The current nationwide shortage of registered nurses is a growing problem impacting patient care and hospital operations. The operating room is the area most affected by the nursing shortage. Reasons cited for this shortage include ineffective nursing orientation programs and a decline in job satisfaction. The purpose of this project was to develop a best practice succession planning educational program to provide novice operating room nurses with an introduction to the operating room. The Dreyfus model of skills acquisition and Benner's novice to expert theory guided this project. A 2-step process was used to assess and validate the content and quality of the educational program. In Phase 1, the educational program was distributed to 10 operating room nurse stakeholders for formative review. There was agreement from these reviewers that the educational program covered key concepts important for novice operating room nurses. Two recommendations were made for additional clarification. In Phase II, the educational program was revised and distributed to a group of 10 perioperative professionals for summative review using the AGREE II instrument. The summative review group found the educational program to be clear and concise. The overall summative approval of 100% and recommendations of both review groups guided the final development of the best practice educational module. This best practice educational module will provide a standardized program for educating novice operating room nurses. This project will contribute to positive social change by empowering these nurses while supporting safe care for all surgical patients. Dissemination will occur first within the organization and then to local and national organizations targeting operating room nurses.

The nursing workforce has experienced considerable change during the previous decade, resulting in a chronic shortage of nurses. Issues such as economic rationalism, increased workloads, changes in nursing education and the advancing age of the current nursing workforce are the chief contributors to this shortage (Australian Institute of Health & Welfare, 2005b; Buerhaus, Staiger, & Auerbach, 2000b). Operating room (OR) nursing is a primary specialty area that has been especially affected by rising nurse attrition and a reduction in nurse recruitment (Australian College of Operating Room Nurses, 2003; Australian Health Workforce Advisory Committee, 2002). Accordingly, the loss of skilled nurses from the OR specialty compounds the negative effects on morale for those who remain in the environment, as they struggle to provide safe patient care while concomitantly being responsible for the clinical development of neophyte and inexperienced nurses (Australian Health Workforce Advisory Committee, 2002; Arndt, 1998). In the midst of working in the OR environs where the nature of the associated stressors is unique, resilient qualities may assist nurses to meet and overcome these challenges. If there is to be a continued nursing presence in the OR, it is essential that nurses be given the opportunity to develop resilience. At this time when nurse retention rates are continuing to decline steadily, there is a compelling need to identify and describe the relationship between resilience and its predictors in the context of the OR. To date, little is known about predictors of resilience and their potential to ameliorate the effects of workplace stress in the OR. The overall purpose of this study was to identify and describe the predictors of resilience in OR nurses. A literature review and concept analysis of resilience was initially conducted. Hope, self-efficacy, coping and personal characteristics were identified as defining characteristics of resilience. Next, the research was conducted as a mixed method phased study that was underpinned by the pragmatist paradigm, and employed a sequenced combination of qualitative followed by quantitative inquiry (Morgan, 1998). The first phase used a mini-ethnography to identify and describe the components of workplace culture in an OR in relation to their potential impact on nurses’ ability to adapt in this culture. A triangulated approach was used involving participant observation, a reflective journal, field notes and interviews. This phase revealed that competence, knowledge, collaboration, peer support and the ability to manage challenges were central components of OR workplace culture. From these categories, three themes were abstracted and subsequently developed into constructs that were measured and validated in the larger second phase. The second phase used a predictive correlation survey to describe empirically the relationship between resilience and its hypothesised predictors in a systematic random national sample of nurses who were members of the Australian College of Operating Room Nurses (ACORN), and a combined sample of hospital nurses purposively drawn from two similar hospital sites. The survey included scales measuring perceived competence, collaboration, managing stress, self-efficacy, hope, coping, and resilience, as well as gathering information about the demographic characteristics of nurse respondents. Out of a total potential sample of 1,730 OR nurses, the overall response rate was 51.7% (n = 896). Differences between the ACORN and hospital samples were found in age, years of experience, education and years of employment; therefore, the national and hospital samples’ findings were analysed separately. Five independent variables – hope, self-efficacy, coping, managing stress and competence – predicted resilience in the larger sample of ACORN respondents (n = 772). For the substantially smaller sample of hospital respondents (n = 124), hope, self-efficacy and managing stress predicted resilience. Given that the smaller hospital sample resulted in a similar model, this consistency lends strength and weight to the revised resilience model. Over 60% of the variance in resilience was explained by the independent variables in each model. Given the dearth of literature describing the efficacy of resilience in ameliorating stress in OR contexts, the results of this study have extended the theoretical application of the resilience concept to include a nursing context. There is a need to implement resilience-building strategies that address the culture of the OR, both at the departmental and organisational levels. Strategies that provide a supportive workplace environment in relation to goal-orientation, the provision of stress management and education programs, and strategies that facilitate cultural assimilation may improve resilience, and hence retention and recruitment rates in the OR. The findings of this study support the need for further research not only to test the stability of the proposed model among other groups of nurses but also to explore further predictors of resilience in the OR setting.

<p>Inom operationssjukvård förebyggs postoperativa infektioner genom att operationspersonalen utför preoperativ handdesinfektion. Det finns två handdesinfektionsmetoder som rekommenderas att använda, Metod 1 för alkoholbaserad handdesinfektion (Sterillium) och Metod 2 för antiseptisk handdesinfektion (Hibiscrub). Syftet med studien var att studera och jämföra olika preoperativa handdesinfektionsmetoder inom operationssjukvård. Metoden var en litteraturstudie som baserades på 11 vetenskapliga studier. Systematiska sökningar gjordes i databaserna CINAHL och Medline samt via manuella sökningar. Sökorden användes enskilt och i kombination. Jämförelse gjordes av de två rekommenderade handdesinfektionsmetoderna utifrån evidens samt framkomna kategorier: effekter, hudens tolerans och tid. Den preoperativa alkoholbaserade handdesinfektionsmetoden med Sterillium (Metod 1) var betydligt mer effektiv än den preoperativa antiseptiska handdesinfektionsmetoden med Hibiscrub (Metod 2). Den visade även bättre resultat gällande hudens tolerans, operationstidens längd samt att den var mer tidssparande och smidigare att utföra. Det visade sig också ha betydelse på effekten hur den preoperativa alkoholbaserade handdesinfektionen utfördes. I studiens resultat framkom inget som styrkte Metod 2.</p> / Uppsatsseminarium utfördes 2008-05-16

Inom operationssjukvård förebyggs postoperativa infektioner genom att operationspersonalen utför preoperativ handdesinfektion. Det finns två handdesinfektionsmetoder som rekommenderas att använda, Metod 1 för alkoholbaserad handdesinfektion (Sterillium) och Metod 2 för antiseptisk handdesinfektion (Hibiscrub). Syftet med studien var att studera och jämföra olika preoperativa handdesinfektionsmetoder inom operationssjukvård. Metoden var en litteraturstudie som baserades på 11 vetenskapliga studier. Systematiska sökningar gjordes i databaserna CINAHL och Medline samt via manuella sökningar. Sökorden användes enskilt och i kombination. Jämförelse gjordes av de två rekommenderade handdesinfektionsmetoderna utifrån evidens samt framkomna kategorier: effekter, hudens tolerans och tid. Den preoperativa alkoholbaserade handdesinfektionsmetoden med Sterillium (Metod 1) var betydligt mer effektiv än den preoperativa antiseptiska handdesinfektionsmetoden med Hibiscrub (Metod 2). Den visade även bättre resultat gällande hudens tolerans, operationstidens längd samt att den var mer tidssparande och smidigare att utföra. Det visade sig också ha betydelse på effekten hur den preoperativa alkoholbaserade handdesinfektionen utfördes. I studiens resultat framkom inget som styrkte Metod 2. / Uppsatsseminarium utfördes 2008-05-16

Syftet med studien var att undersöka hur sköterskor som arbetar på en operationsavdelning där WHO´s Surgical Safety Checklist används, upplever kommunikation, samarbete och patientsäkerhet. Kort metodbeskrivning: Kvantitativ metod. Design: Deskriptiv, retrospektiv, icke-experimentell tvärsnittsstudie. Datainsamlingen genomfördes på en operationsavdelning som använt WHO´s Surgical Safety Checklist drygt ett år. Deltagarna fick anonymt besvara ett frågeformulär med strukturerade frågor, en översatt version av the Safety Attitudes Questionnaire (SAQ) anpassad till operationspersonal (OR). I studien undersöktes 3 av frågeformulärets 6 teman: säkerhetskultur, samarbetsklimat och stressidentifiering. Vidare undersöktes hur sköterskorna tyckte att kommunikationen på operationssalen fungerade; samt i vilken grad checklistan hade förbättrat kommunikationen, samarbetet och patientsäkerheten på operationssalen. Varje fråga besvarades genom en femgradig Likertskala. Huvudresultat: Fynden visar att man kan anta att sköterskorna upplevde att kvaliteten på kommunikationen och samarbetet på operationssalen var hög. Vidare ser det ut som om deltagarna ansåg att patientsäkerheten fungerade adekvat och att checklistan var viktig för patientsäkerheten. Resultaten visar också att sköterskorna tyckte att checklistan i hög grad har förbättrat kommunikationen, samarbetet och patientsäkerheten på operationssalen. Slutsats: Sköterskornas upplevelse av kommunikation, samarbete och patientsäkerhet på operationssalen antas huvudsakligen vara positiv 1 år efter att WHO´s Surgical Safety Checklist infördes. / The aim of the study was to examine the nurses´ experiences of communication, teamwork and patient safety in an operation ward where WHO´s Surgical Safety Checklist is used.  Quantitative method. Design: descriptive, retrospective, non-experimental cross-sectional study. The data collection was implemented in an operation theatre where WHO´s Surgical Safety Checklist had been applied for the last year. The participants responded to a structured questionnaire, a translated version of the Safety Attitudes Questionnaire (SAQ) adjusted for operating rooms (OR). In the study 3 of 6 themes of the questionnaire was examined: safety culture, teamwork climate and stress identity. The study examined the nurses´ experiences of communication in the operating room; and to what extent the checklist has improved the communication, teamwork and patient safety in the operating room. Each item was answered using a 5-point Likert scale. The findings reveal nurses´ experience of high quality of communication and collaboration in the operating room. Further it seems that the participants thought the patient safety was sufficient, and the checklist briefing was important for the patient safety. The results also show that nurses thought the checklist briefing has improved the communication, collaboration and patient safety in the operating room. The nurses´ experiences of communication, teamwork and patient safety in the operating room were assumed as mostly positive 1 year after the introduction of the WHO´s Surgical Safety Checklist.

Objective Healthcare system now, with global budget payment, is facing an increasing challenge mainly due to patient oriented environment, more demand for service quality and organizational re-arrangement. Also due to the high cost of personalle and equipments in the operation room , it is quite important to maintain the high efficiency of management to encompass high volume of surgeries. Staffing and scheduling is the most important issue in the management of the operating room and has direct impact on the operational efficiency, cost and revenue. The purpose of this study is to investigate the influence of staffing and scheduling of the operating room on its efficiency. How we control the sum of the patients requiring operation under present circumstances lies on whether or not we have efficient management of the operation room. The most important part among it depends on the ability of schedule arrangement, which directly influence the performance audit and cost. Materials and Methods:The purpose of this study is to discuss the impact of schedule arrangement on cost in the operation room of one medical center. Retro spective descriptive design. Those first operations performed from July 1st, 2003 to June 30th, 2004 were collected into the controlled group while those performed from July 1st, 2004 to June 30th, 2005 were gathered into the experimental group. Indicators of the effect including the sum of the patients receiving operation, the utilization rate of the operation room, the cancellation rate of scheduled operation, the number of overtime nursing staff and overtime payment, the delayed rate and time of the first operation. We use ANOVA, x2 test, multiple logistic regression and t test to analyze these data. We will discuss issues as the followings to smooth our operation schedule: the arrangement of the fist operation by program manager, setting up a flow chart for nursing staff while admitting the patients, establishing a check-in flow chart for patients of out-patient department and deployment of pageboys. Results: The data showed that the incidence of delaying surgery were decreased by 8.4% in the experiment group as compared to the control group. The operation room occupation rate increased to 84.3% in control group, as compared to 78.25% in experiment group. There is 0.76% decrease in the rate of canceling operation schedule . The number of nursing staff who worked overtime and the overtime payment decreased significantly. The time needed from patients entering operation room to the operation began also decreased significantly. The rate of delaying the first scheduled operation decreased from 52.8% to 12.3%. Conclusion: Operation room managers, leader in department of surgery, and hospital managers could take our results as reference in improving efficiency and decreasing cost.

No description available.

In selected patients, surgical treatments such as cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have enabled curative treatment options for previously incurable diseases, such as peritoneal carcinomatosis (PC). The introduction of resource demanding surgery could affect the work process, efficiency, and productivity within a surgical department and factors influencing patient postoperative recovery processes may have an impact on the efficiency of patient care after major surgery. The aim of this thesis was to investigate operating room efficiency from the perspective of both staff and leaders’ in two different settings (Papers I and II) and the early postoperative recovery of patients with peritoneal carcinomatosis (Papers III and IV). Interviews were held with 21 people in a county hospital and 11 members of the PC team in a university hospital, and a phenomenographic approach was used to analysis the data (Papers I and II). The patients’ postoperative recovery and pulmonary adverse events (AE) were determined from data retrieved from the electronic health records of 76 patients (Papers III and IV). The concept of efficiency was understood in different ways by staff members and their leaders (Paper I). However, when working in a team, the team members had both organisation-oriented and individual-oriented understanding of efficiency at work that focused on the patients and the quality of care (Paper II). The patients with PC regained gastrointestinal functions and could be mobilised during early postoperative recovery phase, although many patients suffered from psychological disturbances, sleep deprivation, and nausea (Paper III). Postoperative clinical and radiological pulmonary AE were common, but did not affect the early recovery process (Paper IV). In conclusion, leaders who are aware of the variation in understanding the concept of efficiency are better able to create the same platform for staff members by defining the concept of efficiency within the organisation. In a team organisation, the team members have a wider understanding of the concept of efficiency with more focus on the patients. The factors affecting postoperative recovery and pulmonary AE should be considered when designing individualised patient care plans in order to attain a more efficient recovery.

Thesis (Ph.D.)--Duquesne University, 2006. / Title from document title page. Abstract included in electronic submission form. Includes bibliographical references (p.146-151) and index.

Operating room nursing skills are some of the most demanding skills in the nursing profession. At the moment nurses trained in operating room technique are in very short supply in Ethiopia, due to the exodus of nurses to better working environments with more reasonable payment. This is especially noticeable in one of the state hospitals in Addis Ababa, Ethiopia, as emerged in conversations with the head nurse of the operating room in this hospital about the high turnover rate, as well as the high absenteeism rate amongst the nurses working in the operating room. Nurses working in the operating room also expressed unhappiness in their work environment which could cause them to look for other jobs or to be absent from duty. The nurses were facing numerous problems in their work environment such as work overload due to staff shortage, stress due to shortage of supplies because they are not able to do their job as much as the need requires. The researcher identified the need to explore the challenges that the operating room nurses are experiencing in their work environment. The researcher used the following questions to meet the research objectives: What are the experiences of the operating room nurses in their work environment?; What potential assistance would such nurses need to better cope with the problems they experience in their work environment? The research study aimed to explore and describe the experience of operating room nurses in their work environment and on the basis of the findings to develop guidelines to assist the operating room nurses in coping more effectively with their work environment. The researcher used a qualitative approach with an explorative, descriptive and contextual design. Fifteen registered nurses were selected using purposive sampling. Informed consent was obtained from the participants and permission from the Ethics Committee of the Nelson Mandela Metropolitan University, as well as Yekatit 12 Hospital. Data were gathered using face to face interviews and field notes were taken to determine the experiences of the participants. Data were analyzed using Tesch's method of descriptive data analysis (in Creswell, 2003:13). Two main themes with two sub-themes related to the experience of the registered nurses working in the operating room of the state hospital were identified. Main theme one focused on the non-conducive work environment and it focused on the lack of support from management and the problems experienced in the environment. It was found that OR nurses had good working relationships among the nursing staff. Main theme two focused on the limited training opportunities in OR techniques. The sub-themes described the limited exposure to new technology and the quality of nursing education which the participants felt was not taken seriously in Ethiopia. Based on the identified themes guidelines were formulated to assist the registered nurses working in the operating room of a state hospital in Ethiopia. Utilization of these guidelines should assist the registered nurses to cope more effectively with their work environment. Recommendation were made, further research and limitations identified.