Page 216 - Hospital Authority Convention 2018

Service Enhancement Presentations
HOSPITAL AUTHORITY CONVENTION 2018

F7.2 Committed and Happy Staff 13:15 Room 421

Behaviour Based Safety Observation Proactive Approach for Promoting Safe Sharp Handling Culture in
Operating Theatre
Law NW, Chan SH, Yip SPC, Che SWA, Lee, SFP, Ma MS, Lui SH
Anaesthesiology and Operating Theatre Services, Queen Elizabeth Hospital, Hong Kong

Introduction
Sharps and needle stick injuries remain a significant threat to both healthcare personnel and patient with exposure to blood
borne pathogens. Perioperative team members are at highest risk (59%) of sharps injuries in Operating Theatre (OT). From
2015 to June 2016, 26 cases related to needle stick injuries were reported. Most of these injuries were preventable when safe
practice was reinforced through sharp safety programme and strengthening safe culture in department.

Objectives
(1) To reduce the rate of sharp injuries; (2) to enhance staff’s awareness and engagement in safe sharp handling; and(3) to
promote and sustain safety culture by reinforcing safe behaviour.

Methodology
Strategies including standardisation of current practice, structural training workshops and Behaviour Based Safety
Observation (BBSO) are implemented to foster safety culture. A workgroup was established to promote the programme;
sharp props production workshop, lecture, training workshop, slogan and posters design competition were organised to
enhance staff skill, awareness and engagement. Photos of standard practices were promulgated to nurses and surgeons
through email and notice board. Related video was uploaded to department website.
BBSO training workshop with emphasis on theory and feedback skill was arranged for OT subspecialty in-charges, surgeons
and anaesthestists as trained observers to conduct observation for surgical team dynamic on sharp handling according to
the critical items identified by the observers and agreed by surgical team partners. BBSO was conducted by random for
continuous improvement through positive reinforcement on safe behaviour and evaluation of causes for unsafe acts. Data
collected is communicated through conveying both safe and at-risk behaviour for staff alertness, and formulating strategies
for removing behaviour barrier. Programme was evaluated by monitoring statistics on Injury-on-duty (IOD) and collecting staff
feedback on a weekly briefing session.

Results
A remarkable reduction in sharps injury rate (50%) was recorded until September 2017 compared to that of last year. Safe
behaviour index calculated from BBSO raised from 89.8% in March to 98.1% in September in 159 observations for seven
months.The average safe behaviour index is 95.8% in 159 observations for six months.

BBSO programme initiates a safety partnership between management and staff with common goal in reducing incidents of
sharp injuries. To achieve sustainable changes in behaviour, buy-in from all involved parties with continuous monitoring are
motivators for staff to follow standardised safe practice and to build up a safety culture.
Tuesday, 8 May 2018

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