C. Mitchell1, L. Butler1, A. Kozlow1, R. Cintron2, C. Greenberg2, L.B. Marks3,4, J.H. Ra2,5, L. Mazur1,6 1University Of North Carolina At Chapel Hill, Division Of Healthcare Engineering, Chapel Hill, NC, USA 2University Of North Carolina At Chapel Hill, Department Of Surgery, Chapel Hill, NC, USA 3University Of North Carolina At Chapel Hill, Department Of Radiation Oncology, Chapel Hill, NC, USA 4University Of North Carolina At Chapel Hill, UNC Health, Chapel Hill, NC, USA 5University Of North Carolina At Chapel Hill, Division Of Acute Care Surgery, Chapel Hill, NC, USA 6University Of North Carolina At Chapel Hill, School Of Information And Library Science, Chapel Hill, NC, USA
Introduction: The use of temporary nursing and operating room staff has increased over the years, particularly since the COVID-19 pandemic. Despite this trend, there has been limited research on how temporary staffing affects teamwork and adherence to standardized safety behaviors in the operating room.
Methods: Safety behaviors during surgical cases were observed and evaluated using the validated Teamwork Evaluation of Non-Technical Skills (TENTS) instrument at a large academic hospital. Mean scores for each of the 20 TENTS metrics were calculated for cases involving temporary staff and compared to cases with only permanent staff using two-sample t-tests. Additionally, analysis of variance (ANOVA) was conducted to assess safety behaviors across three scenarios: cases with only permanent staff, cases with either one temporary scrub technician or circulating nurse, and cases with both a temporary scrub technician and circulating nurse.
Results: Analysis of data from 100 surgical cases showed that all TENTS safety behavior scores averaged above 2, indicating acceptable levels of observed behaviors. Statistical analysis revealed no significant differences (p > 0.05) in TENTS scores between cases with temporary staff (N = 47) and those with only permanent staff (N = 53). ANOVA also showed no significant differences (p > 0.05) in any TENTS metrics among the different staff compositions.
Conclusion: Standardized assessments of surgical cases revealed no significant differences in safety behaviors between permanent and temporary OR staff, regardless of the role of the temporary staff member. This suggests that OR teams, including those with temporary personnel, maintain appropriate safety behaviors. These results may reflect effective leadership, standardized teamwork and communication protocols, or a strong safety culture at the institution. Given the increasing use of temporary staff, further research is needed to assess their impact on patient safety and clinical outcomes, as well as to establish best practices for their integration into hospital teams.