JOURNAL

NAME: Bonilla, Yla Katrina C. YEAR & SECTION: BSN 4-2

CLINICAL INSTRUCTOR: Mary Ann A. Bautista, RN DATE: 3/18/2024

OPERATING ROOM NURSES' UNDERSTANDING OF THEIR ROLES AND

RESPONSIBILITIES FOR PATIENT CARE AND SAFETY MEASURES IN
INTRAOPERATIVE PRACTICE
Chellam Singh, B., & Arulappan, J. (2023). Operating Room Nurses' Understanding of Their Roles
and Responsibilities for Patient Care and Safety Measures in Intraoperative Practice. SAGE open
nursing, 9, 23779608231186247. https://doi.org/10.1177/23779608231186247

Authors: Chellam Singh Bisma and Judie Arulappan

Source of Article: PubMed Central, Google Scholar
Key Terms used for the Search: operating room, operating room nursing, patient safety,
intraoperative period

ABSTRACT: Surgical care has been a vital part of healthcare services worldwide. Several patient
safety measures have been adopted universally in the operating room (OR) before, during, and
following surgical procedures. Despite this, errors or near misses still occur. Nurses in the OR have a
pivotal role in the identification of factors that may impact patient safety and quality of care.
Therefore, exploring the OR nurses’ understanding of their roles and responsibilities for patient care
and safety in the intraoperative practice, which could lead to optimal patient safety, is essential. This
study explored the understanding of OR nurses regarding their roles and responsibilities for patient
care and safety measures in the intraoperative practice. The study was conducted in one of the tertiary
care hospitals in the United Arab Emirates. Qualitative, descriptive, exploratory research design was
utilized. The data were collected using semi-structured face to face interviews. Purposive sampling
included eight nurses. Data analysis was performed following Colaizzi’s seven-step strategy. Seven
emerging themes were identified. The main themes are patient safety, preoperative preparation,
standardization of practice, time management, staffing appropriateness, staff education and
communication, and support to the patient in the OR. OR nurse leaders may take into consideration
the current findings as a reference for quality improvement projects in the hospital, considering the
specific characteristics of each local setting. Although the participants consider that the environment
is safe and the quality of care is high in the study setting, there is still room for improvement on
workflows and processes. OR workflow should be improved especially by addressing the potential
patient safety issues.
 JOURNAL

NAME: Bonilla, Yla Katrina C. YEAR & SECTION: BSN 4-2

CLINICAL INSTRUCTOR: Mary Ann A. Bautista, RN DATE: 3/19/2024

PERIOPERATIVE NURSES’ EXPERIENCES IN RELATION TO SURGICAL PATIENT

SAFETY: A QUALITATIVE STUDY
Peñataro-Pintado, E., Rodríguez, E., Castillo, J., Martín-Ferreres, M. L., De Juan, M. Á., & Díaz
Agea, J. L. (2021). Perioperative nurses' experiences in relation to surgical patient safety: A
qualitative study. Nursing inquiry, 28(2), e12390. https://doi.org/10.1111/nin.12390

Authors: Ester Peñataro-Pintado, Encarna Rodríguez, Jordi Castillo, María Luisa Martín-Ferreres,
María Ángeles De Juan, and José Luis Díaz Agea
Source of Article: Research Gate, Google Scholar
Key Terms used for the Search: Nurses experiences on operating room, safety in operating room

ABSTRACT: Surgical patient safety remains a concern worldwide as, despite World Health
Organization recommendations and implementation of its Surgical Safety Checklist, adverse events
continue to occur. The aim of this qualitative study was to explore the views and experiences of
perioperative nurses regarding the factors that impact surgical patient safety. Data were collected
through five focus groups involving a total of 50 perioperative nurses recruited from four public
hospitals in Spain. Content analysis of the focus groups yielded four main themes: personal qualities
of the perioperative nurse, the surgical environment, safety culture, and perioperative nursing care
plans. One of the main findings concerned barriers to the exercise of leadership by nurses, especially
regarding completion of the Surgical Safety Checklist. Some of the key factors that impacted the
ability of perioperative nurses to fulfil their duties and ensure patient safety were the stress associated
with working in the operating room, time pressures, and ineffective communication in the
multidisciplinary team. Targeting these aspects through training initiatives could contribute to the
profes sional development of perioperative nurses and reduce the incidence of adverse events by
enhancing the surgical safety culture.

QUESTIONS:
1. What is the significance of the research article you have chosen in your Related Learning
Experience?
As a nursing student, I find the research article immensely significant in shaping my
understanding of the critical role that perioperative nurses play in ensuring surgical patient safety. By
delving into the perspectives and experiences of these frontline healthcare providers, the study illuminates
the nuanced
factors that influence the delivery of high-quality care beyond the completion of procedural checklists. It
underscores the pivotal importance of nursing leadership in orchestrating a patient-centric approach to
surgical care, where patient safety is paramount. One of the key takeaways from the research is the
emphasis on the development of personal and social skills among perioperative nurses. This aspect
resonates deeply with me as it highlights the importance of cultivating not only clinical proficiency but
also the ability to respond adeptly to the myriad of stressful and unforeseen situations that can arise in the
operating room. The recognition that effective communication, teamwork, and leadership skills are
instrumental in navigating such challenges underscores the holistic nature of nursing practice, extending
far beyond technical competence alone. Moreover, the study underscores the imperative for ongoing
education and training initiatives to enhance patient safety within surgical settings. As a nursing student,
this reinforces the notion that learning is a lifelong journey, and that continual professional development is
essential for delivering safe and effective care. It underscores the need for nursing education programs to
place a greater emphasis on patient safety principles, ensuring that future generations of nurses are
equipped with the knowledge and skills necessary to uphold the highest standards of care.

Engaging with this research article not only deepens my understanding of the complexities
inherent in perioperative nursing but also underscores the profound responsibility that comes with the
profession. It serves as a call to action for me, both as a student and a future practitioner, to remain
vigilant advocates for patient safety and to continuously strive for excellence in all aspects of my nursing
practice. By internalizing the insights gleaned from this study, I am better prepared to contribute positively
to the safety culture within healthcare settings and to play a proactive role in minimizing the occurrence of
adverse events during surgery, ultimately enhancing patient outcomes and advancing the quality-of-care
delivery.

2. What are the implication of the finding in your patient care?

The findings of this study underscore the critical significance of human factors, particularly
leadership and effective communication, in ensuring the safety of surgical patients. As a perioperative
nurse, integrating these insights into patient care practices can have profound implications for improving
outcomes and enhancing the overall quality of care delivery. Firstly, recognizing the pivotal role of
leadership in patient safety underscores the importance of assertive and proactive decision-making within
the perioperative team. As a nurse, taking on leadership responsibilities involves advocating for patient
safety, coordinating team efforts, and effectively managing resources to address challenges as they arise
during surgical procedures. By assuming leadership roles, nurses can contribute to a culture of safety
where open communication, collaboration, and accountability are prioritized. Moreover, emphasizing the
significance of effective communication highlights the need for clear, concise, and accurate information
exchange among team members throughout the perioperative process. As a nurse, practicing active
listening, providing clear instructions, and fostering a supportive team environment can facilitate seamless
coordination and minimize the risk of errors or misunderstandings. Effective communication not only
enhances patient safety but also promotes mutual respect and trust among interdisciplinary team members.
Furthermore, the suggestion to focus training initiatives on the proper implementation of the Surgical
Safety Checklist aligns with efforts to standardize protocols and enhance procedural compliance in
perioperative care. As a nurse, receiving comprehensive training on the correct use of the checklist can
improve adherence to safety protocols, streamline workflow, and mitigate potential risks during surgical
procedures. Utilizing operating-room simulators and clinical simulations can further enhance competency
by providing hands-on practice in a controlled environment, allowing nurses to develop confidence and
proficiency in executing safety procedures.

Incorporating these findings into patient care practices can lead to tangible improvements in
patient outcomes, such as reduced incidence of adverse events, decreased surgical complications, and
enhanced overall satisfaction with care. By prioritizing leadership, effective communication, and
adherence to safety protocols, perioperative nurses can play a pivotal role in safeguarding patient well-
being and promoting a culture of excellence in surgical care.

3. What intervention/innovation relevant new findings was used of implemented in the study/ies
reviewed?
The intervention or innovation proposed in the discussion is the use of operating room simulators
and clinical simulation to enhance the training of perioperative professionals in leadership, effective
communication, and proper implementation of the Surgical Safety Checklist. This approach suggests
utilizing simulation technology to recreate realistic surgical scenarios, allowing professionals to practice
applying the Checklist according to WHO recommendations. By engaging in simulated surgical
procedures, perioperative professionals can develop their skills in leadership, effective communication,
and checklist utilization in a safe and controlled environment. The proposed intervention builds upon
existing research suggesting that simulation-based training can be effective in improving patient safety
outcomes and reducing the occurrence of adverse events in surgical settings. It aligns with
recommendations to focus on enhancing human factors such as communication and teamwork to ensure
patient safety during surgery.

Overall, the proposed intervention represents an innovative approach to addressing the human
factors involved in surgical patient safety and suggests a practical method for improving perioperative
professionals' skills through simulation-based training.