Anaesthetic assistant competencies: our experience

Review of practice: Facilitating normality at caesarean section

Expectant women often write detailed birth plans outlining their preferences for the birth of their baby. These plans are pushed aside when a caesarean is deemed necessary, being replaced with medical decisions in a clinical setting. In the busiest maternity unit in the South West, our team are trying to change this attitude, encompassing many of the key points of 'normal' birth choices that are important to mothers during caesarean section, without compromising clinical care.

Team communications in surgery - creating a culture of safety

As a key department within a healthcare organisation, the operating room is a hazardous environment, where the consequences of errors are high, despite the relatively low rates of occurrence. Team performance in surgery is increasingly being considered crucial for a culture of safety. The aim of this study was to describe team communication and the ways it fostered or threatened safety culture in surgery. Ethnography was used, and involved a 6-month fieldwork period of observation and 19 interviews with 24 informants from nursing, anaesthesia and surgery. Data were collected during 2009 in the operating rooms of a tertiary care facility in Queensland, Australia. Through analysis of the textual data, three themes that exemplified teamwork culture in surgery were generated: "building shared understandings through open communication"; "managing contextual stressors in a hierarchical environment" and "intermittent membership influences team performance". In creating a safety culture in a healthcare organisation, a team's optimal performance relies on the open discussion of teamwork and team expectation, and significantly depends on how the organisational culture promotes such discussions.