Operating Theatre Nurses Research Articles

Professionalisation of operating department practice: an evolutionary perspective

ABSTRACTThe health care professionals staffing the operating theatres of UK hospitals are pursuing a professionalisation agenda based around increasing the academic level of the credential required for entry to their professional register. This paper explores the impact of this on registered Operating Department Practitioners (ODPs) and Theatre Nurses by proposing a theory of professionalisation as an inter- and intra-professional evolutionary process, which resonates with the Red Queen's Hypothesis. The findings show how registered professionals carry out a benchmarking exercise to determine the most suitable route of professional development. The ODPs and nurses who decide to participate in credentialised continuing professional development do so to remain competitive with the new breed of graduates entering the profession. However, their continued study only serves to bring them to the level of the new breed professionals; they are running fast to stand still. We explore and comment on the ripple of behaviours the rise in academic credential produces.

Responsibility for patient care in perioperative practice.

AimTo obtain an understanding of operating theatre nurses' experiences of responsibility for patient care and safety in perioperative practice.DesignA hermeneutic design were used.MethodData were collected during 2012 from 15 operating theatre nurses who participated in individual interviews. The text was analyzed by hermeneutical text interpretation.FindingsThe texts revealed two main themes: A formal external responsibility and personal ethical value. Responsibility that the patient was not exposed to risks, protecting the patient's body, systematically planning and organizing work in the surgical team. The personal ethical value meant confirming the patient as a person, caring for the patient and preserving the patient's dignity. A new understanding emerged that the operating theatre nurse always have the patient in mind.

Disaster education and preparedness in the acute care setting: A cross sectional survey of operating theatre nurse's disaster knowledge and education

BackgroundOperating theatre services can be heavily relied upon during mass casualty disaster events, which require nurses to have adequate training and education of hospital disaster management plans to respond appropriately. The evidence-base of disaster preparedness in the acute setting is limited, particularly with regard to operating theatre nurses. ObjectivesExplore operating theatre nurse's disaster knowledge of their role in a mass casualty event, and identify the preferred mode of disaster education and training to improve disaster preparedness. DesignA cross-sectional research design was employed with data collected using a survey tool. SettingsThe research was undertaken on operating theatre nurses in a tertiary hospital in Victoria, Australia. ParticipantsThe participants in this research included 53 operating theatre nurses, 51 Registered Nurses and 2 Enrolled Nurses. MethodsThe survey was based on a disaster questionnaire for emergency department nurses from South Australia, exploring knowledge and preparedness for disaster response in the acute setting, and altered to be specific and relevant to the operating theatre environment and broadened to focus on the training needs of perioperative nurses. ResultsThe survey of 53 operating theatre nurses identified that few had previous disaster experience (19.9%). The majority of respondents were aware of their disaster management policy (Code Brown policy) (94.1%), of reporting lines, and appropriate triage (80.4%). However, a significant number of nurses (50.9%) stated that in the event of a disaster they would “call work to see if [they needed] additional assistance” compared with 43.4% of respondents “wait to be contacted by a manager/floor coordinator” as was policy. Finally, disaster nursing general knowledge amongst staff was poor; a mean of 1.79 (SD = 1.20) correct answers out of a possible 7. ConclusionsThis study highlights that disaster education and training methods for disasters be specific to the role required by nurses and all staff during a disaster activation; training drills are preferred although face-to-face education is practical.

Enhancing patient safety in the operating theatre: from the perspective of experienced operating theatre nurses.

Surgical care is an extensive component of modern health care, but patient safety issues and complications of surgery have been identified as a major cause of death and disability. The aim of this study was to identify, from the perspective of experienced operating theatre nurses (OTNs), how patient safety in the operating theatre (OT) can be enhanced. In this phenomenological study, 14 individual interviews were conducted with a purposive sample of 11 participants: ten women and one man. Work experience as an OTN spanned 10-40years. Mean experience was 16years. The enhancement of patient safety in the OT from the perspective of the experienced OTNs is a constant endeavour of managing risks and preventing patient harm it involves respecting the vulnerability of the patient in the OT by being attentive to the patient at each moment, making contact with the patient and recognising how the patient loses all control by being anaesthetised or sedated and is, therefore totally dependent on OT staff. It also involves the OTN navigating the patient as safely as possible through the perioperative process by careful preparation, the use of protocols and checklists and taking measures to prevent complications and harm. Moreover, it involves contributing to a culture of safety by improving work conditions in the OT. Certain competencies of the OTN are essential for the enhancement of patient safety in the OT. These involve both nontechnical and technical competencies. Constantly managing risk and preventing the OT patient from harm is essential according to the experienced OTNs, who are in a key position to identify threats to patient safety and should be empowered to enhance patient safety as a constant endeavour.

Operating Theatre Nurses’ Experiences of Participating in the Organ Donation Process in the Perioperative Setting

Operating Theatre Nurses’ Experiences of Participating in the Organ Donation Process in the Perioperative Setting

Burnout Syndrome Of Operating Theatre Nursing Staff And Related Personal And Occupational Factors, Montevideo, Uruguay.

The objective of this research is to describe the link between the middle and high levels of the Burnout Syndrome as well as the related personal and occupational factors of nursing staff who work in an operating theatre in the city of Montevideo, Uruguay. The method applied was quantitative, descriptive, and cross-sectional, with non-probabilistic sampling by convenience, according to inclusion criteria; it was carried out over October-December 2015. The bioethical aspects were preserved in accordance with to the Declaration of Human Rights of Helsinki, and the research was conducted in compliance with the decree of the Ministry of Health as to research on human subjects; also, the voluntary nature of participation was respected, and informed consent was requested. The findings obtained were that the age of the nursing professional with high and medium burnout syndrome fluctuates between 40 - 59; the older the person, the acuter the syndrome is. The sex of the nursing staff with the syndrome is female. As to the marital status, individuals tend not to live with a permanent partner and have one child. The higher the seniority, the higher the probability of suffering the syndrome, and seniority is also connected with having worked at the operation theatre for shorter periods than 10 years. Working at multiple jobs is a dominant occupational factor for the presence of the syndrome. It is concluded that middle and high level burnout syndrome in nursing staff, who work in areas of an operating theater, is closely linked to occupational and personal factors described by scientific evidence, for exposure to chronic stress at work.Key words : occupational health, operating theatre nursing, operating theatre

Intraoperative Care of the Conscious Patient from the Perspective of the Operating Theatre Nurse: A Grounded Theory

Introduction: Intraoperative care includes a unique knowledge of how to perform a safe and effective surgery procedure. Surgery performed under regional or local anaesthesia allows the patient to remain conscious during the procedure and is rather common in Swedish healthcare today. Aim: The aim was to obtain a deeper understanding of the main concerns of operating theatre nurses (OTN) when caring for conscious patients during the intraoperative phase. Methods: Interviews were conducted with 23 OTNs from five different hospitals in Sweden and analysed according to grounded theory. Findings: The main concern among the OTNs was to take the patient in consideration. The core category “achieve and maintain ethical treatment of patients” in the operating theatre (OT) was a strategy used throughout the intraoperative process. Ethical treatment was described as moral behaviour at different levels and included the team’s behaviour, respectful and individualised patientcare, and the working-morale of the professionals. Being vigilant and being flexible were the categories related to the core category. The OTNs constantly assessed where to pay most attention as they balanced between the needs of the patient, the team, and the surgery procedure. Conclusion: It is important that every patient is taken into consideration and that ethical principles are held to the highest standards in the OT. A familiar team can facilitate that. The complex skills that operating theatre nurses develop can be added to explain important competencies within the profession.

Aseptic practice recommendations for circulating operating theatre nurses.

Aseptic practices prevent exposure of a surgical wound to microbes, operating theatre environment and personnel. The circulating nurse assists the operating theatre personnel and supervises aseptic practices preventing surgical site infections. In the absence of analytical tools, few studies exist on intraoperative nursing-related aseptic practices. This study introduces recommendations to assess the role of the circulating nurse in aseptic practices. The authors used international recommendations and research findings to construct a 20-item self-report instrument with a demonstrated reliability across the scale. The authors structured the scale based on three phases: establishment; maintenance; and disestablishment of a sterile operating field. The tool was tested among operating theatre and day surgery nurses, and compared the differences in the mean acceptance rates of aseptic practice recommendations based on background characteristics. College-level nurses and nurses with 15 or more years' work experience accepted the recommendations at higher levels than bachelor-level nurses and nurses with less work experience. Continual assessment of the evidence base and comprehensive evaluation represent important components in further developing the tool. A reasonable number of items covering clinical practice are necessary for assessing the effectiveness and cost-effectiveness of aseptic practices, and a larger response rate is needed to validate the tool in future.

Operating theatre nurses’ experiences of teamwork for safe surgery

The aim of this study was to describe operating theatre nurses’ experiences of teamwork within the surgical team in regard to achieving patient safety. Safe surgery for patients is based on teamwork in a safe modus between the members in the surgical team. Operating theatre nurses contribute to safe surgery by professional perioperative nursing activities and by participation in teamwork in the surgical team. A qualitative descriptive design using narrative interviews with 16 operating theatre nurses in Sweden was chosen for increased understanding of their experiences of teamwork in regard to achieving patient safety. The findings are presented in three themes, illustrating teamwork in regard to achieving patient safety between the operating theatre nurses’ and other professionals in everyday situations. From the operating theatre nurses’ narrated experiences of teamwork, person-centred nursing care, interdependent collaboration and familiarity of the professionals’ skills contributed to safe surgery. A brief meeting, unfamiliarity of professionals’ skills, uncontrolled tantrums and experiences of exclusion were experienced as counteractive to patient safety. The operating theatre nurses managed demanding situations by diverse strategies to restore patient safety.

Video-Supported Simulation for Interactions in the Operating Theatre (ViSIOT)

This article introduces a data-grounded simulation model for training social interaction strategies to operating theatre nurses. Video-Supported Simulation for Interactions in the Operating Theatre draws on original video-based research on teamwork in the operating theatres in the United Kingdom. The objective of this model was to improve verbal and nonverbal interactions between nurses and surgeons that often fall outside explicit training. These involve visual monitoring of colleagues, verbal responsiveness, speaking up about distractions, and seeking prompt clarification when needed. The model includes two scenarios and video-supported debriefing, which uses authentic research footage from the operating theatres. In the article, the strategies are briefly communicated and implications for training are discussed.

Making the invisible visible--operating theatre nurses' perceptions of caring in perioperative practice.

The aim of this study was to describe operating theatre nurses' (OTNs') perceptions of caring in perioperative practice. A qualitative descriptive design was performed. Data were collected with interviews were carried out with fifteen strategically selected operating theatre nurses from different operating theatres in the middle of Sweden. A phenomenographic analysis was used to analyse the interviews. The findings show that operating theatre nurses' perceptions of caring in perioperative practice can be summarised in one main category: To follow the patient all the way. Two descriptive categories emerged: To ensure continuity of patient care and keeping a watchful eye. The operating theatre nurses got to know the patient and as a result became responsible for the patient. They protected the patient's body and preserved patient dignity in perioperative practice. The findings show different aspects of caring in perioperative practice. OTNs wanted to be more involved in patient care and follow the patient throughout the perioperative nursing process. Although OTNs have the ambition to make the care in perioperative practice visible, there is today a medical technical approach which promotes OTNs continuing to offer care in secret.

Student nurses' experiences of preserved dignity in perioperative practice - Part I.

In recent years, operating theatre nurse students' education focussed on ethical value issues and how the patient's dignity is respected in the perioperative practice. Health professionals are frequently confronted with ethical issues that can impact on patient's care during surgery. The objective of this study was to present what operating theatre nurse students experienced and interpreted as preserved dignity in perioperative practice. The study has a descriptive design with a hermeneutic approach. Data were collected using Flanagan's critical incident technique. Operating theatre nurse students from Sweden and Norway participated and collected data in 2011, after education in ethics and dignity. Data consisting of 47 written stories and the text were analysed with hermeneutical text interpretation. The study was conducted accordance with the Declaration of Helsinki and approved by a local University Ethics Research Committee. The findings revealed that students experienced that operating theatre nurses perserved patient's dignity in perioperative practice by being present for each other and making themselves known to the patient. Operating theatre nurses caring for the patient by being compassionate and preserved the patient privacy. The new understanding that emerged was that the operating theatre nurse students understood that the operating theatre nurse wanted to care for the patient like a human being. In the discussion, we have illuminated how professional ethics may be threatened by more pragmatic and utilitarian arguments contained in regulations and transplant act. Preserved dignity is an ethical and caring act. Ethical questions and how to preserve dignity in perioperative practice should be discussed more both in educations of healthcare professionals and in clinical practice.

Speed of onset of spinal vs general anaesthesia for caesarean section

I read with interest the article by Kathirgamanathan et al. 1 comparing the time taken to achieve ‘adequate surgical anaesthesia’ between spinal and general anaesthesia for category-1 caesarean sections. I believe that their findings are quantitatively correct but that the focus on anaesthetic time in isolation is likely to reinforce potentially harmful practices. The authors found a 7-min difference between the median times to surgical readiness for spinal anaesthesia (8:52 min:s) and general anaesthesia (1:56 min:s). We have previously reported a mean difference of 7 min from the patient's arrival into the operating room to delivery of the infant between spinal and general anaesthesia in 444 category-1 caesarean sections 2. Similarly, Beckmann and Calderbank 3 describe an 8-min difference in decision-to-delivery interval comparing spinal and general anaesthesia in 533 category-1 deliveries. However, there is a lack of convincing evidence that observed time differences result in any meaningful variation in neonatal outcome. Furthermore, a narrow focus on reducing anaesthetic time can result in adverse maternal outcome, as demonstrated in the last Confidential Enquiries into Maternal Deaths report by the death of a woman from an airway-related complication administered general anaesthesia, who had a functioning epidural 4. There is much debate as to what represents an appropriate decision-to-delivery time interval for category-1 caesarean sections, with only a minority of UK units achieving < 30 min 5. Given the median anaesthetic times of just under 9 min for spinals and 2 min for general anaesthetics reported by Kathirgamanathan et al., it is apparent that the anaesthetic time represents only a small proportion of the total decision-to-delivery interval. The decision to perform a category-1 caesarean delivery and transfer a patient to an operating theatre is a complex process requiring a co-ordinated response from a large team including hospital porters, midwives, operating theatre nurses, obstetricians, anaesthetists and paediatricians. Attempts to shorten the anaesthetic time by altering established techniques, whether using general or regional anaesthesia, are likely to result in only modest time savings overall. It is also well known that violations of established work practices contribute to a large proportion of adverse events 6. When this is combined with patient transfer in a time-pressured environment there is a very significant threat to patient safety. Instead, the biggest gains are likely to come from examining the entire process, including decision-making and teamwork issues.

372 Natural rubber latex aeroallergen exposure and allergy among female nurses in governmental hospitals, Thailand

ObjectivesThe aim of the study was to determine the prevalence of latex allergy in nurses and to determine occupational risk factors.MethodsA cross-sectional study was conducted in 899 female nurses from...

Building clinical practice in the Palestine Red Crescent operation theatres in Lebanon: reflections from the perspective of an expatriate nurse

This paper, based on the experience of the first author as an expatriate nurse, aims to describe and discuss some aspects of collaboration that contributed to the building of clinical practice when implementing an operating theatre programme in the Palestine Red Crescent Society (PRCS) hospitals in Lebanon. The operation theatre programme lasted for 8 months: 6 months in 2008 and 2 months in 2009. The programme was part of the partnership project 'Quality of care in the five PRCS hospitals in Lebanon' between the International Committee of the Red Cross and the PRCS Lebanon (PRCS-L) branch. The essential aspects that may have contributed to the building of clinical practice in the operation theatre programme included the expatriate nurse and the Palestine Red Crescent operating theatre nurses working together over time as colleagues, the socio-cultural pedagogic perspective selected for the implementation and the collaboration with the management of the hospitals and counterparts in the PRCS-L branch. One should also note the human and structural issues that seemed to influence the implementation of the programme in a more negative way. This experience may provide insight for other nurses into the importance of working as colleagues, selecting an appropriate pedagogic perspective and establishing productive collaboration with all partners when building clinical practice during a humanitarian mission.

Komandinio darbo operacinėje efektyvumo vertinimas operacinės komandos narių požiūriu

Work in the operating theatre is carried on under the team principle where division of labour, competence, instant reaction, tolerance, work knowledge and skills as well as associating with team members are of greatest significance. Fluctuation of opera-ting theatre team members results in difficulty in concentration, loss of valuable time and work quality, and has negative influence upon work process.The aim of this work was to evaluate the efficacy of the team work in the Operating Theatre Room from the viewpoint of team members.The sample was (n=21): operating theatre nurses, anaesthesiologists reanimatologists, surgeons, other staff. The gender was not homogeneous; the experience of work of the participants was from 3 to 30 years. The qualitative research was done. The methods of critical analysis and semi-structured interview were used.The research should be significant in the development of the science of nursing and nursing practice in Lithuania, especially in the sphere of surgical nursing. It could also be useful to both nurses and patients as both these groups are interested in the improvement of nursing quality: nurses as suppliers of the service and patients as its receivers.

Operating theatre nurses’ experience of patient‐related, intraoperative nursing care

The way patient-related, intraoperative nursing care is performed by operating theatre nurses' has not been elucidated in any great detail. The aim of this study therefore was to describe theatre nurses' experience of patient-related, intraoperative nursing care. The study draws on qualitative, interpretive description methodology. Sixteen specialists in operating theatre nursing care, working in rural or metropolitan hospitals in Sweden, were included in the study. Data were collected by means of interviews and analysed using an inductive, qualitative, descriptive analysis technique. The data analysis resulted in 15 overarching nursing care procedures and three motives for nursing care procedures in the field of intraoperative nursing care with the goal of achieving the best surgical outcome for the patient. The operating theatre nurses' experience of patient-related, intraoperative nursing care was described as procedures to create a continuous, confidence-based relationship and situation-related well-being; procedures to guarantee patient safety and well-being by keeping a watchful eye; and procedures to create a secure environment that promotes wound healing, recovery and well-being.

Operating theatre nurses’ perceptions of competence: a focus group study

This paper is a report of a study exploring nurses' perceptions of the components of competence in the operating theatre. Competency Standards for operating theatre practice are used in some countries to guide clinical and professional behaviours. The need for competence assessment has been enshrined, but the conceptualization and agreement about what signifies competence in Operating Theatre has been lacking. Three focus groups were conducted with 27 operating theatre nurses in three major metropolitan hospitals in Queensland, Australia. Interviews were audio taped and field notes were taken. Data were collected during 2008. Thematic analysis was performed. From the analysis of the textual data, three themes were identified: 'coalescence of theoretical, practical, situational and aesthetic knowledge within a technocratic environment'; 'the importance of highly developed communication skills among teams of divergent personalities and situations'; and 'managing and coordinating the flow of the list'. These findings have identified that competence in respect to components of knowledge, teamwork and communication, and the ability to coordinate and manage are important and should be incorporated in operating theatre Competency Standards. Additionally, findings may assist in the development of an instrument to measure operating nurses' perceived competence.

Ten Reasons Why Operating Department Practitioners and Theatre Nurses Might Not Want to Quote or Cite from this Article

Academic writing can fill pre- and post-registration students with fear and dread. Students often construct written work around re-worded passages from their sources. This results in poor quality work, low marks and frustration. The aim of this article is to inform students embarking on courses in higher education about what academic writing is--and equally importantly what it is not.

Nurses Conceptions of the Professional Role of Operation Theatre and Psychiatric Nurses

The shortage of specialist trained nurses in the operating theatre and psychiatric care is a problem in Swedish health care. There is a great need for recruitment since in both areas nurses have a high average age and few students register in these specialties at university. The reason for the low interest for these specialties is not clear. The purpose of the study was to investigate nurses' and nurse students' conceptions of the professional role of operating theatre and psychiatric care nurses. A qualitative approach with phenomenographic method was used. Twelve nurses and four nurse students were interviewed. Three categories of conceptions within each specialty emerged. Operating theatre nurses'professional role was perceived as: Dependent assistant, Responsible monitor and Fragmented nurse. Psychiatric nurses' professional role was perceived as: Empathetic agent, Conscious diplomat and Fragmented nurse. The informants had difficulties in understanding the professional role in both fields. One conclusion is that the theoretical and clinical training in basic nurse education play an important role for choosing specialist training as operating theatre nurse or psychiatric nurse.