From the Editor

Julie LancasterOur lead story this month is about teams — how the prevailing attitudes among members of a caregiver team can influence patient well-being.And speaking of teams, we’re delighted to welcome Jeremy Gofton, RNFA, our new RNFA program director at the NIFA office 40 hours per week — read on.

Julie Lancaster, Editor

Measuring Teamwork Climate in the OR and Beyond

A Johns Hopkins study of safety-related attitudes in the Operating Room (OR) revealed that nurses exhibit the highest level of teamwork and surgeons the lowest.

Although this “news” is hardly gasp-inducing, the study highlights the impact that teamwork can have on patient safety.

The team of researchers surveyed more than 2,000 caregivers — all the OR personnel in a 60-hospital system — using a Safety Attitudes Questionnaire.  They posed questions in six safety-related areas: teamwork climate, safety climate, job satisfaction, perceptions of management, stress recognition and working conditions. One key question: Would you feel comfortable being operated on in your own hospital? Read more about the study in this Johns Hopkins press release.

“We found that using frontline caregiver assessments of patient safety can give you a valid and reliable consensus on how things are going in a particular patient care area, and that this is related to important outcomes like hospital-acquired infections, length of stay and nurse turnover,” said J. Bryan Sexton, Ph.D., assistant professor of anesthesia and critical care medicine at Johns Hopkins Medicine.

Some 1300 hospitals have now put a version of the Hopkins survey into use to analyze work environments throughout the hospital. As reported in the October ’07 issue of Dome, another Johns Hopkins publication, Sexton has found that “when at least six of every ten caregivers on a clinical unit have positive attitudes about the level of patient safety — as measured by the questionnaire — good things happen. Rates of ventilator-assisted pneumonia, sepsis, surgical site infections and bed sores are significantly lower than when attitudes are below that mark. When at least 60 percent report good teamwork, rates of nurse turnover, absenteeism, and bloodstream infection are lower.”

Jeremy Gofton: RNFA Program Director


In April, traveling perioperative nurse Jeremy Gofton, RN, CNOR, RNFA, joined NIFA as director of education, RNFA program director and instructor.

“The opportunity to teach is really exciting,” he says. “I’ve always enjoyed orienting students and training people in the OR, so mentoring our future RNFAs is a natural transition. I also value remaining current in my skills and caring for patients so I will continue working a flexible schedule in the OR around my NIFA duties. It is exciting to be involved in the academic side of nursing. Currently I am collaborating with Quill SRS barbed sutures for integration into our SutureStar workshops. You can expect a lot of additions to our state-of-the-art classes this year.”

Originally from Ontario, Canada, Gofton moved to the U.S. immediately upon graduation from a nursing program at Conestoga College in Stratford, Ontario. He began his career in Florida as an OR nurse, then joined a travel nursing company. During his more than 12 years as a traveler he has worked in more than 25 hospitals around the country. His responsibilities have included surgical service coordinator for neurosurgery, endoscopy, and laser safety officer. He has also spent time outside the OR cross-training in Endoscopy, Emergency Room, and the Post Anesthesia Care Unit.

Gofton and his wife Kelly, who works as a cardiac catheterization nurse, and their pet cockatoo Monty enjoy adventure and make time for cycling, paragliding, motorcycling and camping. Gofton also enjoys quieter activities like playing his guitar and getting together with friends.

“I’m an energetic and happy person,” Gofton says. “Life . . . truly is fantastic.”


Last month we showed you what cases “always” need an assistant at surgery, but that raises another question: Where can you find specifically the cases that will deny you reimbursement as an assistant?

The American Association of Physician Assistants has the answer with their First Assistant at Surgery Denial List — approximately 1900 CPT (Current Procedural Terminology) codes for which a first assistant will not be reimbursed.

Whoever at AAPA made this list, the entire industry says “THANK YOU!”