Ameliyathanelerdeki Yapısal Kalite Göstergeleri ile Hemşirelerin Risk Algıları Arasındaki İlişki: Yapısal Kalite ve Risk Algısı Ölçekleri ile Bir Değerlendirme

Year 2025, Volume: 12 Issue: 3, 670 - 687, 31.12.2025

Fadime Ulupınar , Sibel Meler , Şeyda Karasu

Abstract

Amaç: Bu çalışma, ameliyathanelerdeki yapısal kalite göstergelerinin hemşirelerin risk algıları üzerindeki etkisini, bireysel ve kurumsal risk yaklaşımlarına odaklanarak incelemeyi amaçlamıştır.
Gereç ve Yöntem: Kesitsel bir tasarım kullanılarak, Türkiye’de Erzurum Şehir Hastanesi ve Konya Selçuk Üniversitesi Tıp Fakültesi Hastanesi’nde, Ağustos-Ekim 2024 tarihleri arasında 174 ameliyathane hemşiresinden veri toplanmıştır. Yapısal kalite, “Ameliyathane Yapısal Kalite Göstergeleri Ölçeği” (SIOR) ile değerlendirilirken risk algısı ise “Hemşirelerin Çalışma Ortamındaki Risklere Yönelik Tutum Ölçeği” (NATWERS) ile değerlendirilmiştir. Veriler, tek yönlü varyans analizi (ANOVA) ile analiz edilmiştir.
Bulgular: Katılımcıların %69’u kadın, yaş ortalaması 33,5 ± 7,2 yıl ve mesleki deneyim ortalaması 11,2 ± 7,8 yıl olarak bulunmuştur. SIOR skorları düşük (2,98 ± 0,77), orta (3,59 ± 0,36) ve yüksek (4,28 ± 0,46) yapısal kalite gruplarında anlamlı farklılıklar göstermiştir (p < 0,001). NATWERS toplam skorları, yapısal kalite arttıkça yükselmiş; özellikle kurumsal yaklaşım alt boyutunda güçlü bir ilişki gözlenmiştir (p < 0,001).
Sonuç: Yapısal kalite göstergelerindeki iyileşmeler, hemşirelerin risk algılarını olumlu yönde etkilemekte ve güvenlik tutumlarını güçlendirmektedir. Ameliyathane tasarımında ergonomi, aydınlatma ve güvenlik kaynaklarının optimizasyonu önerilmektedir.

Keywords

ameliyathaneler , hemşirelerin risk algıları , yapısal kalite göstergeleri

Relationship Between Structural Quality Indicators in Operating Rooms and Nurses' Risk Perceptions in the Working Environment

Abstract

Aim: This study aimed to investigate the effect of structural quality indicators in operating rooms on nurses’ risk perceptions, focusing on individual and institutional risk approaches.
Methods: A cross-sectional design was employed, collecting data from 174 operating room nurses at Erzurum City Hospital and Konya Selçuk University Faculty of Medicine Hospital in Turkey between August and October 2024. Structural quality was assessed using the “Structure Indicators in the Operating Room” (SIOR) scale, while risk perception was measured with the “Nurses’ Attitudes Toward Work Environment Risks Scale” (NATWERS). Data were analyzed using one-way analysis of variance (ANOVA).
Findings: Participants were predominantly female (69%), with a mean age of 33.5 ± 7.2 years and a mean professional experience of 11.2 ± 7.8 years. SIOR scores significantly differed across low (2.98 ± 0.77), moderate (3.59 ± 0.36), and high (4.28 ± 0.46) structural quality groups (p < 0.001). NATWERS total scores increased with higher structural quality, with a particularly strong association in the institutional approach subdimension (p < 0.001).
Conclusion: Improvements in structural quality indicators positively influence nurses’ risk perceptions and enhance safety attitudes. Optimizing operating room design, including ergonomics, lighting, and safety resources, is recommended to improve risk management and workplace safety.

Keywords

nurses’ risk perceptions , operating rooms , structural quality indicators

References

• Aburayya, A., Alshurideh, M., Al Marzouqi, A., Al Diabat, O., Alfarsi, A., Suson, R., and Salloum, S. (2020). An empirical examination of the effect of TQM practices on hospital service quality: An assessment study in uae hospitals. Systematic Reviews in Pharmacy, 11(9), 347-362.
• Akar, Y., Gülhan, Y. B., and Acar, P. (2015). Sağlık sektöründe kalite yönetimi, sağlık yöneticilerinin kalite anlayışı (Ankara İli örneği). Sağlık Akademisyenleri Dergisi, 2(2), 76-81. https://doi.org/10.5455/sad.2015131438505031
• Akgül, G. Y., and Aksoy, N. (2021). The relationship between organizational stress levels and patient safety attitudes in operating room staff. Journal of Perianesthesia Nursing, 36(5), 499-506. https://doi.org/https://doi.org/10.1016/j.jopan.2020.11.002
• Arabacı, A., and Önler, E. (2021). The effect of noise levels in the operating room on the stress levels and workload of the operating room team. Journal of Perianesthesia Nursing, 36(1), 54-58. https://doi.org/https://doi.org/10.1016/j.jopan.2020.06.024
• Araujo, C. A., Siqueira, M. M., & Malik, A. M. (2020). Hospital accreditation impact on healthcare quality dimensions: A systematic review. International Journal for Quality in Health Care, 32(8), 531-544. https://doi.org/https://doi.org/10.1093/intqhc/mzaa090
• Bozkurt, E. G. (2012). Sağlık çalışanlarının hastane, hasta, kalite, hasta güvenliği ve riske bakış açılaının metafor analizi ile değerlendirilmesi. [Master’s thesis, Dokuz Eylul Üniversitesi].
• Breyer, J. Z., Giacomazzi, J., Kuhmmer, R., Lima, K. M., Hammes, L. S., Ribeiro, R. A., Kops, N. L., Falavigna, M., and Wendland, E. M. (2019). Hospital quality indicators: A systematic review. International Journal of Health Care Quality Assurance, 32(2), 474-487. https://doi.org/10.1108/IJHCQA-04-2018-0091
• Carini, E., Gabutti, I., Frisicale, E. M., Di Pilla, A., Pezzullo, A. M., De Waure, C., Cicchetti, A., Boccia, S., and Specchia, M. L. (2020). Assessing hospital performance indicators. What dimensions? Evidence from an umbrella review. BMC Health Services Research, 20, 1-13. https://doi.org/https://doi.org/10.1186/s12913-020-05879-y
• Dimino, K., Learmonth, A. E., and Fajardo, C. C. (2021). Nurse managers leading the way: reenvisioning stress to maintain healthy work environments. Critical Care Nurse, 41(5), 52-58. https://doi.org/https://doi.org/10.4037/ccn2021463
• Endeshaw, B. (2021). Healthcare service quality-measurement models: A review. Journal of Health Research, 35(2), 106-117. https://doi.org/https://doi.org/10.1108/JHR-07-2019-0152
• Er, Ö. S., and Altınbaş, Y. (2024). Ameliyathanelerde Yapısal Kalite İndikatörleri Ölçeği’nin Türkçe’ye uyarlanması. Mersin Üniversitesi Sağlık Bilimleri Dergisi, 17(1), 33-44. https://doi.org/:10.26559/mersinsbd.1286919
• Eriksson, J., Lindgren, B. M., and Lindahl, E. (2020). Newly trained operating room nurses’ experiences of nursing care in the operating room. Scandinavian journal of caring sciences, 34(4), 1074-1082. https://doi.org/https://doi.org/10.1111/scs.12817
• Gao, W., Plummer, V., and McKenna, L. (2020). International operating room nurses' challenges in providing person-centered care during organ procurement surgery. Journal of Perianesthesia Nursing, 35(4), 417-422. https://doi.org/https://doi.org/10.1016/j.jopan.2019.12.005
• Gao, Y., Chen, X., and Kang, L. (2021). The effect of Plan-Do-Check-Act cycle nursing management of gynecological surgery: A systematic review and meta-analysis. Annals of Palliative Medicine, 10(7), 8072081-8078081. https://doi.org/10.21037/apm-21-1590
• Goedhart, N. S., van Oostveen, C. J., and Vermeulen, H. (2017). The effect of structural empowerment of nurses on quality outcomes in hospitals: A scoping review. Journal of Nursing Management, 25(3), 194-206. https://doi.org/ https://doi.org/10.1111/jonm.12455
• Gomes, J. A., Martins, M. M., Trochin, D. M. R., and Fernandes, C. S. (2019). Validation of a scale on structure indicators in the operating room: contributions to nursing. Aquichan, 19(1), 31-35.
• Gülen, S., & Baykal, Ü. (2023). Development of the nurses’ attitude scale toward the risks in the work environment. Journal of Education and Research in Nursing, 20(2), 111-120. https://doi.org/10.14744/jern.2021.216742
• Hung, C.-C., Hsu, S.-C., Lee, L.-L., and Huang, C.-M. (2013). The effects of contextual and structural factors on patient safety in nursing units. Journal of Nursing Research, 21(3), 225-233. https://doi.org/10.1097/jnr.0b013e3182a0b004
• Kakemam, E., Albelbeisi, A. H., Rouzbahani, M., Gharakhani, M., Zahedi, H., and Taheri, R. (2024). Nurses’ perceptions of patient safety competency: A cross-sectional study of relationships with occurrence and reporting of adverse events. Plos one, 19(1), e0297185. https://doi.org/https://doi.org/10.1371/journal.pone.0297185
• Kaya, C., and Ulusoy, H. (2022). Hastanelerin kalite direktörlerinin, kalite birim çalışanlarının ve klinik kalite sorumlularının kalite indikatör yönetimi hakkındaki görüşlerin değerlendirilmesi: Sivas ili örneği. Cumhuriyet Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 7(1), 24-31. https://doi.org/10.51754/cusbed.1035277
• Kocaman, G., Yürümezoğlu, H. A., Uncu, S., Türkmen, E., Göktepe, N., & İntepeler, Ş. S. (2018). Türkiye’de hemşireler için sağlıklı çalışma ortamı standartlarının geliştirmesi. Hemşirelikte Eğitim ve Araştırma Dergisi, 15(1), 30-38.
• Lopes, V. C. A., Silva, D. R. A., Carvalho, H. D., Leite, S., Dos Santos, A. M. R., Batista, E. M. C. A., and Nogueira, L. T. (2020). Structural and Procedural Risk Factors Correlated to Missed Nursing Care in Hospitals. Journal of Nursing and Health Sciences, 6(3), 27.
• Özmen, S., and Akın, G. (2023). Kalite ve indikatör yönetimi, iş güvenliği iklimi ve güvenlik performansı arasındaki ilişkinin incelenmesi: Sağlık çalışanları üzerine bir araştırma. Hacettepe Sağlık İdaresi Dergisi, 26(4), 959-974. https://doi.org/https://doi.org/10.61859/hacettepesid.1289196
• Schutz, A., Counte, M., and Meurer, S. (2007). Assessment of patient safety research from an organizational ergonomics and structural perspective. Ergonomics, 50(9), 1451-1484. https://doi.org/https://doi.org/10.1080/00140130701346765
• Teymoori, E., Zareiyan, A., Babajani-Vafsi, S., and Laripour, R. (2022). Viewpoint of operating room nurses about factors associated with the occupational burnout: A qualitative study. Frontiers in Psychology, 13, 947189. https://doi.org/https://doi.org/10.3389/fpsyg.2022.947189
• Tvedt, C., Sjetne, I. S., Helgeland, J., and Bukholm, G. (2012). A cross-sectional study to identify organisational processes associated with nurse-reported quality and patient safety. BMJ Open, 2(6), e001967. https://doi.org/tps://doi.org/10.1136/bmjopen-2012-001967
• Ulrich, B., Cassidy, L., Barden, C., Varn-Davis, N., and Delgado, S. A. (2022). National nurse work environments-October 2021: A status report. Critical Care Nurse, 42(5), 58-70. https://doi.org/https://doi.org/10.4037/ccn2022798
• Ulupınar, F., and Erden, Y. (2024). Intention to leave among nurses during the COVID‐19 outbreak: A rapid systematic review and Meta‐Analysis. Journal of Clinical Nursing, 33(1), 393-403. https://doi.org/10.1111/jocn.16588
• Wang, Y., Cai, X., Fang, Q., & Zhu, J. (2024). Efficacy and safety outcomes of Tenecteplase versus Alteplase for thrombolysis of acute ischemic stroke: A meta-analysis of 9 randomized controlled trials. Journal of the Neurological Sciences, 458, 122912. https://doi.org/10.1016/j.jns.2024.122912
• Winter, V., Dietermann, K., Schneider, U., and Schreyögg, J. (2021). Nurse staffing and patient-perceived quality of nursing care: a cross-sectional analysis of survey and administrative data in German hospitals. BMJ Open, 11(11), e051133. https://doi.org/10.1136/bmjopen-2021-051133
• Yosiana, Y., Hermawati, A., and Mas’ud, M. H. (2020). The analysis of workload and work environment on nurse performance with job stress as mediation variable. Journal of Socioeconomics and Development, 3(1), 37-46. https://doi.org/10.31328/jsed.v3i1.1326