RESUMO
Background: Adverse effects due to surgery occur in 25% of patients, and the patient safety perception seems to differ between nurses and surgeons in the operating room (OR). This difference can be attributed to lack of communication. However, our hospital has not conducted any studies on patient safety climate (PSC) in the OR. Aims: To determine if the perception of PSC of nurses and surgeons in the OR diverges and understand whether these differences could be explained by communication gap. Methods: A total of 42 perioperative nurses and 44 surgeons in the OR of a tertiary hospital answered the Spanish version of the US Hospital Survey on PSC. This was an observational, cross-sectional study with descriptive statistics and a non-parametric test. Results: Nurses had a worse perception of the dimensions of overall safety, leader expectations, teamwork within units, feedback, staffing, and hospital management (p < .05). Although no differences were found concerning organizational learning/continuous improvement, communication openness, nonpunitive responses, and teamwork across hospital unit dimensions, the findings suggest that the nurses' perception was worse than that of the surgeons. Conclusions: In general, OR nurses have worse PSC than surgeons, mainly in the areas where communication it's important. Our study has provided the data that will enable the hospital management team to make decisions to improve the PSC in the operating room area. We recommend a more active presence of nurses in directive teams.
RESUMO
OBJECTIVE: The subcutaneous venous network (SVN) is difficult to see with the naked eye. Near infrared illumination (NIr-I) claims to improve this. The aims of this observational study were to investigate whether there are differences between the different methods; to quantify the length and diameter of SVNs; and to confirm if they differ between C0A and C1 CEAP limbs. METHODS: In total, 4 796 images, half of them from the visible spectrum (VS) and the other half from the nearninfrared spectrum (NIrS), belonging to 109 females (C0A: n = 50; C1 CEAP: n = 59) were used to establish the morphological characteristics of the SVN by visual analysis. With Photoshop CS4, SVN diameters and lengths were obtained by digital analysis of 3 052 images, once the images of whole extremities were excluded. RESULTS: On NIr-I, the diameters, trajectories, and colouration of SVNs of C1 limbs appeared more irregular than SVNs of C0A limbs. Compared with the VS images, NIr-I allowed visualisation of a greater length of the SVN in both groups (p < .010). This capacity varied from 2.6 ± 0.9 times (C1) to 16.2 ± 11.9 (C0A). While the SVN length seen in the VS images from C1 limbs was greater than observed in C0A limbs (p < .001), differences between NIr-I images only existed in the lateral part of the lower leg (p = .016). With NIr-I, the median diameter of the C1 CEAP SVN veins was 5.8 mm (interquartile range [IQR] 4.3-7.5 mm), while the median diameter in C0A SVN limbs was 2.6 mm (IQR 2.0-3.6 mm) (p < .001). CONCLUSION: The NIr-I reveals the characteristics of the SVN better than the naked eye. Further studies are required to determine the significance of the changes in the SVN in C0A and C1 limbs, and the factors causing them.
