Q&A: Small Actions Change OR Cultures

Q&A with Elizabeth Enriquez, RN, a safety champion who encourages staff to bring a ‘speak-up’ mentality to the operating room.

What does your role as the OR safety champion entail?
My role embodies all things safety. I’m responsible for promoting safe behaviors, raising awareness about potential hazards, encouraging reporting, auditing, and coming up with and inspecting preventative measures. Advocating for a “speak-up culture” within my unit has proven to be essential in maintaining our commitment to patient and employee safety. I participate in non-punitive incident investigations to gather information about the event, provide demonstrations of how an injury occurred and offer solutions to prevent the injury from happening again. This gives us an opportunity to explore a change in workflow, increase situational awareness and purchase a device or make a change to mitigate the risk.

What do you cover in your onboarding safety checklist?
I enforce our goal for a zero-injury department and stress the importance of reporting injuries, faulty equipment and any hazard that could lead to injury to ourselves or our patients. I share our PPE and PAPR location and policies, discuss the process for reporting an injury or hazard and explain our incident investigation procedure. I share our Go Clear designation and policy, sharps safety use of transfer tray and neutral zone and bloodborne pathogen injury prevention and policy.

How would you describe your facility’s safety culture?
It’s alive and thriving. Whenever a safety concern is brought up, we are supported by management in making changes or purchasing safer alternatives. This trust is critical. It takes a “vigilant village” to maintain a high-functioning safety culture. Culture takes time to change, but persistence and actions are what move people.

How do you encourage staff to speak up if/when they notice a safety concern?
Safety concerns become ideas, then those ideas grow into changes, and eventually those changes become a part of the culture. We all want our concerns to be heard and acknowledged. When colleagues bring forward issues, I always follow up with a resolution. A safety champion makes it easier for staff to report concerns in real time.

What small changes can a facility can make to improve patient and staff safety?
One small change could be more frequent rounding and observation, which enhances policy adherence with PPE. It also helps leaders better understand the practices taking place within the unit. Also, something as minor as changing old kick buckets to height-adjustable ones will bring great satisfaction prevent repetitive bending down and straining of the back and knees. Start small and a big difference can be made. OSM