RSS-Feed abonnieren
DOI: 10.1055/a-2577-2301
Dysfunktionales Verhalten im Operationssaal: Was wissen wir überhaupt?
Autoren
Im hektischen OP-Alltag können Koordinationsprobleme oder Reaktionen auf Fehler zu einem angehobenen Ton führen. Dies kann sowohl für Mitarbeitende als auch für die Patientensicherheit negative Auswirkungen haben: Beispielsweise trauen sich die Mitarbeitende nicht mehr, Fragen zu stellen oder Probleme anzusprechen. Mit gezielten Strategien können solche Situationen besser bewältigt werden. Auch den Führungskräften kommt hierbei eine wichtige Rolle zu.
-
Dysfunktionale Verhalten sind sehr vielfältig und schließen nicht nur sichtbares Verhalten ein.
-
Im Operationssaal werden die meisten dysfunktionalen Verhaltensweisen durch situative Aspekte ausgelöst.
-
Einige Ausprägungsformen sind:
-
disruptive Behaviours (u.a. unprofessionelles, unhöfliches, herablassendes, aggressives Verhalten, Feindseligkeit)
-
incivility
-
verbal abuse
-
nicht professionelles Verhalten
-
intra-professioneller Konflikt
-
-
Für die Eindämmung von dysfunktionalem Verhalten gibt es auf allen 3 Ebenen (Opfer, Täter und Führungskräfte/Management) Handlungsmöglichkeiten. Allerdings ist zuerst eine sorgfältige Analyse der Situation notwendig, bevor Strategien umgesetzt werden.
-
Es hat sich bewährt, nicht nur eine einzelne Methode anzuwenden, sondern verschiedene Strategien zu kombinieren.
Schlüsselwörter
Personalführung - Führungskraft - Patientensicherheit - Kommunikation - Teamfähigkeit - disruptive BehaviorPublikationsverlauf
Artikel online veröffentlicht:
27. November 2025
© 2025. Thieme. All rights reserved.
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
-
Literatur
- 1 Shen H, Wang H, Yan L. et al. Incivility in nursing practice education in the operating room. Nurse education today 2020; 88: 104366
- 2 Rashid G, Kim E, Evenson A. et al. What is the Medical Student Experience of Incivilities on the Surgery Clerkship and Do They Matter?. J Surgical Education 2025; 82: 103535
- 3 Lingard L, Reznick R, Espin S. et al. Team communications in the operating room: talk patterns, sites of tension, and implications for novices. Academic Medicine 2002; 77: 232-237
- 4 Petrovic MA, Scholl AT. Why we need a single definition of disruptive behavior. Cureus 2018; 10: e2339
- 5 Andersson LM, Pearson CM. Tit for tat? The spiraling effect of incivility in the workplace. Academy of Management Review 1999; 24: 452-471
- 6 Aunger J, Maben J, Westbrook JI. How unprofessional behaviours between healthcare staff threaten patient care and safety. Expert Review of Pharmacoeconomics & Outcomes Research 2025; 25: 635-638
- 7 Mullan CP, Shapiro J, McMahon GT. Interns' experiences of disruptive behavior in an academic medical center. J Graduate Medical Education 2013; 5: 25-30
- 8 Shetty AL, Vaghasiya M, Boddy R. et al. Perceived incivility during emergency department phone consultations. Emergency Medicine Australasia 2016; 28: 256-261
- 9 Kaiser JA. The relationship between leadership style and nurse-to-nurse incivility: Turning the lens inward. J Nursing Management 2017; 25: 110-118
- 10 Oja KJ. Incivility and professional comportment in critical care nurses. AACN Advanced Critical Care 2017; 28: 345-350
- 11 Keller R, Krainovich-Miller B, Budin W. et al. Predictors of nurses' experience of verbal abuse by nurse colleagues. Nursing Outlook 2018; 66: 190-203
- 12 Martinez W, Pichert JW, Hickson GB. et al. Qualitative content analysis of coworkers’ safety reports of unprofessional behavior by physicians and advanced practice professionals. J Patient Safety 2021; 17: e883-e889
- 13 Boateng GO, Adams TL. „Drop dead… I need your job”: an exploratory study of intra-professional conflict amongst nurses in two Ontario cities. Social Science & Medicine 2016; 155: 35-42
- 14 Guo L, Ryan B, Leditschke IA. et al. Impact of unacceptable behaviour between healthcare workers on clinical performance and patient outcomes: a systematic review. BMJ Quality & Safety 2022; 31: 679-687
- 15 Cooper WO, Spain DA, Guillamondegui O. et al. Association of coworker reports about unprofessional behavior by surgeons with surgical complications in their patients. JAMA Surg 2019; 154: 828-834
- 16 Flin R. Rudeness at work. BMJ 2010; 340: c2480
- 17 Porath CL, Pearson CM. The cost of bad behavior. Organizational Dynamics 2010; 39: 64-71
- 18 Salazar MJB, Minkoff H, Bayya J. et al. Influence of surgeon behavior on trainee willingness to speak up: a randomized controlled trial. J the American College of Surgeons 2014; 219: 1001-1007
- 19 Cortina LM, Sandy Hershcovis M, Clancy KB. The embodiment of insult: A theory of biobehavioral response to workplace incivility. J Management 2022; 48: 738-763
- 20 Keller S, Yule S, Zagarese V. et al. Predictors and triggers of incivility within healthcare teams: a systematic review of the literature. BMJ Open 2020; 10: e035471
- 21 Keller S, Tschan F, Semmer NK. et al. „Disruptive behavior” in the operating room: A prospective observational study of triggers and effects of tense communication episodes in surgical teams. PloS one 2019; 14: e0226437
- 22 Heslin MJ, Singletary BA, Benos KC. et al. Is disruptive behavior inherent to the surgeon or the environment? Analysis of 314 events at a single academic medical center. Ann Surg 2019; 270: 463-472
- 23 Charité-Universitätsmedizin Berlin, Hrsg. Mustercurriculum Patientensicherheit der Weltgesundheitsorganisation. Multiprofessionelle Ausgabe. In. Berlin: Charité– Universitätsmedizin Berlin; 2018. https://www.who.int/docs/default-source/patient-safety/9783000606267-ger.pdf?sfvrsn=35da6b35_1
- 24 Kent L, Anderson G, Ciocca R. et al. Effects of a senior practicum course on nursing students’ confidence in speaking up for patient safety. J Nursing Education 2015; 54: S12-S15
- 25 Bies RJ, Barclay LJ, Tripp TM. et al. A systems perspective on forgiveness in organizations. Academy of Manag Ann 2016; 10: 245-318
- 26 Babchenko O, Scott K, Jung S. et al. Resident perspectives on effective surgical training: incivility, confidence, and mindset. J Surg Education 2020; 77: 1088-1096
- 27 Marzuki E, Cummins C, Rohde H. et al. Saving lives, saving face: mitigated directives during out-of-hospital cardiac arrest resuscitation. J Politeness Res 2025; 21: 457-480
- 28 Baker A, Perreault D, Reid A. et al. Feedback and organizations: Feedback is good, feedback-friendly culture is better. Canadian Psychology/Psychologie Canadienne 2013; 54: 260
- 29 Kluger AN, DeNisi A. The effects of feedback interventions on performance: a historical review, a meta-analysis, and a preliminary feedback intervention theory. Psychological Bull 1996; 119: 254
- 30 Keller S, Yule S, Smink DS. et al. Alone Together: Is Strain Experienced Concurrently by Members of Operating Room Teams?: An Event-based Study. Ann Surg Open 2023; 4: e333
- 31 Longo J. Combating Disruptive Behaviors: Strategies to Promote a Healthy Work Environment. Online J Issues in Nursing 2010; 15
- 32 Keogh T, Martin WM. Managing unmanageable physicians: leadership, stewardship, and disruptive behavior. The Physician Exec 2004; 30: 18-22
- 33 Pearson CM, Porath CL. On the nature, consequences and remedies of workplace incivility: No time for „nice”? Think again. Academy of Management Perspectives 2005; 19: 7-18
- 34 Keller S, Jelsma JG, Tschan F. et al. Behavioral sciences applied to acute care teams: a research agenda for the years ahead by a European research network. BMC Health Services Research 2024; 24: 71
- 35 King HB, Battles J, Baker DP. et al. TeamSTEPPS: team strategies and tools to enhance performance and patient safety. Advances in patient safety: New directions and alternative approaches (Vol 3: Performance and tools). Henriksen K, Battles JB, Keyes MA, et al., editors. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008.
- 36 Tschan F, Keller S, Semmer NK. et al. Effects of structured intraoperative briefings on patient outcomes: multicentre before-and-after study. Br J Surg 2022; 109: 136-144
