Operating room team's perception of procedure shift to cemented hemiarthroplasty

Abstract

Introduction: A procedural change in the treatment of patients with femoral neck fracture from uncemented to cemented hemiarthroplasty was to be implemented to follow new national guidelines. In accordance with implementation science, it is important to understand the team's thoughts and educational needs. The study aimed to explore surgeons', scrub nurses', anaesthesiologists' and anaesthesia nurses' perceptions of barriers and facilitators to foster a safe educational introduction.

Methods: We conducted four semi-structured group interviews with 15 team members. The interviews were recorded, transcribed, and analysed using systematic text condensation to define important factors.

Results: We found barriers, e.g., potential fear related to handling the cement and "thoughts" concerning limited time. Patient, individual and organisational factors were also identified. A "cement-time-out" was suggested to prepare and complete cementation safely. The interviewees emphasised continuous training to ensure the procedure's success and maintain skills and confidence after the initial training. The importance of a safe learning culture, team collaboration and the provision of feedback was discussed.

Conclusions: The study provides novel insights into the specific educational needs that may arise during the transition to cemented hemiarthroplasty. A training package including simulation was proposed to maintain a safe learning environment and ensure patient safety. The team highlighted the importance of maintaining their competence. Results are relevant for departments introducing procedural change.

Funding: None.

Trial registration: Not relevant.