Importance-Performance Analysis of Patient-Safety Nursing in the Operating Room: A Cross-Sectional Study

Figures & data

Table 1 General Characteristics of Participants (n=47)

Characteristics	Categories	n	%	Mean±SD
Gender	M	5	10.6
	F	42	89.4
Age (yr)	< 40	25	53.2	36.60±8.80
	≥ 40	22	46.8
OR career (yr)	< 10	20	42.6	13.48±10.18
	≥ 10	27	57.4
Experience of patient-safety education	< 2	29	61.7
	≥ 2	18	38.3
Experience of medical institution evaluation certification	No	7	14.9
	Yes	40	85.1
Experience of patient-safety incident	No	30	63.8
	Yes	17	36.2
Total		47	100.0

Abbreviation: OR, operation room nursing.

Table 2 Importance-Performance Comparison

No	Item	Importance (Median) M±SD	Performance (Median) M±SD	Difference M±SD	z	p
1	Compliance with hand hygiene regulations	(5) 4.85±0.36	(5) 4.68±0.56	0.17±0.48	2.309	0.021
2	Close door during surgery	(5) 4.64±0.61	(5) 4.34±0.84	0.30±0.55	3.300	0.001
3	Wearing protective equipment	(5) 4.62±0.57	(5) 4.43±0.80	0.19±0.74	1.789	0.074
4	Environmental management for surgery of infected patients	(5) 4.38±0.74	(4) 4.28±0.85	0.11±0.73	0.994	0.320
5	Surgical instruments management for infected patients	(5) 4.85±0.42	(5) 4.87±0.34	−0.02±0.39	0.378	0.705
6	Coordinate surgery schedules for infected patients	(5) 4.72±0.65	(5) 4.66±0.60	0.06±0.76	0.774	0.439
A	Infection management	(4.83) 4.68±0.36	(4.67) 4.54±0.46	0.13±0.42	2.144	0.032
7	Specimen identification and recording	(5) 4.89±0.31	(5) 4.85±0.42	0.04±0.46	0.632	0.527
8	Management according to specimen type	(5) 4.91±0.28	(5) 4.91±0.28	0.00±0.36	0.000	1.000
9	Use of exclusive containers for specimens	(5) 4.74±0.49	(5) 4.83±0.43	−0.09±0.46	1.265	0.206
10	Attach specimen label	(5) 4.87±0.40	(5) 4.96±0.20	−0.09±0.46	1.265	0.206
11	Management of human extracts	(5) 4.83±0.43	(5) 4.89±0.31	−0.06±0.53	0.832	0.405
B	Specimen management	(5) 4.85±0.25	(5) 4.89±0.25	−0.04±0.33	1.203	0.229
12	Patient identification with more than one piece of information	(5) 4.98±0.15	(5) 4.94±0.25	0.04±0.29	1.000	0.317
13	Check the surgical site mark	(5) 4.98±0.15	(5) 4.91±0.35	0.06±0.25	1.732	0.083
14	Time-out	(5) 4.79±0.51	(5) 4.74±0.61	0.04±0.66	0.312	0.755
15	Procedure in case of patient identification error	(5) 4.87±0.40	(5) 4.85±0.47	0.02±0.44	0.333	0.739
16	Check “5 Rights” before medication	(5) 4.87±0.40	(5) 4.81±0.45	0.06±0.32	1.342	0.180
C	Patient identification	(5) 4.90±0.20	(5) 4.85±0.33	0.05±0.33	0.673	0.501
17	Medical item sterilization check	(5) 4.81±0.45	(5) 4.72±0.54	0.09±0.54	1.069	0.285
18	Sealing of medical item, checking the expiry date, use	(5) 4.85±0.36	(5) 4.85±0.47	0.00±0.51	0.000	1.000
19	Gas (CO2, Argon, N2, etc.) safety check	(5) 4.38±0.74	(5) 4.30±0.91	0.09±0.93	0.613	0.540
20	Check medical equipment before surgery	(5) 4.79±0.51	(5) 4.83±0.38	−0.04±0.59	0.500	0.617
D	Medical equipment and item management	(5) 4.71±0.37	(5) 4.68±0.48	0.03±0.49	0.000	1.000
21	Storage of high-alert medications	(5) 4.81±0.50	(5) 4.94±0.25	−0.13±0.49	1.732	0.083
22	High-alert medications 5-Rights check	(5) 4.87±0.40	(5) 4.77±0.52	0.11±0.48	1.508	0.132
23	High-alert medications checked by 2 people	(5) 4.74±0.53	(5) 4.68±0.63	0.06±0.67	0.660	0.509
24	Dispose of high-alert medications immediately after use	(5) 4.68±0.56	(5) 4.70±0.55	−0.02±0.57	0.250	0.803
E	High-alert medications	(5) 4.78±0.34	(5) 4.77±0.39	0.01±0.42	0.044	0.965
25	Use only x-ray detectable surgical gauze	(5) 4.38±0.85	(5) 4.45±0.97	−0.06±0.82	0.513	0.608
26	Use gauze without cutting	(5) 4.38±0.82	(5) 4.51±0.86	−0.13±0.80	0.847	0.397
27	All counted gauze remain until surgery is over	(5) 4.96±0.20	(5) 4.94±0.25	0.02±0.25	0.577	0.564
28	Do not use count items before count is completed	(5) 4.68±0.52	(5) 4.83±0.43	−0.15±0.55	1.087	0.071
29	Checking with circulating nurse and scrub nurse during counting	(5) 4.87±0.40	(5) 4.94±0.32	−0.06±0.48	0.828	0.408
30	Check broken sharps complete	(5) 4.91±0.35	(5) 4.94±0.25	−0.02±0.39	0.378	0.705
31	After checking the gauze count, inform the surgeon and record	(5) 4.94±0.25	(5) 4.98±0.15	−0.04±0.29	1.000	0.317
32	Procedure in case of surgical count error	(5) 5.00±0.00	(5) 4.98±0.15	0.02±0.15	1.000	0.317
F	Surgical count	(4.88) 4.77±0.26	(5) 4.82±0.29	−0.05±0.31	2.110	0.035
33	Attach electrode plate to appropriate area	(5) 4.89±0.37	(5) 4.87±0.40	0.02±0.25	0.577	0.564
34	Electrode plates are used according to the patient’s age and weight	(5) 4.79±0.55	(5) 4.85±0.42	−0.06±0.38	1.134	0.257
35	Operating room environment management	(5) 4.72±0.50	(5) 4.74±0.57	−0.02±0.57	0.250	0.803
36	Check the side rail when moving the patient	(5) 4.96±0.20	(5) 4.91±0.28	0.04±0.20	1.414	0.157
37	Fix patient bed wheels	(5) 5.00±0.00	(5) 4.98±0.15	0.02±0.15	1.000	0.317
38	Safety belt use during surgery	(5) 4.91±0.28	(5) 4.83±0.43	0.09±0.46	1.265	0.206
39	Use of pressure sore prevention pads when positioning the patient	(5) 4.81±0.40	(5) 4.81±0.54	0.00±0.63	0.277	0.782
G	Damage prevention	(5) 4.87±0.21	(5) 4.86±0.26	0.01±0.22	0.021	0.984
	Total	(4.85) 4.79±0.22	(4.82) 4.78±0.24	0.02±0.26	0.126	0.900

Table 3 Differences in Importance and Performance According to General Characteristics (n=47)

Characteristics		Importance (Median) M±SD	z	p	Performance (Median) M±SD	z	p
Gender	M	(4.92) 4.90±0.12	−1.27	0.215	(4.90) 4.74±0.38	0.312	0.776
	F	(4.82) 4.78±0.22			(4.82) 4.78±0.23
Age (yr)	<40	(4.82) 4.76±0.21	−1.55	0.108	(4.77) 4.75±0.25	1.307	0.191
	≥40	(4.88) 4.83±0.22			(4.88) 4.81±0.24
OR career (yr)	0–9	(4.82) 4.74±0.23	−0.52	0.604	(4.77) 4.77±0.22	0.746	0.456
	≥10	(4.85) 4.87±0.17			(4.87) 4.78±0.29
Experience of patient safety education	≤1	(4.82) 4.77±0.23	−2.32	0.020	(4.79) 4.74±0.27	0.825	0.410
	≥2	(4.94) 4.81±0.21			(4.88) 4.80±0,22
Experience of Medical institution evaluation	No	(4.64) 4.68±0.31	0.41	0.420	(4.74) 4.70±0.34	0.495	0.629
	Yes	(4.85) 4.81±0.19			(4.87) 4.79±0.23
Experience of patient safety incident	No	(4.83) 4.79±0.20	−0.66	0.511	(4.81) 4.76±0.25	0.645	0.519
	Yes	(4.85) 4.81±0.24			(4.90) 4.80±0.23

Abbreviation: OR, operation room nursing.

Figure 1 Importance-performance analysis of patient-safety nursing.

Notes: A: infection management; B: specimen management; C: patient identification; D: medical equipment and item management; E: high-alert medications; F: surgical count; G: damage prevention.

Figure 2 Patient-safety nursing matrix.

Notes: A: infection management; B: specimen management; C: patient identification; D: medical equipment and item management; E: high-alert medications; F: surgical count; G: damage prevention.

Data Sharing Statement

Data cannot be shared publicly because of restrictions by the Konyang University Institutional Review Board. Data are available from the Konyang University Institutional Data Access/Ethics Committee for researchers who meet the criteria for access to confidential data. Data requests can be addressed to the Konyang University Institutional Review Board (82-42-600-8466, [email protected]).