Creating Our Future Through Team Communication

摘要

Perioperative nursing is the ultimate team sport. Every day, nurses, surgeons, anesthesia professionals, surgical technologists, and a multitude of other health care professionals work side by side to provide safe, efficient care to patients undergoing surgical or other invasive procedures. Safety and efficiency are achieved by knowing our roles and responsibilities and performing them competently. I make the analogy with sports because the success of any team in any sport—such as baseball, football, soccer, or basketball—is dependent on each person's knowledge of his or her specific role or position, effective communication, and collaboration to achieve a common goal. Many things have changed in health care and nursing since I started my career more than 30 years ago. One of the biggest catalysts of change has been technology. Traditional ORs with basic components of a back table, mayo stand, and electrosurgical unit have been transformed into high-tech video-imaging suites with voice-activated equipment and robotics. Our documentation systems have moved from cumbersome paper charts to sophisticated systemwide electronic health records with information from all patient encounters available at our fingertips. The need to adapt to all these changes and learn these new technologies further emphasizes the need for effective communication and collaboration. The one thing that has not changed is the importance of communication in all that we do—whether it is with patients and their family members, team members, or personnel in other departments. Communication with patients occurs from the time they are scheduled for a procedure through discharge and may occur through phone calls, an electronic portal, or even encrypted text messages. Identifying ourselves as the RNs ensuring their safety and advocating for them when they cannot speak for themselves is our number-one priority during surgical or other invasive procedures. Our verbal and nonverbal interaction with the patient and their family members when they enter our facilities must demonstrate our compassion and the commitment we have made to them and our profession. Effective communication with team members is critical to help ensure optimal patient safety and to help achieve the best outcomes possible for patients undergoing surgical or other invasive procedures. There are several key points of care that require special attention and structured tools and processes to make sure every detail is covered. A thorough preprocedure briefing, time out, and debriefing are key elements of effective communication and teamwork. The World Health Organization's Surgical Safety Checklist, which contains key steps to confirm verbally before induction, before skin incision, and before the patient leaves the OR, was developed to decrease errors and adverse events and increase teamwork and communication, and its use has shown significant reduction in morbidity and mortality.1 There may be variations on how the surgical safety checklist is conducted, even at the same facility, but the important thing is that we are talking with each other and ensuring key elements of patient safety are being followed. provides guidance for improving perioperative team communication through a culture of safety that incorporates team training, simulation training, standardized transfer of patient information (commonly referred to as hand overs or hand offs), briefings, time outs, surgical safety checklists, and debriefings.2(p1063) The suite of related team communication tools available to members through the Guideline Essentials3 includes case studies, a gap analysis tool, a policy and procedure template, a competency verification tool, and more. Lastly, teamwork also is critical among other departmental personnel. One key area that requires precise, clear communication is sterile processing. Sterile processing personnel are valuable members of the perioperative team and effective communication between these departm