The effects of temporary staff on observable teamwork outcomes within operating rooms

IntroductionThe use of temporary nursing and operating room staff has increased, particularly following the COVID-19 pandemic. Despite this, limited research examines how temporary staffing impacts communication and teamwork behaviors in the operating room.Materials and methodsSurgical case safety b...

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Main Authors: Logan Butler, Andrew Kozlow, Cody Mitchell, Rebecca S. Cintron, Caprice Greenberg, Lawrence B. Marks, Jin H. Ra, Lukasz Mazur
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Health Services
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Online Access:https://www.frontiersin.org/articles/10.3389/frhs.2025.1514431/full
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author Logan Butler
Andrew Kozlow
Cody Mitchell
Rebecca S. Cintron
Caprice Greenberg
Lawrence B. Marks
Lawrence B. Marks
Jin H. Ra
Lukasz Mazur
Lukasz Mazur
author_facet Logan Butler
Andrew Kozlow
Cody Mitchell
Rebecca S. Cintron
Caprice Greenberg
Lawrence B. Marks
Lawrence B. Marks
Jin H. Ra
Lukasz Mazur
Lukasz Mazur
author_sort Logan Butler
collection DOAJ
description IntroductionThe use of temporary nursing and operating room staff has increased, particularly following the COVID-19 pandemic. Despite this, limited research examines how temporary staffing impacts communication and teamwork behaviors in the operating room.Materials and methodsSurgical case safety behaviors were assessed using the Teamwork Evaluation of Non-Technical Skills (TENTS) tool at a large academic hospital. Mean scores for the 20 TENTS metrics were calculated for cases involving temporary staff and compared to cases with only permanent staff using two-sample t-tests. An analysis of variance (ANOVA) was also conducted to compare three staff compositions: only permanent staff, either a temporary scrub technician or circulating nurse, both a temporary scrub technician and circulating nurse.ResultsData from 100 surgical cases indicated that all TENTS safety behavior scores averaged above 2, suggesting acceptable behavior levels. Statistical analyses revealed no significant differences (p > 0.05) between TENTS scores in cases with temporary staff (N = 47) and permanent staff (N = 53). ANOVA showed no significant differences (p > 0.05) in TENTS metrics among the different staff compositions.DiscussionStandardized evaluations of teamwork behaviors revealed no significant differences between cases involving permanent and temporary operating room staff. This suggests that teams maintain communication and safety standards regardless of staff composition, potentially due to effective leadership, standardized protocols, and a strong institutional safety culture. Further research must explore the long-term effects of temporary staffing on patient safety and clinical outcomes, and to identify best practices for integrating temporary personnel into surgical teams.
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spelling doaj-art-908014f9b9b9416da0f987e8ad9dfb062025-08-20T03:46:53ZengFrontiers Media S.A.Frontiers in Health Services2813-01462025-06-01510.3389/frhs.2025.15144311514431The effects of temporary staff on observable teamwork outcomes within operating roomsLogan Butler0Andrew Kozlow1Cody Mitchell2Rebecca S. Cintron3Caprice Greenberg4Lawrence B. Marks5Lawrence B. Marks6Jin H. Ra7Lukasz Mazur8Lukasz Mazur9Division of Healthcare Engineering, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesDivision of Healthcare Engineering, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesDivision of Healthcare Engineering, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesDepartment of Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesDepartment of Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesDepartment of Radiation Oncology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesUNC Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesDivision of Acute Care Surgery, Department of Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesDivision of Healthcare Engineering, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesSchool of Information and Library Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesIntroductionThe use of temporary nursing and operating room staff has increased, particularly following the COVID-19 pandemic. Despite this, limited research examines how temporary staffing impacts communication and teamwork behaviors in the operating room.Materials and methodsSurgical case safety behaviors were assessed using the Teamwork Evaluation of Non-Technical Skills (TENTS) tool at a large academic hospital. Mean scores for the 20 TENTS metrics were calculated for cases involving temporary staff and compared to cases with only permanent staff using two-sample t-tests. An analysis of variance (ANOVA) was also conducted to compare three staff compositions: only permanent staff, either a temporary scrub technician or circulating nurse, both a temporary scrub technician and circulating nurse.ResultsData from 100 surgical cases indicated that all TENTS safety behavior scores averaged above 2, suggesting acceptable behavior levels. Statistical analyses revealed no significant differences (p > 0.05) between TENTS scores in cases with temporary staff (N = 47) and permanent staff (N = 53). ANOVA showed no significant differences (p > 0.05) in TENTS metrics among the different staff compositions.DiscussionStandardized evaluations of teamwork behaviors revealed no significant differences between cases involving permanent and temporary operating room staff. This suggests that teams maintain communication and safety standards regardless of staff composition, potentially due to effective leadership, standardized protocols, and a strong institutional safety culture. Further research must explore the long-term effects of temporary staffing on patient safety and clinical outcomes, and to identify best practices for integrating temporary personnel into surgical teams.https://www.frontiersin.org/articles/10.3389/frhs.2025.1514431/fullteamwork observationssurgerytemporary staffTeamSTEPPScommunication
spellingShingle Logan Butler
Andrew Kozlow
Cody Mitchell
Rebecca S. Cintron
Caprice Greenberg
Lawrence B. Marks
Lawrence B. Marks
Jin H. Ra
Lukasz Mazur
Lukasz Mazur
The effects of temporary staff on observable teamwork outcomes within operating rooms
Frontiers in Health Services
teamwork observations
surgery
temporary staff
TeamSTEPPS
communication
title The effects of temporary staff on observable teamwork outcomes within operating rooms
title_full The effects of temporary staff on observable teamwork outcomes within operating rooms
title_fullStr The effects of temporary staff on observable teamwork outcomes within operating rooms
title_full_unstemmed The effects of temporary staff on observable teamwork outcomes within operating rooms
title_short The effects of temporary staff on observable teamwork outcomes within operating rooms
title_sort effects of temporary staff on observable teamwork outcomes within operating rooms
topic teamwork observations
surgery
temporary staff
TeamSTEPPS
communication
url https://www.frontiersin.org/articles/10.3389/frhs.2025.1514431/full
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