Communication in the Surgical Environment to Promote a Climate of Safety: Implementation of Evidence

The aim of the study is to identify whether the implementation of a surgical briefing protocol promotes the strengthening of the 'communication in the surgical environment' domain of safety climate in the operating room. A multi-method study is proposed to be developed in the surgical center of a university hospital located in the city of Rio de Janeiro. The study will be carried out in two phases: In Phase I, a surgical briefing protocol will be developed, validated and implemented that will follow the JBI (Joanna Briggs Institute) methodology of evidence implementation. As a support for methodological rigor, the tool SQUIRE2.0 (Standards for QUalityImprovement Reporting Excellence): revised publication guidelines from a detailed consensus process will be used. Finally, Phase II will have a quantitative approach with a cross-sectional design, using the Safety Attitudes Questionnaire/Operating Room (SAQ/OR). As a support for methodological rigor, the tool Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) will be used. The population will be composed of: nurses, nursing technicians, surgeons and anesthesiologists who work in orthopedic surgery and management of the unit. Regarding sampling, for Phase I of the study, a focus group will be constituted, called a working group (WG), adopting an intentional sampling, ensuring the participation of all health professional categories that work in orthopedic surgery. The inclusion criteria will be health professionals who work at least 20 hours per week, working in orthopedic surgeries and/or managers of the surgical center. For the validation stage, professionals withhigher education with specialization in the operating room (for nursing professionals) or orthopedic surgery (for medical professionals) will be adopted as inclusion criteria, as well as professors and researchers whose lines of research are directly related to surgical communication, patient safety and safety culture. For Phase II, a non-probabilistic sampling will be adopted, the sample calculation will be performed with the aid of the EpiInfo v5.5.9 application, adopting a confidence level of 95%. For this sample, health professionals who work at least 20 hours a week, who work directly or indirectly in patient care and who have been working in the sector for at least one month will be adopted as inclusion criteria. The exclusion criteria were the professionals who will compose the focus group. It is expected to implement a surgical briefing protocol and advance in the implementation of evidence to promote the maturation of the safety culture in the operating room, fostering safer surgical care, especially in this highly specialized sector that is the operating room. In addition to encouraging future studies involving the science of implementation in safety culture, allowing research to be truly focused on the best available evidence. It is intended that the research serves as a source of data on patient safety in the surgical environment and offers an innovative model to evaluate and intervene in complex aspects of the safety culture, involving professionals and senior management in health in the surgical environment.