravenous antibiotics in elective foot and ankle surgery. Journal of Foot and Ankle Surgery, 43(2), 97–103. https://doi.org/10.1053/j.jfas.2004.01.003

Zimlichman, E., Henderson, D., Tamir, O., Franz, C., Song, P., Yamin, C. K., … Bates, D. W. (2013). Health care-associated infections: AMeta-analysis of costs and financial impact on the US health care system. JAMA Internal Medicine, 173(22), 2039–2046. https://doi.org/10.1001/jamainternmed.2013.9763


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