|
|
|
| Qualitative study on the barriers to the implementation of thermal insulation measures in the perioperative period |
| MA Wenjuan1,2 ZHANG Hongyan3 LI Li1,2▲#br# |
1.School of Nursing, Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi 830000, China;
2.Operating Room, the First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi 830000, China;
3.Disinfection Supply Room, the First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi 830000, China |
|
|
|
Abstract Objective To explore the barriers to the implementation of thermal insulation measures in the perioperative period, to provide a reference for the targeted optimization team to implement body temperature management. Methods After the approval of the Ethics Committee of the First Affiliated Hospital of Xinjiang Medical University, a purpose-based sampling method was used from December 2020 to May 2021. A total of 43 nurses, anesthesiologists, anesthesiologists and surgeons were selected for semi-structured interviews. Based on the theoretical domain framework, an interview outline was developed and the interview content was recorded and transcribed. The interview recording was coded using direct content analysis, and the relevant theoretical domain framework (TDF) domains that affected the implementation of perioperative insulation measures were identified. Results After 43 interviews, the data reached saturation. This study identifies barriers related to 11 domains of the theoretical domain framework, namely knowledge, skills, memory attention and decision-making processes, social/professional roles and identities, environmental context and resources, beliefs about abilities, emotions, social influences, reinforcement, behavior regulation, and information about consequences. Conclusion Based on the theoretical domain framework, the surgical team has insufficient knowledge and skills to implement perioperative thermal insulation; insufficient thermal insulation resources and management; lack of supervisory feedback and poor communication and collaboration obstacles.
|
|
|
|
|
|
[1] 贾风菊，李丽，孙奇，等.开腹手术患者术中保温方法的探讨[J].中华现代护理杂志，2016，22（10）：1362-1366.
[2] Duff J，Walker K，Edward KI，et al. Effect of a thermal care bundle on the prevention，detection，and treatment of perioperative inadvertent hypothermia [J]. J Clin Nurs，2018，27（5/6）：1239-1249.
[3] Yi J，Zhan L，Lei Y，et al. Establishment and Validation of a Prediction Equation to Estimate Risk of Intraoperative Hypothermia in Patients Receiving General Anesthesia [J]. Scientific Reports，2017，7（1）：13927.
[4] Atkins L，Francis J，Islam R，et al. A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems [J]. Implement Sci，2017，12（1）：77.
[5] Poet S，Patey AM，Baron JS，et al. Factors that influence effective perioperative temperature management by anesthesiologists：a qualitative study using the Theoretical Domains Frameworkl [J]. Can J Anaesth，2017，64（6）：581-596.
[6] Smith JD，Corace KM，MacDonald TK，et al. Application of the Theoretical Domains Framework to identify factors that influence hand hygiene compliance in long-term care [J]. J Hosp Infect，2019，101（4）：393-398.
[7] Presseau J，Mutsaers B，Al-Jaishi AA，et al. Barriers and facilitators to healthcare professional behaviour change in clinical trials using the Theoretical Domains Framework：A case study of a trial of individualized temperature-reduced haemodialysis [J]. Trials，2017，18（1）：227.
[8] Munday J，Delaforce A，Forbes G，et al. Barriers and enablers to the implementation of perioperative hypothermia prevention practices from the perspectives of the multidisciplinary team：A qualitative study using the Theoretical Domains Framework [J]. J Multidiscip Healthc，2019，12：395-417.
[9] 陈向明.质的研究方法与社会科学研究[M].北京：教育科学出版社，2000.
[10] Hsieh HF，Shannon SE. Three approaches to qualitative COntent analysis [J]. Qual Health Res，2005，15（9）：1277-1288.
[11] Torossian A，Brauer A，Hocker J，et al. Preventing inadvertent perioperative hypothermia [J]. Dtsch Arztebl Int，2015，112（10）：166-172.
[12] Scott AV，Stonemetz JL，Wasey JO，et al. Compliance with surgical care improvement project for body temperature management （SCIP Inf-10） Is associated with improved clinical outcomes [J]. Anesthesiology，2015，123（1）：116-125.
[13] Sun Z，Honar H，Sessler D，et al. Intraoperative core temperature patterns，transfusion requirement，and hospital duration in patients warmed with forced air [J]. Anesthesiology，2015，122（2）：276-285.
[14] Giuliano KK，Hendricks J. Inadvertent perioperative hypothermia：current nursing knowledge [J]. AORN J，2017， 105（5）：453-463.
[15] Torossian A. Thermal management during anaesthesia and thermoregu lation standards for the prevention of inadvertent perioperative hypothermia [J]. Best Pract Res Clin Anaesthesiol，2008，22（4）：659-668.
[16] Soysal GE，lice A，Erkol MH. Effect of “an innovative technology” active warming and passive warming on unplanned hypothermia during perioperative period：a clinical trial [J]. Ther Hypothermia Temp Manag，2018，8（4）：216-224.
[17] Hopf HW. Perioperative temperature managementtime for a new standard of care [J]. Anesthesiology，2015，122（2）：229-230.
[18] Duryea EL，Nelson DB，Wyckoff MH，et al. The impact of ambient operating room temperature on neonatal and maternal hypothermia and associated morbidities：a randomized controlled trial [J]. Am J Obstet Gynecol，2016， 214（4）：505.e501-e507.
[19] Amaniyan S，Faldaas BO，Logan PA，et al. Learning from Patient Safety Incidents in the Emergency Department：A Systematic Review [J]. J Emerg Med，2020，58（2）：234-244.
[20] 柯胜男.手术室护理安全管理评价指标体系的构建策略探讨[J].实用临床护理学杂志，2017，2（4）：195-198.
[21] G?觟rges M，West NC，Whyte SD. Using physiological monitoring data for performance feedback：an initiative using thermoregulation metrics [J]. Can J Anaesth，2017，64（3）：245-251.
[22] Pimentel MPT，Choi S，Fiumara K，et al. Safety Culture in the Operating Room：Variability Among Perioperative Healthcare Workers [J]. J Patient Saf，2021，17（6）：412-416.
[23] Ridelberg M，Roback K，Nilsen P. How Can Safer Care Be Achieved? Patient Safety Officers’ Perceptions of Factors Influencing Patient Safety in Sweden [J]. J Patient Saf，2020，16（2）：155-161.
[24] Tveit C，Belew J，Noble C. Prewarming in a pediatric hospital：process improvement through interprofessional collaboration [J]. J Perianesth Nurs，2015，30（1）：33-38.
[25] 蔡志敏，谢士芳，丁金玲，等.多学科团队协作在房颤患者门诊综合管理中的干预研究[J].护理学报，2019，26（10）：57-60. |
|
|
|
