Concerns About Verbal Communication in the Operating Room: A Field Study.

OBJECTIVE: To assess verbal communication patterns which could contribute to poor performance among surgical team members in an operating room. BACKGROUND: There exist certain challenges in communication in health care settings. Poor communication can have negative effects on the performance of a surgical team and patient safety. A communication pattern may be associated with poor performance when the process of sending and receiving information is interrupted or the content of conversation is not useful. METHOD: This cross-sectional field study was conducted with 54 surgical teams working in two Iranian hospitals during 2015. Two observers recorded all verbal communications in an operating room. An in-depth assessment of various annotated transcripts by an expert panel was used to assess verbal communication patterns in the operating room. RESULTS: Verbal communication patterns which could contribute to poor performance were observed in 63% of the surgeries, categorized as communication failures (17 events), protests (23 events), and irrelevant conversations (164 events). The anesthesiologists and the circulating nurses had the most concerning communication patterns. The failure of devices and poor planning were important factors that contributed to concerning patterns. CONCLUSION: Concerning patterns of verbal communication are not rare in operating rooms. Analyzing the annotated transcripts of surgeries can conduce to identifying all these patterns, and their causes. Concerning communication patterns can be reduced in the operating room by providing interventions, properly planning for surgeries, and fixing defective devices. APPLICATION: The method used in this study can be followed to assess communication problems in operating rooms and to find solutions.

Assessment of occupational safety, health, and ergonomics issues in agriculture in some cities of Iran.

BACKGROUND: Iran has a variety of climates which support agriculture in different seasons. Hence, a significant proportion of people, especially in rural areas, are engaged in farming. Agriculture is considered one of the most insecure job sectors in developing and developed countries. OBJECTIVE: Since there is no comprehensive study on safety, health, and ergonomics issues in Iran's agriculture, it is necessary to use checkpoints to assess occupational safety, health, and ergonomics issues in Iran's agriculture. METHODS: In this study, 430 villages from seven provinces of Iran were selected to study safety, health, and ergonomics in agriculture using ergonomic checkpoints. The checkpoints were collected with the help of rural health centers. RESULTS: The results of the study showed that the villages of Kurdistan Province had the best safety, health, and working conditions (66.12%); and Khuzestan province villages had the worst safety, health, and working conditions (38.16%). Among the ergonomic checkpoints in agriculture, the control of hazardous chemicals (CHC) index with 71.41% and work organization and work schedule (WOWS) index with 35.25% represented the best and worst ergonomic conditions of the study villages, respectively. Furthermore, the general index of ergonomics in agriculture for the study villages was 53.64%. Therefore, Khuzestan Province and the WOWS index top the priorities for corrective actions to improve the safety, health and working conditions in agriculture. CONCLUSIONS: The ergonomics indices in Iranian agriculture are important, and should be prioritized for corrective actions.