1
|
Ninow B, Rettke H. [Intervention-related demands: Criteria for an operating room-specific patient classification. A qualitative focus group study]. Pflege 2024; 37:131-138. [PMID: 37431560 DOI: 10.1024/1012-5302/a000949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
Intervention-related demands: Criteria for an operating room-specific patient classification. A qualitative focus group study Abstract: Background: Optimal workforce deployment in the operating room-setting has gained high priority in the context of an economized health care system and the development of skill-grade mix. Therefore, mapping intervention-related demands on perioperative nurses as precisely as possible is a frequently discussed need. A surgery-specific patient classification might be helpful. Aim: This paper aims to present core elements of perioperative nursing care in the Swiss-German context and to establish a link to the Perioperative Nursing Data Set (PNDS). Methods: Three focus group interviews with perioperative nurses took place at a university hospital in the German-speaking part of Switzerland. Data analysis was performed in analogy to qualitative content analysis according to Mayring. The content structuring of the categories was based on the relevant PNDS taxonomies. Results: Intervention-related requirements can be divided into three areas: "patient safety", "nursing and caring", and "environmental factors". The conjunction with the PNDS taxonomy serves as a theoretical foundation. Conclusions: Elements of the PNDS taxonomies can describe the demands on perioperative nurses in the Swiss-German context. The identified definition of intervention-related demands can contribute to the visibility of perioperative nursing and promote professionalization as well as practice development in the operating room-setting.
Collapse
Affiliation(s)
- Beate Ninow
- Abteilung Pflege, Spezialgebiete OP-Pflege, Universitätsspital Zürich, Schweiz
| | - Horst Rettke
- Abteilung Pflege, Spezialgebiete OP-Pflege, Universitätsspital Zürich, Schweiz
| |
Collapse
|
2
|
Nyberg A, Jirwe M, Fagerdahl A, Otten V, Haney M, Olofsson B. Perioperative patient safety indicators-A Delphi study. J Clin Nurs 2024. [PMID: 38757741 DOI: 10.1111/jocn.17212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/28/2024] [Accepted: 04/27/2024] [Indexed: 05/18/2024]
Abstract
AIM To identify, define and achieve consensus on perioperative patient safety indicators within a Swedish context. DESIGN A modified Delphi method. METHODS A purposeful sample of 22 experts, all experienced operating room nurse specialists, was recruited for this study. A questionnaire was constructed incorporating statements derived from a preceding study. The experts were asked to rate the importance of each statement concerning patient safety during the perioperative phase. The data collection occurred through an online survey platform between November 2022 and April 2023. The CREDES checklist guided the reporting of this study. RESULTS The three-round Delphi study resulted in consensus on 73 statements out of 103, encompassing 74% process indicators and 26% structure indicators. Key areas of consensus included the use of the Surgical Safety Checklist and optimizing the operating room environment. CONCLUSION Consensus was reached on perioperative safety indicators, underscoring the intricate challenges involved in ensuring patient safety in the operating room. It emphasizes the important integration of both structure and process indicators for comprehensive safety assessment during surgical procedures. Recognizing the difficulty in measuring factors like teamwork and communication, essential for patient safety, the study offers practical guidance. It underlines a balanced approach and specific consensus areas applicable in clinical practice to enhance perioperative patient safety. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE This study provides concrete practice guidance and establishes a structured framework for evaluating perioperative care processes. It emphasizes the critical role of professionals having the necessary skills and being present during surgical procedures. Additionally, the study underscores the paramount importance of effective communication and teamwork within the operating room team, substantively contributing to overall patient safety enhancement. IMPACT The study focused on addressing the challenge of ensuring patient safety in operating rooms, acknowledging the persistent complications related to surgery despite global efforts to eliminate avoidable harm in healthcare. Consensus was reached on 73 crucial indicators for perioperative patient safety, emphasizing a balanced approach integrating both process and structure indicators for a comprehensive assessment of safety during surgical procedures. The study has a broad impact on professionals and healthcare systems, providing concrete guidance for practice and offering a structured process for evaluating perioperative care. REPORTING METHOD The study is reported informed by 'Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations derived from a methodological systematic review'. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
Collapse
Affiliation(s)
- Anette Nyberg
- Department of Nursing, Umeå University, Umeå, Sweden
- Department of Diagnostics and Intervention, Anaesthesiology and Intensive Care Medicine, Umeå University, Umeå, Sweden
| | - Maria Jirwe
- Department of Health Sciences, Swedish Red Cross University, Huddinge, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Solna, Sweden
| | - Ami Fagerdahl
- Department of Clinical Research and Education, Södersjukhuset, Karolinska Institutet, Solna, Sweden
| | - Volker Otten
- Department of Diagnostics and Intervention, Orthopaedics, Umeå University, Umeå, Sweden
| | - Michael Haney
- Department of Diagnostics and Intervention, Anaesthesiology and Intensive Care Medicine, Umeå University, Umeå, Sweden
| | - Birgitta Olofsson
- Department of Nursing, Umeå University, Umeå, Sweden
- Department of Diagnostics and Intervention, Orthopaedics, Umeå University, Umeå, Sweden
| |
Collapse
|
3
|
Ninow B, Staudacher D, Meier B. [Patient safety counts: Counting control in the OR]. UROLOGIE (HEIDELBERG, GERMANY) 2023; 62:961-964. [PMID: 37286778 DOI: 10.1007/s00120-023-02115-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 06/09/2023]
Affiliation(s)
- Beate Ninow
- Universitätsspital Zürich, Rämistraße 100, 8091, Zürich, Schweiz
| | - Diana Staudacher
- Universitätsspital Zürich, Rämistraße 100, 8091, Zürich, Schweiz
| | - Bernadette Meier
- Universitätsspital Zürich, Rämistraße 100, 8091, Zürich, Schweiz.
| |
Collapse
|
4
|
Kymre IG, PhD LU, Pedersen MK, Ingstad K, Pedersen PU. Development and validation of the perioperative care and user participation (POUP) questionnaire. Scand J Caring Sci 2023; 37:141-152. [PMID: 36050922 DOI: 10.1111/scs.13119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/13/2022] [Accepted: 08/14/2022] [Indexed: 11/27/2022]
Abstract
AIM To validate a Perioperative User Participation questionnaire (POUP) that measures elective adult surgical patient experiences and evaluation of the significance of selected perioperative care items. MATERIALS AND METHODS A generic perioperative user involvement questionnaire (POUP) was developed in the form of four psychometric scales based on the Fundamentals of Care (FoC) framework. The POUP is designed to capture patients' perceived and subjective importance of selected items of perioperative care. It was developed in Danish and comprehensive Danish-Norwegian translations were conducted. Face and content validation were conducted involving patients and expert nurses. The relevance of items was assessed by 68 patients, and the internal consistency of the scales was calculated. RESULTS Danish and Norwegian patients assessed the POUP's face validity, and perioperative expert nurses reported no problems in clarity or ambiguity. However, a few reformulations of the questionnaire texts were suggested. None of the questions were reported as irrelevant or difficult to answer nor was any topic reported missing. Patients assessed all items as relevant, and the internal consistency for the three scales was between 0.8 and 0.9, and no differences between countries were found. CONCLUSION The POUP questionnaire has four scales; the items are valid, but the scales need further statistical validation and refinement. At present, the POUP might provide insight into how elective adult surgical patients value the significance of perioperative care.
Collapse
Affiliation(s)
| | | | - Mona Kyndi Pedersen
- Centre for Clinical research, North Denmark Regional Hospital, Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Kari Ingstad
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | - Preben Ulrich Pedersen
- Centre of Clinical Guidelines, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| |
Collapse
|
5
|
White LB, Coyne E, Grealish L. Management of delirium within intraoperative settings for older adults with hip fracture: a scoping review. J Clin Nurs 2021; 30:2169-2178. [PMID: 33616299 DOI: 10.1111/jocn.15720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/20/2021] [Accepted: 02/12/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Delirium is a common adverse event in older patients undergoing hip fracture repair surgery. The impact of hospital-acquired delirium during intraoperative phase of their treatment can have a significant impact on post-operative outcomes. While non-pharmacological, multicomponent delirium prevention interventions are considered standard practice in acute medical units, delirium management in the intraoperative setting is less clear. OBJECTIVES The aim was to identify evidence-based delirium management interventions which are, and could be, undertaken within the intraoperative setting for older patients undergoing hip fracture repair surgery. DESIGN A scoping review following the principles developed by Arksey and O'Malley (2005). DATA SOURCES Seven databases including Cochrane, CINAHL, Embase, MEDLINE, PsychINFO, PubMed and SCOPUS were systematically searched. The search was limited to the last 11 years (2009-2020). Research studies included both primary and secondary sources of evidence. RESULTS A total of 2464 articles were initially identified. These articles were further refined using keyword searches and exclusion criteria, with a final set of 16 articles meeting the inclusion criteria. Three main themes were as follows: anaesthetic-related interventions used to prevent delirium; recognising non-modifiable and potentially modifiable risk factors; and screening and diagnosis of delirium. CONCLUSIONS While there is a strong focus on anaesthetist-led interventions in the intraoperative setting, there are opportunities for more nurse-led interventions through adequate pain management and haemodynamic monitoring that require further research. Identifying the best test for screening and diagnosing delirium in the intraoperative setting requires further research.
Collapse
Affiliation(s)
- Laura Beth White
- School of Nursing & Midwifery & Menzies Health Institute, Griffith University
| | - Elisabeth Coyne
- School of Nursing & Midwifery & Menzies Health Institute, Griffith University
| | - Laurie Grealish
- School of Nursing & Midwifery & Menzies Health Institute, Griffith University.,Gold Coast Health
| |
Collapse
|
6
|
Park BH, Chang SO. A Phenomenographic Approach to Understanding the Expertise of Perioperative Nurses. AORN J 2020; 109:612-620. [PMID: 31025345 DOI: 10.1002/aorn.12663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Understanding the ways that perioperative nurses view the acquisition of expertise may provide foundational information for perioperative nurse educators. Our study aimed to evaluate specific types of expertise exhibited by experienced perioperative nurses and identify how nurses perceived these areas of expertise. We interviewed 20 perioperative nurses working in a university hospital in Korea. We extracted six themes regarding perioperative nursing expertise: sticking to principles, using available resources in complex situations, paying close attention to details, seeing the whole picture, prioritizing actions according to patients' conditions, and organizing a team to maximize efficiency. These findings may help perioperative educators develop practical educational strategies for novice perioperative nurses by providing a common language regarding the areas of expertise exhibited by experienced perioperative nurses.
Collapse
|
7
|
von Vogelsang A, Swenne CL, Gustafsson BÅ, Falk Brynhildsen K. Operating theatre nurse specialist competence to ensure patient safety in the operating theatre: A discursive paper. Nurs Open 2020; 7:495-502. [PMID: 32089845 PMCID: PMC7024629 DOI: 10.1002/nop2.424] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 11/05/2019] [Indexed: 12/15/2022] Open
Abstract
Aim To discuss specialist operating theatre nurses' competence in relation to the general six core competencies and patient safety. Design A discursive analysis of legal statutes and scientific articles. Methods Swedish legal statutes and an overview of scientific articles on operating theatre nursing were deductively analysed and classified into healthcare providers' general six core competencies. Results All healthcare professionals should possess the general core competencies, regardless of their discipline. The specific content within these competencies differs between disciplines. The specialized operating theatre nurse is the only healthcare professional having the competence to be responsible for asepsis, instrumentation, infection and complication, control and management of biological specimens during the surgical procedure. Besides operating theatre nurses, no other healthcare profession has the formal education, competence or skills to perform operating theatre nursing care in the theatre during the surgical procedure. Operating theatre nurse competence is therefore indispensable to ensure patient safety during surgery.
Collapse
Affiliation(s)
- Ann‐Christin von Vogelsang
- Neuro ThemeKarolinska University HospitalStockholmSweden
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
| | | | | | | |
Collapse
|
8
|
Improving Perioperative Knowledge, Self-Efficacy, and Performance in Labor and Delivery Nurses: A Quality Improvement Project. J Nurses Prof Dev 2019; 35:E9-E14. [PMID: 31135616 DOI: 10.1097/nnd.0000000000000559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The obstetrical unit utilized a training product (Periop 101: A Core Curriculum OB) to enhance the knowledge, self-efficacy, and performance of nurses circulating for cesarean births. Knowledge was measured using product provided testing. Self-efficacy was assessed using a modified perioperative self-efficacy scale, and performance was evaluated by analyzing documentation accuracy and incident reports. Results demonstrated improvements in perioperative knowledge, self-efficacy, and documentation as well as a reduction in incident reports.
Collapse
|
9
|
Blomberg A, Bisholt B, Lindwall L. Responsibility for patient care in perioperative practice. Nurs Open 2018; 5:414-421. [PMID: 30062035 PMCID: PMC6056433 DOI: 10.1002/nop2.153] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 03/15/2018] [Indexed: 11/18/2022] Open
Abstract
AIM To obtain an understanding of operating theatre nurses' experiences of responsibility for patient care and safety in perioperative practice. DESIGN A hermeneutic design were used. METHOD Data were collected during 2012 from 15 operating theatre nurses who participated in individual interviews. The text was analyzed by hermeneutical text interpretation. FINDINGS The 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.
Collapse
|
10
|
O'Brien B, Andrews T, Savage E. Anticipatory vigilance: A grounded theory study of minimising risk within the perioperative setting. J Clin Nurs 2017; 27:247-256. [DOI: 10.1111/jocn.13881] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Brid O'Brien
- Department of Nursing & Midwifery; Faculty of Education & Health Science; University of Limerick; Limerick Ireland
| | - Tom Andrews
- School of Nursing and Midwifery; University Collect Cork; Cork Ireland
| | - Eileen Savage
- School of Nursing and Midwifery; University Collect Cork; Cork Ireland
| |
Collapse
|
11
|
Walters C, Webb PJ. Maximizing Efficiency and Reducing Robotic Surgery Costs Using the NASA Task Load Index. AORN J 2017; 106:283-294. [DOI: 10.1016/j.aorn.2017.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 05/25/2017] [Accepted: 08/04/2017] [Indexed: 10/18/2022]
|
12
|
Ingvarsdottir E, Halldorsdottir S. Enhancing patient safety in the operating theatre: from the perspective of experienced operating theatre nurses. Scand J Caring Sci 2017; 32:951-960. [DOI: 10.1111/scs.12532] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 09/05/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Eydis Ingvarsdottir
- Faculty of Graduate Studies; School of Health Sciences; University of Akureyri; Akureyri Iceland
- Akureyri Hospital v. Eyrarlandsveg; Akureyri Iceland
| | - Sigridur Halldorsdottir
- Faculty of Graduate Studies; School of Health Sciences; University of Akureyri; Akureyri Iceland
| |
Collapse
|
13
|
Rauta S, Salanterä S, Vahlberg T, Junttila K. The Criterion Validity, Reliability, and Feasibility of an Instrument for Assessing the Nursing Intensity in Perioperative Settings. Nurs Res Pract 2017; 2017:1048052. [PMID: 28798876 PMCID: PMC5535700 DOI: 10.1155/2017/1048052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 04/02/2017] [Accepted: 06/08/2017] [Indexed: 11/17/2022] Open
Abstract
Patient classification systems generate information for staff allocation based on a patient's care needs. This study aims to test further the instrument for assessing nursing intensity (NI) in perioperative settings. Nine operating departments from five university hospitals were involved. The perioperative nurses gathered data from patients (N = 876) representing different fields of surgery. Reliability was tested by parallel classifications (n = 144). Also, the users' (n = 40) opinions were surveyed. The results support the predictive validity and interrater reliability of the instrument. The nurses considered the instrument feasible to use. The patients' low ASA class did not automatically signify low NI; however, high ASA class was more frequently associated with high intraoperative NI. Intraoperative NI indicated the length of the postanaesthesia care and the type of the follow-up unit. Parallel classifications ensured the homogenous use of the instrument. The use of the instrument is recommended.
Collapse
Affiliation(s)
- Satu Rauta
- Helsinki University Central Hospital, P.O. Box 340, 00029 HUS, Finland
| | - Sanna Salanterä
- Department of Nursing Science and Turku University Hospital, Turku University, 20004 Turku, Finland
| | - Tero Vahlberg
- Department of Biostatistics, Turku University, 20004 Turku, Finland
| | | |
Collapse
|
14
|
Erhaze EK, Dowling M, Devane D. Parental presence at anaesthesia induction: A systematic review. Int J Nurs Pract 2016; 22:397-407. [PMID: 27272603 DOI: 10.1111/ijn.12449] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 04/01/2016] [Accepted: 04/10/2016] [Indexed: 02/02/2023]
Abstract
This systematic review assessed the effectiveness of parental presence for children undergoing surgical or diagnostic procedures under general anaesthesia (such as bronchoscopy, laryngoscopy and laparoscopy). Randomized and quasi randomized trials with healthy children scheduled for elective diagnostic and surgical procedures under general anaesthesia (age range 0-16 years) where the intervention was parental presence at anaesthesia induction were included. A comprehensive literature search was conducted using electronic databases and the reference lists of included studies. The Cochrane collaboration's tool for assessing risk of bias was used for assessment of risk of bias. The Review Manager software was used to analyse and synthesize data. A random-effect meta-analysis was used when there was evidence of clinical and/or statistical heterogeneity. Of the 102 citations identified, nine trials involving 1021 children were eligible for inclusion. Only four were sufficient to be included in the meta-analysis. There was no statistically significant difference on average in the level of anxiety in children and their parents either at separation or at induction between children allocated to parental presence and those allocated to no presence, premedication or parental presence plus premedication groups. Significant debate still surrounds this issue, and future trials should focus on the use of reliable and validated tools in assessing outcome measures.
Collapse
Affiliation(s)
| | - Maura Dowling
- School of Nursing and Midwifery, Aras Moyola, National University of Ireland Galway, Ireland
| | - Declan Devane
- Health Research Board - Trials Methodology Research Network (HRB-TMRN), School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
| |
Collapse
|
15
|
Rauta S, Salanterä S, Vahlberg T, Junttila K. Testing an Instrument for Assessing Nursing Intensity in Perioperative Settings: Construct Validity. Int J Nurs Knowl 2015; 28:233-240. [PMID: 26459138 DOI: 10.1111/2047-3095.12117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Satu Rauta
- Helsinki University Hospital; Helsinki Finland
| | | | | | | |
Collapse
|