BRIEF RESEARCH REPORT article
Front. Health Serv.
Sec. Patient Safety
Volume 5 - 2025 | doi: 10.3389/frhs.2025.1514431
The Effects of Temporary Staff on Observable Teamwork Outcomes within Operating Rooms
Provisionally accepted
Logan Butler
Andrew Thomas Kozlow
Cody MitchellRebecca CintronCaprice Greenberg
Lawrence Marks
JIn RaLukasz Mazur*- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States
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Introduction: The 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 Methods: Surgical 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.Results: Data 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.Discussion: Standardized 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.
Keywords: Teamwork Observations, Surgery, Temporary staff, TeamSTEPPS, Communication
Received: 20 Oct 2024; Accepted: 27 May 2025.
Copyright: © 2025 Butler, Kozlow, Mitchell, Cintron, Greenberg, Marks, Ra and Mazur. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lukasz Mazur, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States
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