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Received 05 March 2021; Accepted 01 April 2021.

The effect of Mobile-based Education of the Safe Surgery Principles on the Knowledge, Attitude and Performance of Operating room Surgical

Technologists

Fardin Amiri

1*

, Masoud Chahartangi

2

, Sedigheh Hannani

3

, Namamali Azadi

4

1*Assistant Professor of Nursing, Department of Operating Room, School of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran.

2Masters of Operating Room Technology, Department of Operating Room, School of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran.

3Instructor of Nursing Education, Department of Operating Room, School of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran.

4Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

ABSTRACT

Introduction: The principles of safe surgery include a monitoring system in order to reduce errors and maximize the reliability of the processes. The aim of this study was to determine the effect of mobile-based education of the safe surgery principles on the knowledge, attitude and performance of operating room surgery technologists.

Methods: This quasi-experimental study was conducted on 125 operating room surgery technologists of Iran University of Medical Sciences in 2020.The stratified method with proportional allocation was used for sampling. Data was obtained through demographic information form and researcher-made questionnaires of knowledge and attitude and checklist of operating room surgery technologist’s performance. The performance of the samples was observed and recorded by the researcher using a checklist before the training. Then, teaching the principles of safe surgery was presented for 4 sessions using mobile phone. Two weeks after the last session, a post-test was taken as a pre-test and compared with each other.

Paired t-test was used to analyze the data.

Results: Findings showed that the level of knowledge, attitude and performance of surgical technologists increased significantly after training based on mobile phone of safe surgery principles (P <0.001).

Conclusion: Considering the positive effect of mobile-based training of safe surgery principles on the level of knowledge, attitude and performance of operating room surgery technologists, it is suggested that this training method be used to teach safe surgery principles to operating room surgery technologists.

KEYWORDS

Principles of Safe Surgery, Mobile-Based Education, Knowledge, Attitude, Performance, Operating Room Surgery Technologists.

Introduction

Nowadays, patient safety is an important issue in clinical practice worldwide (1). Patient safety is a health care discipline that emerged with the evolving complexity in health care systems and the resulting rise of patient harm in health care facilities. It aims to prevent and reduce risks, errors and harm that occur to patients during provision of health care. The principles of safe surgery include the establishment of a monitoring system that minimizes errors and maximizes the reliability of the process(2). Undoubtedly, providing the required security in the operating room is a team work and everyone has a joint responsibility to ensure the safety of themselves and the patient (3). General principles of safe surgery include 3 steps, the first step includes: surgery on the correct patient and in the correct position, and the second step includes marking the surgical site, and the third step includes the interruption / delay of surgery, as well as the safety of anesthesia (4). Evidence shows that 10% of patients in hospitals suffer from medical errors, while the errors are prevent able in half of them(1).Incidence of patient safety events is 850,000 out of a total of 8 million cases per year in the UK, with an estimated of over 2 billion pound per day for hospitalization cost(5).

The operating room, as one of the main units in the hospital, is an important place for the treatment of the patient.

Observance of safety points is very important for patients and staff due to physical characteristics, available medical gases, and use of different electrical devices (6). In this regard, effective management is necessary to coordinate with rapid changes in order to ensure the safety of staff and patients in the operating room(7). The study of safe surgery can be studied from several aspects, such as infection in the operating room, fire protection, staff safety, physical and construction space of the operating room(8). Every year in Italy, about 8 million patients undergo surgery, of which 4% (320,000) suffer avoidable injuries due to mistakes or poor service delivery (9). Some previous studies have

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Received 05 March 2021; Accepted 01 April 2021.

shown that between 3 and 17% of hospital admissions have caused an unwanted injury to the patient, so that 30 to 70% of these events were preventable (10).

A study by Christine et al. (2006) found that employee communication, information loss, increased workload, and job responsibilities are the greatest threats to patient safety and security in the operating room(11). Complications of surgery are a significant cause of death and disability worldwide(12). According to the World Health Organization, data extracted from 56 countries showed that 187 to 281 million surgeries were performed in 2004 in the world(1 surgery for every 25 people), of which approximately at least 7 million people are injured as a result of surgery each year(13).Despite sending about four warnings to the hospital regarding the safety of the environment, but unfortunately due to the negligence of the authorities, a fire broke out in Sina Athar Clinic in Tehran (Tehran, Iran) resulting in the loss of a number of staff and clients(14).Increasing knowledge and improving employee's attitudes toward implementing these principles will lead to better performance. Studies show that staff knowledge is insufficient in this field (15, 16). Studies have also shown that employees do not have an appropriate attitude and performance in this regard(17). To solve this problem, there are various solutions, including education of the safe surgery principles with different methods. The results of Kiani et al. (18) showed that face-to-face safety education increases knowledge and consequently employee's attitudes. The low percentage of positive attitudes seems to indicate the need for a comprehensive approach to improving the safety situation in hospitals (19). Virtual education is one of the educational methods by which the appropriate educational content can be taught without the presence of people and at a lower cost, and also due to the corona virus pandemic, this type of education has become of special importance in the world (20). In Iran, this training method has not been used to teach the principles of safe surgery.

Evidence shows that in clinical settings, especially in the operating room, standards and principles related to safe surgery are sometimes ignored by managers and medical staff. On the other hand, operating room medical staff may not be familiar with the rules and standards of safe surgery. Thus, the first step to achieve this is to raise knowledge, attitude and performance of the medical staff in this field. Therefore, the present study was conducted to investigate the effect of mobile-based education of the safe surgery principles on the knowledge, attitude and performance of operating room surgery technologists in educational centers of Iran University of Medical Sciences.

Methods

The present quasi-experimental study was conducted as an educational intervention in 2020. A total of 125 operating room surgery technologists in 10 hospitals affiliated to Iran University of Medical Sciences in Tehran were enrolled in a stratified method with proportional allocation. The number of samples was calculated using the formula for determining the number of samples with alpha 0.05 and power 0.8. Inclusion criteria included surgical technologists with associate degree and above, non-participation in any workshop on patient privacy principles during the past year, and having a work experience of at least 6 months, and exclusion criteria included a defect in the questionnaire.

Consent form was obtained from all the samples to participate in the research and they were assured that the results of this project will be used only for research work. Data collection tools included a demographic characteristics form, a researcher-made questionnaire on the level of knowledge and attitude, and a researcher-made checklist to evaluate the performance of surgical technologists on the principles of safe surgery. The first part of the questionnaire includes demographic information of the samples such as age (year), gender (male or female), marital status (single, married, deceased and divorced spouse), income level (sufficient, not sufficient), college degree (associate, bachelor, master). The second part of the questionnaire included questions to assess the knowledge and attitude of surgical technologists about the principles of safe surgery and a researcher-made checklist to examine the performance of surgical technologists on the principles of safe surgery. The researcher-made questionnaire of the knowledge of surgical technologists about the safe surgery principles consisted of 38 questions. Each item was measured using a three-point scale including true [1], do not know [0] and false [-1]. Knowledge score is the sum of all questions ranging from -38 to 38. The level of knowledge of individuals was divided into three categories: poor, moderate and good. Thus, scoring less than 50% indicated poor knowledge, between 50% and 75% considered as average knowledge and more than 75% was good knowledge. Also, a researcher-made questionnaire to examine the attitudes of surgical technologists about the principles of safe surgery included 13 items, each of which was measured using a three-point scale, I agree [3], I have no opinion [2] and I disagree [1]. Attitude score is the sum of the total questions, which ranges from 13 to 39. In the end, the attitude of individuals was divided into three categories: poor (score: less than 50%), moderate (score: between 50 to 75%) and good (score: above 75%). Also, the researcher-made checklist for evaluating the performance of surgical technologists on the principles of safe surgery included 27 items, each of which was measured using a two-point scale of yes [1] and no [0]. The performance score is equal to the sum of the

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Received 05 March 2021; Accepted 01 April 2021.

total performance questions, which ranges from 0 to 27. At the end, the performance of individuals was divided into three categories: poor (0 to 9), moderate (10 to 18) and good (19 to 27).

Content validity was used to determine the validity of the knowledge and attitude questionnaire and performance checklist, so that the questionnaires and checklist were provided to 10 faculty members of the operating room of Tehran University of medical sciences. Reliability of knowledge questionnaire [0.78] and attitude [0.85] were determined using Cronbach's alpha method and the reliability of performance checklist [0.86] was determined by simultaneous evaluation method. The results show that the questionnaires used have the necessary reliability. The total sampling time was about 6 months. Statistical analysis was performed using SPSS software version 16 at two levels of descriptive (mean and standard deviation) and inferential (Paired t-test). The significance level was considered less than 0.05.

The researcher referred to the research environment in order to conduct the research. First, a pre-test was taken from the samples so that the knowledge and attitude questionnaires about the principles of safe surgery were completed by individuals before the training. The performance of surgical technologists was observed by the researcher and recorded in the checklist (to eliminate the effect of the researcher's presence on the performance of surgical technologists, they were informed that their performance was observed three times and recorded only once). Then, the principles of safe surgery were taught via mobile phone by messengers (Soroush, Bale, iGap) in 4 sessions with one week intervals from each other. Finally, two weeks after the end of the last training session, a post-test was taken and the results obtained were compared with the pre-test results.

Ethical considerations: This research has been approved by the ethics committee of Iran University of Medical Sciences (Ethics code: IR.IUMS.REC/1399.718) and all ethics requirements were observed related to research.

Results

Table 1. Frequency distribution of demographic variables of the subjects

Variable N %

Age group (year)

20-27 28-36 37-43 44 ≤ Total

48 36 22 19 125

38.4 28.8 17.6 15.2 100.0 Gender

Male Female Total

77 48 125

61.6 38.4 100.0

Marital status

Single Married Divorced Deceased spouse Total

65 53 5 2 125

52.0 42.4 4.0 1.6 100.0 Level of education

Operating room - associate Operating room- bachelor Total

45 80 125

36.0 64.0 100.0 Income

Sufficient Insufficient Total

68 57 125

54.4 45.6 100

Work experience (year) 0-5 6-10 11-15 16-20 20<

Total

47 35 16 24 3 125

37.6 28.0 12.8 19.2 2.4 100.0

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Received 05 March 2021; Accepted 01 April 2021.

The present study was conducted in the operating room (General, Neurology, Dermatology, Orthopedics, Ophthalmology, Gynecology, ENT, Pediatrics, Urology and Cardiology) affiliated to Iran University of Medical Sciences. Out of 125 participants in the present study 77 (61.6%) were male and 48 (38.4%) were female. Most of the samples in the study (52%) were single in terms of marital status. Most of the subjects in the study (64.0%) had a bachelor's degree of operating room. Most of the samples in the study (38.4%) were between 20 and 27 years old.

Also, most of the samples in the study (37.6%) had a work experience of 0 to 5 years. The variables of age, gender, and marital status, level of education, income, and work experience are presented in Table 1. The average scores obtained from knowledge questions for surgical technologists were 17.05 ± 2.75 in the pre-test, which increased to 17.20 ± 2.59 after the intervention (P< 0.001). Also, the average scores obtained from the attitude questions for surgical technologists were 47.68 ± 3.30 in the pre-test, which increased to 49.11 ± 5.45 after the intervention (P<

0.001). The mean scores obtained from performance questions for surgical technologists were 32.32 ± 5.89 and 34.22

± 5.99 in pre-test and after intervention, respectively (P< 0.001, Table 2).

Table 2. Effect of mobile-based education of the safe surgery principles on the knowledge, attitude and performance of operating room surgical technologists

P-Value Statistics

Means±SD Stage

Questions

<0.001 t= 0.861

t= 0.01 17.05 ± 2.75

Before training Knowledge

17.20 ± 2.59 After training

<0.001 t= 0.778

t= 0.001 47.68 ± 3.30

Before training Attitude

49.11 ± 5.45 After training

<0.001 t= 0.118

t= 0.022 32.32 ± 5.89

Before training Performance

34.22 ± 5.99 After training

Discussion

The results showed that the level of knowledge of surgical technologists increased significantly after mobile -based education of the safe surgery principles (P<0.001). The results of Pakzad et al. )21( showed that virtual patient safety education increases the safety culture in nurses. Also, the study of Azimi et al. )22 ( showed that all aspects of patient safety culture among nurses participating in the training program were significantly improved compared to before the intervention. Also, regarding the effect of mobile-based education on knowledge, we can refer to the study of Amiri et al. )23(which showed that the level of knowledge of operating room staff increased significantly after mobile- based education on the principles of patient privacy. Hashemiparast et al. )24(also showed that e-learning increases the knowledge of hospital staff about controlling nosocomial infections.The results of a study by Sung et al. )25 ( showed that combined e-learning is effective in increasing nurse's knowledge about drug therapy.

The results of the present study indicate a significant increase in the attitude of surgical technologists as a result of mobile-based education on the principles of safe surgery (P<0.001). Pourteimour et al. )26( reported that the average attitude of nurses has increased significantly after e-learning to prevent medication errors.Borhani et al. )27( also reported that the attitude of nursing students has increased significantly towards virtual education after the virtual educational intervention.The results of the study by Abu AlRub et al. )28(with the aim of evaluating the effectiveness of a 7-session online video training program, showed that the attitude of nurses towards patient safety improvedafter the educational intervention.The results of the present study showed that the performance of surgical technologists increased significantly after virtual training of the principles of patients safe surgery (P<0.05). Bloomfield et al. )29( showed that computer-assisted learning is an effective method of teaching both theoretical and practical hand washing in nursing students. The study of Mettiäinen et al. )30( shows the positive effect of web-based training courses on the practical competence of nursing students. A 2007 study on mobile-based education was conducted by Kumar et al. (31) in India. The results of their study showed that 69.2% of participants considered mobile as an immediate tool in their effective learning and 72.2% considered mobile learning as a new opportunity and 66.2% of participants considered mobile learning as fast feedback. 73.4% of the respondents believed that the mobile learning method has flexibility in time and space and is more inclusive.Therefore, it can be said that the path of learning is expanding through distance learning to e-learning and from e-learning to mobile learning (m-learning). Mobile phones have been able to change the traditional method of face-to-face training and provide a new definition of training. It has also provided learners with opportunities to learn at home, at work, and travel, and has overcome many limitations. Research has shown that learners are interested in learning by mobile and think that mobile learning is one of the programs of hope for the future (32).

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Received 05 March 2021; Accepted 01 April 2021.

Conclusion

It seems that increasing the knowledge, attitude and performance of surgical technologists after mobile-based education on the principles of safe surgery is due to the availability, attractiveness, low cost and convenience of this training method.

Acknowledgments

We would like to thank all the participants and officials of the teaching hospitals of Iran University of Medical Sciences who cooperated with this study.

Authors Contributions

All authors participated in the initial writing or revision of the article and accept responsibility for the accuracy of the content.

Conflict of Interest

The authors state that there is no conflict of interest in the present study.

References

[1] Targett K. An introduction to clinical governance and patient safety. Oxford University Press; 2011.

[2] Nakhleh REJAop, medicine l. Patient safety and error reduction in surgical pathology. 2008;132(2):181-5.

[3] Musavi SJJoGUoMS. Professional problems in the operating room from employee working in operating rooms in Iran. 2003;12(47):73-9.

[4] Mostofian F. Safe Surgery Guide. Ministry of Health and Medical Education 2014.

[5] Thomas A, Panchagnula UJA. Medication‐related patient safety incidents in critical care: a review of reports to the UK National Patient Safety Agency. 2008; 63(7): 726-33.

[6] Mousavi SMH, Dargahi H, Hasibi M, Mokhtari Z, Shaham GJJoPS. Evaluation of safety standards in operating rooms of Tehran University of Medical Sciences (TUMS) Hospitals in 2010. 2011; 5(2): 10-7.

[7] Papaspyros SC, Javangula KC, Prasad Adluri RK, O'Regan DJJIc, surgery t. Briefing and debriefing in the cardiac operating room. Analysis of impact on theatre team attitude and patient safety. 2010; 10(1): 43-7.

[8] Jalali H, Asl EB, Mehr AM, Pourafzali SM, Ghasemi MJAJoNE, Research. Prevention and control of operating room fires: Knowledge of staff employed by selected hospitals of Isfahan University of Medical Sciences. 2016; 6(3): 342-6.

[9] Gawande AJNYT. A lifesaving checklist. 2007; 30.

[10] Weiser TG, Haynes AB, Molina G, Lipsitz SR, Esquivel MM, Uribe-Leitz T, et al. Size and distribution of the global volume of surgery in 2012. 2016; 94(3): 201.

[11] Christian CK, Gustafson ML, Roth EM, Sheridan TB, Gandhi TK, Dwyer K, et al. A prospective study of patient safety in the operating room. 2006; 139(2): 159-73.

[12] Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat A-HS, Dellinger EP, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. 2009; 360(5): 491-9.

[13] Pacini D, Leone A, Di Marco L, Marsilli D, Sobaih F, Turci S, et al. Antegrade selective cerebral perfusion in thoracic aorta surgery: safety of moderate hypothermia. 2007; 31(4): 618-22.

[14] Zibrowski E, Shepherd L, Booth R, Sedig K, Gibson C. A qualitative study of the theory behind the chairs:

Balancing lean-accelerated patient flow with the need for privacy and confidentiality in an emergency medicine setting. Journal of Medical Internet Research. 2019; 21(2).

(6)

Received 05 March 2021; Accepted 01 April 2021.

[15] Pakzad N, Norouzi K, Fallahi Khoshknab M, Norouzi M. A Comparison of the Effect of Virtual and Lecture-Based Patient Safety Education on Patient Safety Culture among Nurses %. J Qom Univ Med Sci J.

2016; 10(9): 27-34.

[16] Ara, R., Mohammad Reza. Prioritization of effective factors on patient safety and the effect of educational interventions on it in the hospitals of Gonabad University of Medical Sciences, in 2013. Gonabad University of Medical Sciences.

[17] Zaravoshani V, Sheikhi S, Amini M, Mohammadi Zaidi I. Survey of safety attitude of operating room staff working in teaching hospitals of Qazvin University of Medical Sciences. Safe Society Conference. 2009; 2.

[18] Kiani F, Samavatian H, Pourabdian S, Mansournejad Z, Jafari J. The effectiveness of safety training on changing employees' attitudes toward safety issues and its dimensions: A pathological study. 2011; 9 (2).

[19] Mohammadfam IJJMM. Application of safety signs in controling unsafe acts rate. 2010; 12(1): 39-44.

[20] GhafouriFard M. The boom in e-learning in Iran: The potential of the Corona virus. 2020; 33: 4-20.

[21] Pakzad N, Tabrizi N, Kian F, Khoshknab M, et al. Comparison of the effect of patient safety training program, virtually and lecture on nurse's patient safety culture. 2016; 10 (9): 27-34.

[22] Azimi L, Tabibi SJ, Maleki MR, Nasiripour AA, Mahmoodi M. Influence of training on patient safety culture: a nurse attitude improvement perspective. 2012.

[23] Amiri F, Neshati A, Hannani S, Azadi NJAotRSfCB. Effect of Mobile-Based Education of Patient's Privacy Protection Principles on the Knowledge, Attitude and Performance of Operating Room Staff. 2021; 25(6):

6876-82.

[24] Hashemiparast MS, Sadeghi R, Ghaneapur M, Azam K, Tol AJJoPS. Comparing E-learning and lecture- based education in control of nosocomial infections. 2016; 10(3): 230-8.

[25] Sung YH, Kwon IG, Ryu EJNet. Blended learning on medication administration for new nurses:

integration of e-learning and face-to-face instruction in the classroom. 2008; 28(8): 943-52.

[26] Sima P, Masoumeh H, Madineh J. The effect of e-learning on knowledge, attitude and performance of nursing students about the prevention of medication errors in the pediatric ward.

[27] Borhani F, Vatanparast M, Abbaszadeh A, Seyfadini R. The Effect of Training in Virtual Environment on Nursing Students Attitudes toward Virtual Learning and its Relationship with Learning Style % J Iranian Journal of Medical Education. 2012; 12(7): 508-17.

[28] Abu AlRub RF, Abu Alhijaa EH, editors. The impact of educational interventions on enhancing perceptions of patient safety culture among Jordanian senior nurses. Nursing forum; 2014: Wiley Online Library.

[29] Bloomfield J, Roberts J, While AJIjons. The effect of computer-assisted learning versus conventional teaching methods on the acquisition and retention of handwashing theory and skills in pre-qualification nursing students: a randomised controlled trial. 2010; 47(3): 287-94.

[30] Mettiäinen S, Luojus K, Salminen S, Koivula MJNEiP. Web course on medication administration strengthens nursing students' competence prior to graduation. 2014; 14(4): 368-73.

[31] Kumar B. The international review of research in open distance learning, India, open university. 2007.

[32] Varney H, Kriebs JM, Gegor LC. Varney ׳Smidwifery. 4th Edition, Sudbury Mass: Jones & Bartlet: Uk, 2004.

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