Newly trained operating room nurses' experiences of nursing care in the operating room

Using Virtual Reality for Perioperative Nursing Education in Complex Neurosurgical Surgeries: A Feasibility and Acceptance Study

Background Operating room (OR) nurses' training for surgical fields such as neurosurgery is often inconsistent and overly lengthy due to the lack of consistently scheduled procedures and the nature of procedures being for the most part emergencies. Virtual reality (VR) simulation has been explored for nurses training in various contexts with positive results. Objectives To develop a VR simulation that could replicate a pediatric neurosurgery craniotomy procedure reflecting a real OR scenario and the surgical procedural sequence of a craniotomy; and to assess OR nurses' confidence in assisting craniotomy procedures as scrub nurses before and after the VR simulation. Methods A pediatric craniotomy procedure was replicated using VR technology by a collaborative partnership between education, content, and technology experts within the Hospital for Sick Children, Toronto. Self-confidence among OR nurses to assist in craniotomy procedures was explored pre- and post-VR training sessions with a questionnaire ideated by the authors evaluating knowledge relevant to assisting craniotomy procedures with seven items. Results In total, 7 OR nurses participated in the study. The post-VR sessions questionnaires showed an increase of positive answers "extremely comfortable with the procedure" and "moderately comfortable with the procedure" compared to pre-VR sessions in all items except for "identify the hemostatic agents required during a bleed," for which no difference was noted. There were no issues with the equipment. Conclusion VR simulation session is an acceptable model to train OR nurses for the scrub nurse role in craniotomy procedures. VR simulation is a practical learning strategy for clinical situations that may occur inconsistently in real-time practice.

Transition support arrangements to support new graduate & novice nurses entry into perioperative nursing: A scoping review

Background and objectives

As novice nurses transition into the workforce, they often experience transition shock as they assimilate into a new role, causing cause significant stress, anxiety and job dissatisfaction. This phenomenon is commonly observed within the perioperative nursing speciality. The development of transition support programs is aimed at assisting novice nurses' transition by providing fundamental knowledge, socialisation, support, and training.This review aimed to uncover the support programs and their components available to nurses transitioning into the perioperative speciality. The research question that provided guidance for this review was 'What are the transition support arrangements, and their characteristics, to support new graduate nurses and novice nurses who are transitioning into perioperative nursing?'.

Literature search

Arksey & O'Malley's' five-step scoping review framework was used. The researchers performed a comprehensive literature search of PubMed, Proquest, CINHAL and SCOPUS with no limit on publication date until April 2023. A blinded screening process was undertaken, and the data extraction was tabulated. Data was presented as a narrative synthesis following thematic analysis.

Results

The initial search identified 537 publications. Screening and duplicate removal led to the exclusion of 512 publications. Of the 25 publications included in this review, two were primary research publications, while the other 23 were discussion papers. Analysis indicated that program approaches and components of programs were frequently described.

Conclusion

The findings highlight the significance of transition programs within the perioperative speciality area. However, the paucity of empirical evidence on the pedagogical underpinnings and evaluation of effectiveness indicates the need for further research. Conducting further research within perioperative transition to practice will enable programs to be designed based on theoretically-sound and evidence-based approaches to support nursing transition to practice within the speciality perioperative environment.

Longer work experience and age associated with safety attitudes in operating room nurses: an online cross-sectional study

BACKGROUND

Patient safety is fundamental when providing care in the operating room. Still, adverse events and errors are a challenge for patient safety worldwide. To avoid preventable patient harm, organisations need a positive safety culture, the measurable component of which is known as the safety climate. To best improve the safety climate the current attitudes to safety must first be understood.

AIM

To explore operating room nurses' safety attitudes and their views on how to improve patient safety in operating rooms.

METHOD

A cross-sectional study using the Swedish-translated version of the Safety Attitudes Questionnaire, Operating Room version. Data were collected using an online survey platform.

RESULTS

358 operating room nurses completed the questionnaire. The results show that the older age group rated their working conditions and management support as better than the younger age groups. The older age group also rated their stress recognition as lower compared with the younger age groups. The same pattern was seen in terms of work experience, with more-experienced respondents showing a higher mean score for the factor working conditions and a lower mean score for the factor stress recognition as compared with their less-experienced colleagues. When comparing hospital types, county hospital employees had higher factor scores for safety climate, job satisfaction and working conditions than university hospital employees. The respondents' most recurring recommendations for improving patient safety were 'Having better and clearer communication' followed by 'Having enough time to do things the way they should be done'.

CONCLUSION

More focus on safety with increasing age and experience was observed in this cohort. Need for improvements is reported for patient safety in operating rooms, mainly when it comes to communication and workload. To improve and develop patient safety in the operating room, the organisational safety climate needs to be actively managed and developed. One step in actively managing the safety climate may be efforts to retain experienced operating room nurses.

Expanding the non-technical skills vocabulary of operating room nurses: a qualitative study

BACKGROUND

Operating room nurses have specialised technical and non-technical skills and are essential members of the surgical team. The profession's dependency of tacit knowledge has made their non-technical skills difficult to access for researchers, thus, creating limitations in the identification of the non-technical skills of operating room nurses. Non-technical skills are categorised in the crew resource management framework, and previously, non-technical skills of operating room nurses have been identified within the scope of the framework. The purpose of this study is to explore operating room nurses' descriptions of their practices in search for non-technical skills not included in the crew resource management framework.

METHODS

This study has a qualitative design. An expert panel of experienced operating room nurses (N = 96) in Norway provided qualitative descriptions of their practice in a Delphi survey. The data were analysed in an inductive thematic analysis. This study was conducted and reported in line with Standards for Reporting Qualitative Research (SRQR).

RESULTS

The inductive thematic analysis developed two themes, 'Ethical competence' and 'Professional accountability', that encompass operating room nurses' novel descriptions of their non-technical skills. The participants take pride in having the patients' best interest as their main objective even if this may threaten their position in the team.

CONCLUSIONS

This study has identified novel non-technical skills that are not described in the crew resource management framework. These findings will contribute to the development of a new behavioural marker system for the non-technical skills of operating room nurses. This system will facilitate verbalisation of tacit knowledge and contribute to an increased knowledge about the operating room nursing profession.

Evolving with technology: Machine learning as an opportunity for operating room nurses to improve surgical care-A commentary

AIMS

To describe machine learning applications in an operating room setting, raise awareness of the lack of nursing inclusion on machine learning algorithm development, and show how operating room nurses can co-create this new technology.

BACKGROUND

Operating room nurses and managers perform anticipatory work on a daily basis to manage intrinsic and extrinsic factors that can cause surgical delays.

EVALUATION

Recent literature on machine learning and its potential use in operating room settings was reviewed along with literature on the role of the nurse in co-creating novel technology.

KEY ISSUE

Machine learning technology is rapidly evolving and being created for the operating room environment to improve patient safety and flow. Operating room nurses and managers are not being included in the development of machine learning algorithms, meaning products may be created that are not usable for all members of the surgical team.

CONCLUSION

This commentary highlights the ways machine learning effectively assists nurses and nursing managers, suggesting a pathway forward for surgical nursing as co-creators and implementers.

IMPLICATION FOR NURSING MANAGEMENT

Nursing managers will be exposed to machine learning programmes in the near future and need to understand the benefits they have for patient safety and patient flow.

Analysis of the Effect of Holistic Nursing in the Operating Room Based on PDCA and Evidence-Based Nursing in the Otorhinolaryngology Operating Room: Based on a Retrospective Case-Control Study

Objective

Based on a retrospective case-control study, this study aims to explore the effect of holistic nursing in operating room based on PDCA (plan, do, check, and action) process and evidence-based nursing (EBN) in a ear, nose, and throat operating room.

Methods

About 200 patients who underwent otorhinolaryngology surgery in our hospital from January 2019 to September 2021 were enrolled. According to the difference of nursing mode, patients were assigned into a control group and study group; holistic nursing in operating room was included in control group, and holistic nursing in the operating room based on PDCA and EBN was included in study group. Nursing satisfaction, hypothermia, chills, restlessness, related indexes of operating room, nursing quality scores of operating room, and individual quality control scores were compared.

Results

First of all, we compared the nursing satisfaction, the study group was very satisfied in 69 cases, satisfactory in 30 cases, general in 1 case, the satisfaction rate was 100.00%, while in the control group, 46 cases were very satisfied, 34 cases were satisfied, 13 cases were general, and 7 cases were dissatisfied, the satisfaction rate was 93.00%. The nursing satisfaction of the study group was higher compared to the control group (P < 0.05). Second, we compared the incidence of hypothermia, chills and restlessness. The incidence of hypothermia, chills, and restlessness in the study group was lower compared to the control group (P < 0.05). The time of tracheal tube extubation, PACU stay time, postoperative hospitalization time, hospitalization cost, and operation time in the study group was significantly lower compared to the control group (P < 0.05). In terms of the scores of nursing quality in the operating room, the instruments and equipment management, equipment preparation, nurses' cooperation skills, disinfection and isolation quality, and total score in the study group were higher compared to the control group (P < 0.05). Finally, we compared the scores of individual quality control examination. The scores of ward management, rescue, therapeutic articles, drug management, first-level nursing, nursing documents, and head nurse management in the study group were higher compared to the control group (P < 0.05).

Conclusion

Incorporating the concepts of PDCA and EBN into the overall care of the operating theatre is effective for patients in the ENT operating theatre. Our results show that this care can be effective in improving patients' surgical indicators, reducing the incidence of postoperative infections, shortening postoperative resuscitation and length of stay, reducing hospital costs, and promoting surgical patient satisfaction. While further multicenter studies are necessary, this series of nursing interventions remains worthy of replication in the clinical setting.

Effects of Seamless Operating Room Nursing Combined with Multistyle Health Education on the Psychological State, Rehabilitation Quality, and Nursing Satisfaction in Patients with Internal Fixation of Femoral Fracture

Objective. To explore the effects of seamless operating room nursing combined with multistyle health education on the psychological state, rehabilitation quality, and nursing satisfaction in patients with internal fixation of femoral fracture. Methods. Eighty patients who received internal fixation of femoral fracture in our hospital (November 2020–November 2021) were chosen as the research objects, and their clinical data were retrospectively analyzed. They were divided into experimental group and control group according to the sequence of hospital admission. In perioperative period, the control group received routine nursing measures and the experimental group received seamless operating room nursing combined with multistyle health education. The patients’ psychological state, rehabilitation quality, and nursing satisfaction after intervention were compared between the two groups. Results. Compared with the control group, the experimental group achieved remarkably lower score of Profile of Mood States (POMS) after nursing ( $p$  < 0.001). The experimental group had much higher cognitive level scores, Harris hip score (HHS), Functional Independence Measure (FIM) score, and nursing satisfaction score in comparison with the control group ( $p$  < 0.05). In perioperative period, the experimental group had much lower total incidence of complications in comparison with the control group ( $p$  < 0.05). Conclusion. Seamless operating room nursing combined with multistyle health education, as an effective measure to improve the rehabilitation quality of the patients with internal fixation of femoral fracture, has better effects on improving the patients’ psychological state and reducing complications in perioperative period in comparison with the routine nursing intervention. Further studies are conducive to providing a better solution for the patients with internal fixation of femoral fracture.

Examining the views of operating room nurses and physicians on the relationship between professional values and professional communication

Purpose

Professional communication and professional values are two basic concepts in operating rooms and should be studied more closely in view of the nature of work and the high circulation of patients in operating rooms.

Methods

The present work is a descriptive-analytic study with a cross-sectional design. The sample was 603 operating room physicians and personnel selected from the public hospitals of Shiraz. The data collection instruments were the 41-item professional communication questionnaire and the 26-item professional values scale.

Results

The results showed that the operating room nurses and physicians perceived the status of professional communication and professional values to be satisfactory. As for professional communication, the participants’ perception of the domains of mutual respect and trust (p ≤ 0.001), teamwork (p ≤ 0.001), ethical competence (p ≤ 0.017), and workplace conflicts (p ≤ 0.001) was significant. As for professional values, only the dimension of care (p ≤ 0.016) was perceived to be significant. Moreover, a significant positive relationship was found to exist between professional communication and professional values (p ≤ 0.001).

Conclusion

Considering the significance of the concept of professional communication and its connection with professional values, it is recommended that operating room personnel and physicians receive systematic education about professional communication and the harms of destructive attitudes as part of their academic education and afterwards.

Operating room nurses' experience about patient cares for laparotomy surgeries: A phenomenological study

Introduction:

The primary purpose of the present study was to explain the lived experiences of operating room nurses in the field of patient care undergoing laparotomy surgeries.

Methods:

The analytical phenomenological method was used. Ten operating room nurses employed in the operating rooms were selected using purposeful sampling. In-depth and semi-structured interviews were used for data collection. Data analysis was also applied using van Manen’s six-step test.

Results:

In this study, 749 initial codes were extracted, classified into three main themes and six sub-themes following the elimination of similar codes. The main themes included a positive view of patient care, preservation of the physical safety of patients, and consideration of patient vulnerability in the operating room. Moreover, responsibility, holistic care, readiness standards of the surgical environment, physical care provision, medical team malpractice, and lack of care context were considered as sub-themes.

Conclusion:

The operating room nurses’ experiences of patient care in operating rooms included a positive view of patient care, preservation of the patient’s physical safety, and consideration of patient vulnerability in the operating room.