Exploring the Decision-Making of OR Nurses: A Qualitative Study.

The Role of the Operating Room Nurse Manager in the Successful Implementation of Preoperative Briefings and Postoperative Debriefings in the VHA Medical Team Training Program

With the introduction of robot-assisted surgery, the role and responsibility of the operating room nurses have been expanded. The surgical team for robotic-assisted surgery depends on the ability of the operating room nurses to operate and handle the robotic system before, during, and after procedures. However, operating room nurses must acquire the necessary competencies for robotic-assisted surgery. We performed a systematic review using the databases MEDLINE and EMBASE to review the evidence on educating and training operating room nurses in robot-assisted surgery. Studies describing operating room nurses' training and team-training with operating room nurses for robot-assisted surgery were included. The Medical Education Research Study Quality Instrument (MERSQI) and the Newcastle-Ottawa Scale-Education (NOS-E) were used to evaluate the quality of the included studies. We identified 3351 potential studies and included 16 in the final synthesis. Nine studies focused on team-training in robot-assisted surgery: four focused solely on training for operating room nurses, and only three on operating room nurses as first assistants in robot-assisted surgery. Most studies examined team-training in RAS, including OR nurses, focused on emergency situations and conversion to an open procedure. Only a few studies addressed other competencies relevant to OR nurses in RAS. No randomized controlled trials were identified. Only a few studies used pre- and post-testing, and only one examined clinical outcomes. The quality assessment of the included studies was moderate to low, with a median MERSQI score of 10.3 and a median NOS-E score of 2. There is sparse research on the education of operating room nurses in robot-assisted surgery, and the literature emphasizes the training of surgeons. More research is needed to develop evidence-based training for operating room nurses in robot-assisted surgery.

Operating room nurses play a crucial role in maintaining sterile technique to prevent surgical site infections and ensure patient safety. Despite guidelines in place, challenges persist in maintaining sterility due to systemic issues and interpersonal dynamics. This study aims to explore the experiences of OR nurses in maintaining sterile technique, focusing on the challenges they face, the emotional burden they experience, the dynamics of teamwork, and recommendations for improving practice. A qualitative descriptive study using semi-structured interviews was conducted with twelve OR nurses from a university hospital in Turkey. Data were collected between May 5 and 9, 2023, through in-depth, face-to-face interviews, which were transcribed verbatim and analysed using a content analysis approach. Analysis of interviews with 12 operating room (OR) nurses produced four main themes and eleven subthemes. General Chaos and Systemic Challenges reflected barriers such as rushed scheduling, excessive OR traffic, technical limitations, and staff shortages, all of which compromised sterility. Teamwork Challenges and Interpersonal Dynamics highlighted protocol non-compliance, inadequate training of novice staff, communication breakdowns, and a lack of respect from some surgeons. The Emotional Burden theme described nurses' experiences of persistent stress, anxiety, helplessness, and a strong sense of moral responsibility for patient safety. Finally, Training and Staff Selection captured participants' recommendations. OR nurses face significant challenges in maintaining sterile technique, influenced by organisational inefficiencies, interpersonal conflicts, and emotional stress. To enhance practice, support systems, communication protocols, and structured training programs must be improved. Recommendations include implementing structured training programs, enhancing communication protocols, and selecting appropriate personnel to ensure effective sterile technique maintenance in the OR.

Bi-lingual content validation of the Non-Technical Skills for Operating Room Nurses (NOTSORN) tool: A Delphi study

The Operating Room (OR) nurse many times is the unique working in Surgical Theatre. They have so many duties and solicitation that they are stressed in the end of each shift. Since 19901, the Perioperative Nursing System (SAEP) has been developed and encouraged its implementation. OBJECTIVES: identify the activities realized by OR nurses and compared their work in public and private hospitals. METHOD: An invitation was sent to each hospital with more than 50 beds, located in Rio de Janeiro, Brazil. A sample of 14 hospitals accepted and 7 were public and 7 private hospitals. The data was collected using a structured questionnaire composed by open questions about: characteristics of hospital; description of surgical theatre; activities of nursing staff. To collect data about OR nurse activities, they are described as: preparation for anesthesia and surgery (14 items); during intraoperative period (24 items); at the end of surgery (14 items); management (9 items) and education, research and social role (8 items). The OR nurses, leader of nursing staff in surgical theatre, were interviewed at hospital, from September 2004 to May 2005. The anonymity and secret were observed. The statistical analysis was descriptive and used non parametric test x2. The Cronbach’s Alpha coefficient was 0.86. RESULTS: All phase of surgery that means, immediate preoperative, intraoperative and postoperative phases the presence of OR nurse is detected. The activities involved on preparation of the environment were most frequent. Data showed relations statistically significant, for OR nurses in private hospitals for activities related to preparation of surgery and intraoperative period due anesthesiologists and surgeons (p=0.01). The relations statistically significant for OR in public hospitals were: activities related to materials and equipments in preparation for surgery (p = 0.014) and intraoperative period due to anesthesiologists and surgeons (p=0.004). These results showed the difference between private and public hospitals. The activities in order to obtain materials and equipment were presented more in public hospitals, where the lack of maintenance and high technology were observed. CONCLUSIONS: OR nurses work as facilitator of surgical team work included conditions to performance the anesthesia and surgery. This is an important part of OR nurses’ role but they would like to have the possibility in developing more activities in order to implement SAEP. REFERENCE Castellanos BEP, Jouclas VMG. Assistencia de enfermagem perioperatoria: um modelo conceitual. Revista da Escola de Enfermagem da USP 1990; 24(3): 359-70.

Objective To analyze the prospective coping styles of nurses in operation room of plastic surgery department and its influencing factors. Methods A total of 169 nurses of two tertiary first-class hospitals and two secondary hospitals in Yuncheng city were selected as the research objects by convenient sampling from January 2016 to January 2017, their general data, dispositional hope, occupational expectations, occupational values, occupational maturity and prospective coping styles were analyzed. The influencing factors of prospective coping style were analyzed. Results The quality of hope was (31.78±4.24) points, occupational expectation was (72.41±7.24) points, professional values were (86.63 ± 7.02) points, professional maturity was (94.58 ± 6.25) points, and prospective coping style was (40.64 ± 6.13) points in the nurses in plastic surgery operation room. The results of multivariate linear regression model showed that the longer working time, high professional title, high degree of education, high monthly income, longer working hours in plastic surgery operation room, high hope quality, high career expectation, high occupational values and high career maturity were all the prospective coping styles of nurses in the operation room. Significant factors (P <0.05). Conclusions The nurses in the plastic surgery operation room have a certain prospective coping style, improve the treatment of nurses, set up their active work goals, improve their hope traits, career expectations, occupational values and career maturity, which can significantly enhance the level of prospective coping style. Key words: Nurses; Plastic surgery operation room; Prospective coping styles

Background: Operation room (OR) nurses are at a high risk for bloodborne pathogen (BBP) exposures because they are constantly in contact with blood and body fluid (BBF) through surgical sites, and they frequently use sharp surgical instruments and sutures during surgeries. We explored occupational experiences with BBP exposures among OR nurses in South Korea. Methods: With an institutional review board’s approval, this qualitative research was performed with 12 OR nurses who had worked for &gt;3 months and had experienced BBP exposures. Based on the main research question “How is the experience of BBP exposure among OR nurses?” the semistructured questions for in-depth interview were prepared. Narrative data were collected through 1-hour individual interviews from June to September 2020 and were analyzed using a thematical analysis method. Results: The average age of the participants was 34.4 years with an average 9.75 years of clinical experience. The main theme extracted was “The nurses are alerted to their safety after experiencing the aftereffects and emotional trauma from BBP exposures,” with 4 subthemes and 14 concepts. The first subtheme, “OR nurses risking exposure to BBF,” included (1) hurried doctors and hasty nurses; (2) sharp surgical instruments everywhere; (3) deprioritized self-protection due to ongoing surgery; (4) inattentive to BBF risk; and (5) uncomfortable, foggy goggles and receded safety devices. The second subtheme, “BBP exposures occurred in a flash,” included (1) sharp injury occurred in a split second; (2) temporarily treat sharp wounds while hiding frightened feelings; and (3) OR nurses concentrated on surgery by suppressing anxiety and sharp wounds. The third subtheme, “Burdened time that could be overwhelmed alone,” included (1) BBP exposures moments that I wish to reverse; (2) anger over dangerous environments and the turmoil of anxiety; (3) exhausted body and facial discoloration due to taking postexposure prophylaxis; and (4) exposure to BBP that I want to hide from family and friends. The fourth subtheme, “Voice for everyone’s safety,” included (1) establishing a safety culture, which requires everyone’s efforts, and (2) necessity of practical resources for decreasing BBP exposures. Conclusions: The participating OR nurses felt that they were working with a high risk to BBF exposures and called for institutional interventions to reduce the risks, including surgeons’ attentive collaboration. Korean hospitals should make greater efforts to establish safety culture in ORs and to provide repeated, tailored education to prevent BBF exposures. They should also supply high-quality protective equipment and safety-engineered devices for OR nurses.Funding: NoDisclosures: None

Le but de cette thèse est de développer des outils statistiques permettant d'initialiser et de calibrer les modèles de microsimulation dynamique stochastique, en partant de l exemple du modèle SimVillages (développé dans le cadre du projet Européen PRIMA). Ce modèle couple des dynamiques démographiques et économiques appliquées à une population de municipalités rurales. Chaque individu de la population, représenté explicitement dans un ménage au sein d une commune, travaille éventuellement dans une autre, et possède sa propre trajectoire de vie. Ainsi, le modèle inclut-il des dynamiques de choix de vie, d étude, de carrière, d union, de naissance, de divorce, de migration et de décès. Nous avons développé, implémenté et testé les modèles et méthodes suivants : 1 / un modèle permettant de générer une population synthétique à partir de données agrégées, où chaque individu est membre d un ménage, vit dans une commune et possède un statut au regard de l emploi. Cette population synthétique est l état initial du modèle. 2 / un modèle permettant de simuler une table d origine-destination des déplacements domicile-travail à partir de données agrégées. 3 / un modèle permettant d estimer le nombre d emplois dans les services de proximité dans une commune donnée en fonction de son nombre d habitants et de son voisinage en termes de service. 4 / une méthode de calibration des paramètres inconnus du modèle SimVillages de manière à satisfaire un ensemble de critères d'erreurs définis sur des sources de données hétérogènes. Cette méthode est fondée sur un nouvel algorithme d échantillonnage séquentiel de type Approximate Bayesian Computation.

Background/Objectives: Operating room (OR) nurses are frequently exposed to high-stress environments, including verbal violence, which may induce post-traumatic stress (PTS). This study investigated the effects of verbal violence, resilience, and social support on PTS among OR nurses. Methods: A cross-sectional descriptive correlational study was conducted with 150 OR nurses who had at least one year of work experience. Data were collected via a mobile-based questionnaire and analyzed using SPSS Statistics 25. The main variables included experiences of verbal violence (from doctors and nurses), resilience, social support, and OR work satisfaction. Results: Exposure to verbal violence from doctors and nurses, as well as having 10 or more years of clinical experience, were significantly associated with higher PTS levels. In contrast, greater OR work satisfaction was associated with lower PTS. These variables collectively explained 36.6% of PTS variance (F = 8.64, p < 0.001). Conclusions: Verbal violence significantly contributes to PTS among OR nurses. Enhancing resilience and social support may mitigate the impact of PTS. Therefore, interventions such as structured peer-support systems, resilience training, and violence-prevention policies are recommended to reduce PTS risk. In addition, interventions to prevent verbal violence, and strengthen resilience and social support, and OR work satisfaction are crucial to protect nurses’ mental health and ensure patient safety.

BackgroundOperating room (OR) nurses need to be resilient in order to cope with extreme demands in their workplace. This research focused on the effectiveness of sensory stimulation therapy (SST) to strengthen the resilience of nurses in the OR of a private hospital in the North West Province.PurposeThe purpose was to determine the effectiveness of SST as an intervention to strengthen the resilience of OR nurses.DesignA quasi-experimental design was used.MethodThe population consisted of OR nurses and ICU nurses at private hospitals in the North West Province. All-inclusive sampling was used. Forty-one OR nurses formed the intervention group. A pilot group (8 subjects, OR nurses), as well as a comparison group (23 subjects, ICU nurses), was also sampled. An intervention, namely SST, was implemented with the intervention group. The resilience of the intervention group, pilot group and comparison group was measured before and after the implementation of the SST by means of Wagnild and Young’s resilience questionnaire. The intervention group also completed a self-report questionnaire on their needs and suggestions for SST and wrote short narratives on their experience of SST. Data were analysed using descriptive and inferential statistics, and by thematic coding.ResultsResults indicated a significant statistical increase in the intervention group’s resilience levels. Results from the narratives confirmed that the intervention group’s resilience may have been strengthened through SST.ConclusionSST has potential to strengthen the resilience of OR nurses.

Surgical site infection (SSI), the third most common type of nosocomial infection in Sweden, is a patient injury that should be prevented. Methods of reducing SSIs include, for instance, disinfecting the skin, maintaining body temperature, and ensuring an aseptic environment. Guidelines for most of these interventions exist, but there is a lack of studies describing to what extent the preventive interventions have been implemented in clinical practice. We describe the daily clinical interventions Swedish operating room (OR) nurses performed to prevent SSIs following national guidelines. A descriptive cross-sectional study using a Web-based questionnaire was conducted among Swedish OR nurses. The study-specific questionnaire included 32 items addressing aspects of the interventions performed to prevent SSI, such as preparation of the patient skin (n = 12), maintenance of patient temperature (n = 10), and choice of materials (n = 10). The response format included both closed and open-ended answers. In total, 967 nurses (43% of the total) answered the questionnaire; of these, 77 were excluded for various reasons. The proportions of the OR nurses who complied with the preventive interventions recommended in the national guidelines were high: skin disinfection solution (93.5%), sterile drapes (97.4%) and gowns (83.8%) for single use, and the use of double gloves (73.0%). However, when guidelines were lacking, some interventions differed, such as the frequency of glove changes and the use of adhesive plastic drapes. To standardize OR nurses' preventive interventions, implementing guidelines seems to be the key priority. Overall, OR nurses have high compliance with the national guidelines regarding interventions to prevent bacterial growth and SSIs in the surgical patient. However, when guidelines are lacking, the preventive interventions lose conformity.

Objective To explore the clinical effect of holistic nursing in the operation room for surgical children patients. Methods 120 patients required surgical treatment were selected and divided into the control group(45 cases)and the observation group(75 cases)randomly.The control group was given routine nursing,the observation group was given holistic nursing including preoperative interview,psychological care and all the preparations,strict check upon going into the operation room and before surgery,to help children keep graceful position,to cooperate closely with the anesthetist and surgeon,to observe the condition of patients and give good infusion management,to give continued observation of the disease condition after surgery,to make children safe escort back to the ward,and to make transfer with ward nurses.The treatment effect was compared between two groups. Results Two groups of children passed the period of operation and anesthesia safely,without appearing accidental situation.The satisfaction degree of the observation group was significantly higher than the control group.One case appeared operation accident and two cases appeared anesthesia awareness in the control group,and they were correctly handled.No one appeared operation accident and anesthesia awareness in the observation group.The differences between the two groups were significant. Conclusions Application of holistic nursing in the operation room for children patients puts forward higher requirements for nurses.It can help children cooperate with surgery better to achieve better surgical results,which is worthy of promotion. Key words: Operation room; Holistic care; Children patients

IntroductionSurgical care has been a vital part of healthcare services worldwide. Several patient safety measures have been adopted universally in the operating room (OR) before, during, and following surgical procedures. Despite this, errors or near misses still occur. Nurses in the OR have a pivotal role in the identification of factors that may impact patient safety and quality of care. Therefore, exploring the OR nurses’ understanding of their roles and responsibilities for patient care and safety in the intraoperative practice, which could lead to optimal patient safety, is essential.ObjectiveThis study explored the understanding of OR nurses regarding their roles and responsibilities for patient care and safety measures in the intraoperative practice.MethodsThe study was conducted in one of the tertiary care hospitals in the United Arab Emirates. Qualitative, descriptive, exploratory research design was utilized. The data were collected using semi-structured face to face interviews. Purposive sampling included eight nurses. Data analysis was performed following Colaizzi's seven-step strategy.ResultsSeven emerging themes were identified. The main themes are: patient safety, preoperative preparation, standardization of practice, time management, staffing appropriateness, staff education and communication, and support to the patient in the OR.ConclusionOR nurse leaders may take into consideration the current findings as a reference for quality improvement projects in the hospital, considering the specific characteristics of each local setting. Although the participants consider that the environment is safe and the quality of care is high in the study setting, there is still room for improvement on workflows and processes. OR workflow should be improved especially by addressing the potential patient safety issues.

BackgroundWith the frequent occurrence of public health emergencies, conflicts and natural disasters around the world, mobile surgical teams are becoming more crucial. The competency of the operating room (OR) nurse has a substantial impact on the effectiveness and quality of the surgical team’s treatment, still there is limited knowledge about OR nurse competencies in mobile surgical teams. This study aimed to explore the competencies of OR nurses in mobile surgical teams based on the Onion Model.MethodsWe conducted a qualitative descriptive study of participants from 10 mobile surgical teams in 2022. Twenty-one surgical team members were interviewed, including 15 OR nurses, four surgeons, and two anesthesiologists. Data were collected through semi-structured interviews. The data were analyzed using Mayring’s content analysis.ResultsTwenty-eight competencies were found in the data analysis, which were grouped into four major domains using the Onion Model. From the outer layer to the inner layer were knowledge and skills, professional abilities, professional quality, and personal traits. The qualitative data revealed several novel competencies, including triage knowledge, self and mutual medical aid, outdoor survival skills, and sense of discipline.ConclusionsThe application of the Onion Model promotes the understanding of competency and strengthens the theoretical foundations of this study. New competencies can enrich the content of the competencies of OR nurses. The results of this study can be used for clinical recruitment, evaluation and training of OR nurses in mobile surgical teams. This study encourages further research to develop competency assessment tools and training programs for OR nurses.

The effects of educational intervention on operating room nurses' use of electrosurgical units