Incivility in surgery is prevalent and negatively impacts effectiveness and staff well-being. The purpose of this study was to a) examine relationships between incivility, team dynamics, and well-being outcomes, and b) explore a low-cost intervention of 'eye' signage in operating theater areas to reduce incivility in surgical teams. A mixed methods design was used in an orthopedic hospital. Surveys of incivility, teamwork, and well-being were administered three months apart in a small private hospital. An intervention of signage with eyes was placed in the theater area after administration of the first survey, using a pretest-posttest design. Participants also responded to an open-ended question about suggestions for improvements at the end of the survey which was then thematically analyzed. At the individual level (n = 74), incivility was statistically significantly related to team dynamics which in turn was significantly related to burnout, stress, and job attitudes. At the aggregate level, reported incivility was statistically significantly lower after the 'eye' sign intervention. Thematic analysis identified core issues of management behaviors, employee appreciation, communication, and work practices. Incivility in surgical teams has significant detrimental associations with burnout, stress, and job attitudes, which occurs through its impact on decreased team dynamics and communication. A simple intervention that evokes perceptions of being observed, such as signage of eyes in theater areas, has the potential to decrease incivility at least in the short term, demonstrating that incivility is amenable to being modified. Additional research on targeted interventions to address incivility are needed to improve teamwork and staff well-being.

中文翻译：

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关注手术团队中的不文明行为：团队合作、福祉和干预。

手术中的不礼貌行为很普遍，会对手术效率和员工福祉产生负面影响。本研究的目的是 a) 检查不文明行为、团队动力和幸福结果之间的关系，b) 探索手术室区域“眼睛”标牌的低成本干预措施，以减少手术团队中的不文明行为。一家骨科医院采用了混合方法设计。关于不文明行为、团队合作和幸福感的调查每隔三个月在一家小型私立医院进行。在进行第一次调查后，使用前测后测设计在剧院区域放置了带有眼睛的标牌干预措施。参与者还在调查结束时回答了有关改进建议的开放式问题，然后对调查进行了主题分析。在个人层面（n = 74），不文明行为在统计上与团队动力显着相关，而团队动力又与倦怠、压力和工作态度显着相关。总体而言，在“眼”手势干预后，所报告的不文明行为在统计上显着降低。主题分析确定了管理行为、员工欣赏、沟通和工作实践的核心问题。手术团队中的不礼貌行为与倦怠、压力和工作态度有显着的有害关联，这是通过其对团队活力和沟通的影响而发生的。一种简单的干预措施可以唤起被观察的感觉，例如剧院区域的眼睛标志，至少在短期内有可能减少不文明行为，表明不文明行为是可以改变的。需要对解决不文明行为的有针对性的干预措施进行更多研究，以改善团队合作和员工福祉。