Perioperative patient safety indicators—A Delphi study

Author:

Nyberg Anette12ORCID,Jirwe Maria34ORCID,Fagerdahl Ami5ORCID,Otten Volker6ORCID,Haney Michael2ORCID,Olofsson Birgitta16ORCID

Affiliation:

1. Department of Nursing Umeå University Umeå Sweden

2. Department of Diagnostics and Intervention, Anaesthesiology and Intensive Care Medicine Umeå University Umeå Sweden

3. Department of Health Sciences Swedish Red Cross University Huddinge Sweden

4. Department of Neurobiology, Care Sciences and Society, Division of Nursing Karolinska Institutet Solna Sweden

5. Department of Clinical Research and Education, Södersjukhuset Karolinska Institutet Solna Sweden

6. Department of Diagnostics and Intervention, Orthopaedics Umeå University Umeå Sweden

Abstract

AbstractAimTo identify, define and achieve consensus on perioperative patient safety indicators within a Swedish context.DesignA modified Delphi method.MethodsA purposeful sample of 22 experts, all experienced operating room nurse specialists, was recruited for this study. A questionnaire was constructed incorporating statements derived from a preceding study. The experts were asked to rate the importance of each statement concerning patient safety during the perioperative phase. The data collection occurred through an online survey platform between November 2022 and April 2023. The CREDES checklist guided the reporting of this study.ResultsThe three‐round Delphi study resulted in consensus on 73 statements out of 103, encompassing 74% process indicators and 26% structure indicators. Key areas of consensus included the use of the Surgical Safety Checklist and optimizing the operating room environment.ConclusionConsensus was reached on perioperative safety indicators, underscoring the intricate challenges involved in ensuring patient safety in the operating room. It emphasizes the important integration of both structure and process indicators for comprehensive safety assessment during surgical procedures. Recognizing the difficulty in measuring factors like teamwork and communication, essential for patient safety, the study offers practical guidance. It underlines a balanced approach and specific consensus areas applicable in clinical practice to enhance perioperative patient safety.Implications for the profession and patient careThis study provides concrete practice guidance and establishes a structured framework for evaluating perioperative care processes. It emphasizes the critical role of professionals having the necessary skills and being present during surgical procedures. Additionally, the study underscores the paramount importance of effective communication and teamwork within the operating room team, substantively contributing to overall patient safety enhancement.ImpactThe study focused on addressing the challenge of ensuring patient safety in operating rooms, acknowledging the persistent complications related to surgery despite global efforts to eliminate avoidable harm in healthcare. Consensus was reached on 73 crucial indicators for perioperative patient safety, emphasizing a balanced approach integrating both process and structure indicators for a comprehensive assessment of safety during surgical procedures. The study has a broad impact on professionals and healthcare systems, providing concrete guidance for practice and offering a structured process for evaluating perioperative care.Reporting MethodThe study is reported informed by ‘Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations derived from a methodological systematic review’.Patient or Public ContributionNo patient or public contribution.

Publisher

Wiley

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