文章基本信息

标题：Building shared situational awareness in surgery through distributed dialog
本地全文：下载
作者：Brigid M Gillespie ; Karleen Gwinner ; Nicole Fairweather 等
期刊名称：Journal of Multidisciplinary Healthcare
印刷版ISSN：1178-2390
电子版ISSN：1178-2390
出版年度：2013
卷号：6
页码：109-118
DOI：10.2147/JMDH.S40710
出版社：Dove Medical Press Ltd
摘要：Background: Failure to convey time-critical information to team members during surgery diminishes members' perception of the dynamic information relevant to their task, and compromises shared situational awareness. This research reports the dialog around clinical decisions made by team members in the time-pressured and high-risk context of surgery, and the impact of these communications on shared situational awareness. Methods: Fieldwork methods were used to capture the dynamic integration of individual and situational elements in surgery that provided the backdrop for clinical decisions. Nineteen semistructured interviews were performed with 24 participants from anesthesia, surgery, and nursing in the operating rooms of a large metropolitan hospital in Queensland, Australia. Thematic analysis was used. Results: The domain "coordinating decisions in surgery" was generated from textual data. Within this domain, three themes illustrated the dialog of clinical decisions, ie, synchronizing and strategizing actions, sharing local knowledge, and planning contingency decisions based on priority. Conclusion: Strategies used to convey decisions that enhanced shared situational awareness included the use of "self-talk", closed-loop communications, and "overhearing" conversations that occurred at the operating table. Behaviors that compromised a team's shared situational awareness included tunneling and fixating on one aspect of the situation.
关键词：shared situational awareness; surgery; distributed dialog