Table 4 Factors influencing patient safety culture in the OR: themes, subthemes and main codes
From: Patient safety culture as perceived by operating room professionals: a mixed-methods study
Themes | Subthemes | Main codes |
|---|---|---|
Patient safety concerns | Theory–practice gap | lack of compliance to guidelines, existing knowledge (trainings, educational flyers and posters…), struggle to integrate knowledge into practice, |
Misbehavior | Ranging from laziness, lack of dynamism, tardiness and absenteeism, delaying the surgical schedule, cancelling scheduled surgeries | |
Equipment failures | Missing or unfunctional equipment leading to surgical schedule delay, an improper or lack of scheduled maintenance of OR equipment, | |
Teamwork | Sufficient support | Sufficient respect & mutual support |
Communication issues | Lack of communication, absence of communication openness, divided team, tension impairing communication, nurse/physician relationship, difficulties concerning information sharing and inclusion in the decision-making process | |
Failing AEs reporting | Underreporting | Not everything is reported, absence of an effective incident reporting system, lack of reactivity, |
Lack of freedom of expression | Professionals don’t feel free to talk about errors or report them | |
Blame culture | perceived culpability and fear of punishment when reporting an error, committing errors is treated as a lack of skills or recklessness | |
Poor working conditions | Staff shortages | Inadequate staffing compromising patient safety, unsatisfying working conditions, shifting towards the private sector, |
High workload | excessive workload, a constant climate of pressure and stress, error inducing | |
Hospital management obstacles | Inappropriate risk management strategies | Necessity of proactive strategies, should predict system weaknesses to minimize patient harm |
Absence of adequate supervision | insufficient supervision leading to disrespect of protocols, the importance of a constant practice evaluation | |
Lack of training opportunities | Existing barriers to training adherence, difficulty to have permissions, lack of scheduled educational sessions, discrepancy between teams in terms of facilitating trainings |