Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Associate Professor Axel Ros, School of Welfare, Jönköping University, Sweden
- Second opponent: Associate Professor Hilde Valen Wæhle, University of Bergen, Norway
- Third member and chair of the evaluation committee: Associate Professor Randi Opheim, University of Oslo
Chair of the Defence
Professor Olav Magnus Søndenå Fredheim, University of Oslo
Principal Supervisor
Associate Professor Anne Karin Lindahl, University of Oslo
Summary
Postanesthesia care units (PACUs) play an important role in keeping surgical patients safe in the immediate postoperative period. To do this, the patient safety culture (PSC) must constantly be worked on.
The Green Cross (GC) method, a method for healthcare professionals to report and discuss incidents, has significantly improved PSC, but its longitudinal effect has not been explored. Learning from Excellence (LfE), an initiative that promotes positive feedback and learning from successful work, may improve PSC, but this has not been explored.
The overall aim of this thesis was to investigate whether and how the GC method and LfE affected aspects of PSC over time in a PACU, based on healthcare professionals’ experiences and the PACU nurses’ perceptions. Semistructured focus group interviews and annual self-reporting questionnaires were used to reach the aim.
The GC method had a positive effect on PACU nurses’ perceptions of the PSC dimensions work engagement, teamwork climate, and safety climate over 4 years, but work engagement was the only factor that remained significantly increased after 4 years. LfE did not have a significant effect on PACU nurses’ perceptions of work engagement, teamwork climate, working conditions or safety climate, over 16 months.
The GC method facilitated open communication about incidents. There was however a lack of visible improvements, a lack of interprofessional collaboration to improve the system, and a negative focus that was experienced as tiring.
LfE facilitated a more positive working climate by reminding them of everyday successful work. However, excellent patient care was rarely reported as it was taken for granted. Also, there was no space to discuss these events. This hindered learning from excellence. The uneven distribution of LfE reports could also lead to some feeling unappreciated.
In conclusion, the GC method may improve the PSC, but LfE may not be able to do so. LfE may however be a useful addition to the GC method.
Additional information
Contact the research support staff.