Journal of

Background:In the healthcare system, teamwork is important to improve the quality of services and provide safe and effective cares. Operation room, as a high-risk environment, requires high levels of teamwork employees to secure performance. This study aimed at assessing the teamwork among surgical teams of hospitals affiliated to Social Security Organizations in Tehran City.

Materials and Methods: In this cross-sectional study "Observational Teamwork Assessment for Surgery" checklist was used to evaluate teamwork skill in surgical teams. Sixty surgical teams from two hospitals were assessed. In order to data analysis, descriptive statistics was used to calculate mean and standard deviation of age, work experience and teamwork scores in surgical, nursing and anesthesia sub teams. Two-Way ANOVA test was used to study relationship between scores of three surgical phases, sub teams and behaviors domains.

Results: Mean and standard deviation of age and work experience of participants were 42.81±8.57 and 10.62±6.18 years, respectively. Mean score of teamwork was 3.60±0.51 (out of 6) that showed higher than average team performance level. Among three sub teams, nursing achieved the highest score (3.78±0.44). There was a significant difference between nursing sub team and others (p<0.05).

Conclusion: Although mean score of teamwork was in higher than average level in studied teams, but discrepancies between three sub teams were high and worrisome. Use of educational solutions utilization can be effective to improve teamwork and increase quality of behaviors in operation room. 

Background:Human reliability assessment consists ofusing quantitative and qualitative methods to predict human contribution to the occurrence of error;so, using reliability assessment techniques is necessary to prevent and limit the consequences of errors in sensitive work environments.Healthcare considers as the high-risk areas.With due attention to the high rates of cesarean section in Iran, this study aimed at evaluating human reliability during this operation.
Materials and Methods:This was a qualitative-descriptive study which was performed as a cross-sectional one using the EMEA technique. At first, the process of operation was divided in to tasks and sub-tasks using the method of hierarchical task analysis. Then, according to the EMEA instructions, the work sheet was completed for all personnel in the operating room.
Results: A total of 126 errors, including 40 errors (31.75%) related to circular nurse activities, 34 errors (26.98%) related to anesthesia activities, 33 errors (26.19%) related to scrub nurse activities and 19 errors (15.08%) related to the activities of the surgeon, were identified.In general, skill-based errors (51.59%)  and judgment-based errors (1.59%) were the highest and the lowest amount, respectively.
Conclusion:According to the study results, among three working groups, skill-based errors forcircularand scrub nurses and anesthesiology expert with the most frequency, and knowledge-based errorsfor surgeon tasks, with the highest frequency should be considered as priorities tocontrol errors.