Diversities in perceived knowledge and practice of preoperative skin preparation in Swedish orthopaedic surgery

Operating room nurses' experiences of skin preparation in connection with orthopaedic surgery: A focus group study

BACKGROUND

Preoperative skin preparation is performed differently by different operating room nurses.

AIM

To deepen the understanding of skin preparation within an orthopaedic surgical setting from the operating room nurse perspective and to explore their experiences.

METHODS

A qualitative exploratory design was used. Four focus group interviews were conducted during 2016-2017, at four hospitals in Sweden, using procedures developed by Krueger and Casey. A total of 19 operating room nurses were recruited through purposive sampling.

RESULTS

Statements were categorized into four categories of experiences: (1) Knowing, which related to learning and sources of knowledge; (2) Doing, which related to skin preparation and activities based on tradition and evidence; (3) The Team, which related to the assignment of responsibility and collaboration with patients and other professions; and (4) The Setting, which related to factors around the patient and included feelings of time pressure and access to supplies.

CONCLUSIONS

Theory and practice differ, and some skin preparation used are based on tradition rather than on evidence or recommendations. Elements both within the team in the operating room and within the organization influence the result. Operating room nurses' duty to perform safe skin preparation must be respected in the team.

Congruence between perceived and theoretical knowledge before and after an internet-based continuing education program about venous leg ulcer nursing care

BACKGROUND

Previous research has revealed nurses' knowledge gaps in venous leg ulcer (VLU) nursing care, and continuing education is needed. The closer nurses' perceived knowledge is to their evidence-based theoretical knowledge, the better possibilities they have to conduct evidence-based VLU nursing care.

OBJECTIVES

To assess the congruence between nurses' perceived and theoretical knowledge about VLU nursing care before and after an internet-based education about VLU nursing care (eVLU).

DESIGN

Quasi-experimental study with intervention and comparison groups and pre- and post-measurements.

SETTING

Home health care in two Finnish municipalities.

PARTICIPANTS

Nurses (n = 946) working in home health care were invited to participate. In the intervention group, 239 nurses and 229 nurses in the comparison group met the inclusion criteria, and they were all recruited to the study.

METHOD

Nurses were divided into intervention and comparison groups with lottery between the municipalities. Nurses in both groups took care of patients with VLU according to their organizations' instructions. In addition to this, nurses in the intervention group received a 6-week eVLU while those in the comparison group did not. Data were collected with a questionnaire about perceived and theoretical knowledge before education, at six weeks, and at 10 weeks. The percentages of congruence were calculated at every measurement point, and the McNemar test was used to detect statistical significance of changes between measurements.

RESULTS

The increase of congruence was more often statistically significant in the intervention group than in the comparison group.

CONCLUSION

The results support the hypothesis that the congruence between perceived and theoretical knowledge will be higher among nurses receiving eVLU. Because of the low participation and drop-outs, the results should be interpreted with caution.