Clinical Decision Support Systems for Operating Room Nurses: A Rapid Review.

This rapid review delves into Clinical Decision Support Systems (CDSS) for Operating Room Nurses (ORN). Analyzing three studies over 20 years, it highlights limited impact on ORN decision-making. The findings suggest that CDSS positively influence some aspects of care, ORN perceive them as supplementary rather than pivotal to their decision-making processes. Our review highlights the importance of understanding ORN' decision-making for customizing CDSS effectively.

Investigation of related factors of operating room nurses' attitudes and awareness towards surgery-related pressure injury prevention in Turkey, Croatia, and Italy.

OBJECTIVE: The aim of this study is to examine related factors of operating room nurses' attitudes and awareness towards surgery-related pressure injury prevention in Turkey, Croatia, and Italy. METHODS: A descriptive and cross-sectional design was used. The study was conducted between March and September 2023. Data were collected with an online questionnaire created on Google Forms, consisting of a Nurse Information Form, a Surgery-related Pressure Injury Awareness Form, and the Attitude towards Pressure Ulcer Prevention Instrument. RESULTS: The sample of the study consisted of 258 operating room nurses working in Turkey, Croatia, and Italy. It was found that the majority of the participants (70.90 %) did not use a risk scale, had not received education on pressure injury prevention and treatment (58.10 %) but wanted to receive it (86 %). Mean attitude scores of operating room nurses by country were at an adequate level in Turkey (42.48 ± 4.30) but not at the desired level in Croatia (37.48 ± 3.44) and Italy (36.20 ± 4.02). While there was a significant positive relationship between the awareness and attitudes of operating room nurses in Turkey (p = 0.002) and Croatia (p < 0.001), no relationship was found between these variables of nurses in Italy (p = 0.109). A statistically significant difference was found between nurses' consideration of themselves sufficient and their attitudes and awareness in all three countries (p < 0.05). It was also determined that reading articles affected nurses' awareness in all countries. CONCLUSIONS: While operating room nurses' attitudes towards preventing pressure injuries were adequate in Turkey, it was determined that those of the nurses in Croatia and Italy were not at the desired level. Nurses should receive regular training on surgical pressure injuries to increase their awareness and to support them in implementing the recommendations of pressure injury guidelines in accordance with institutional policy.

Effect of virtual reality training to enhance laparoscopic assistance skills.

BACKGROUND: While laparoscopic assistance is often entrusted to less experienced individuals, such as residents, medical students, and operating room nurses, it is important to note that they typically receive little to no formal laparoscopic training. This deficiency can lead to poor visibility during minimally invasive surgery, thus increasing the risk of errors. Moreover, operating room nurses and medical students are currently not included as key users in structured laparoscopic training programs. OBJECTIVES: The aim of this study is to evaluate the laparoscopic skills of OR nurses, clinical medical postgraduate students, and residents before and after undergoing virtual reality training. Additionally, it aimed to compare the differences in the laparoscopic skills among different groups (OR nurses/Students/Residents) both before and after virtual reality training. METHODS: Operating room nurses, clinical medical postgraduate students and residents from a tertiary Grade A hospital in China in March 2022 were selected as participants. All participants were required to complete a laparoscopic simulation training course in 6 consecutive weeks. One task from each of the four training modules was selected as an evaluation indicator. A before-and-after self-control study was used to compare the basic laparoscopic skills of participants, and laparoscopic skill competency was compared between the groups of operating room nurses, clinical medical postgraduate students, and residents. RESULTS: Twenty-seven operating room nurses, 31 clinical medical postgraduate students, and 16 residents were included. The training course scores for the navigation training module, task training module, coordination training module, and surgical skills training module between different groups (operating room nurses/clinical medical postgraduate/residents) before laparoscopic simulation training was statistically significant (p < 0.05). After laparoscopic simulation training, there was no statistically significant difference in the training course scores between the different groups. The surgical level scores before and after the training course were compared between the operating room nurses, clinical medical postgraduate students, and residents and showed significant increases (p < 0.05). CONCLUSION: Our findings show a significant improvement in laparoscopic skills following virtual surgery simulation training across all participant groups. The integration of virtual surgery simulation technology in surgical training holds promise for bridging the gap in laparoscopic skill development among health care professionals.

Association Between Sunlight Exposure and Mental Health: Evidence from a Special Population Without Sunlight in Work.

Purpose: In recent years, mental health problems have become the most serious social problems worldwide. Past studies have proposed that some links exist between sunlight and mental health; however, relevant studies examining low-dose sunlight exposure populations are lacking. We conducted a study among a group of operating room nurses (ORNs) who work long hours in operating rooms and have limited sunlight exposure. We aim to add to and refine previous researches on the association between mental health and sunlight exposure in community population. Patients and Methods: A total of 787 ORNs were interviewed and analyzed. Mental health, sunlight exposure duration, sociodemographic and work-related variables, and chronic diseases were evaluated. The Kessler 10 scale (K10) was used to assess participants' mental health status, and their sunlight exposure duration was assessed using their self-reports. Multiple linear regression analysis was adopted to examine the association between sunlight exposure and mental health. Results: The average K10 score of ORNs was 25.41. ORNs exhibit poorer mental health than other populations. Poor mental health was negatively associated with greater sunlight exposure hours per day (ß=-0.378) and sleep regularity (ß=-3.341). Poor mental health was positively associated with chronic disease (ß=3.514). Conclusion: This study indicated that the positive association between sunlight exposure and mental health existed. Appropriate enhancement of sunlight exposure will be beneficial to mental health. Hospitals, related organizations and individuals should pay greater attention to ORNs' mental health and sunlight exposure conditions. More policy recommendations as well as building structure recommendations should be proposed.

Determining knowledge and attitudes related to pressure injury prevention among operating room nurses and associated factors.

AIM: To determine attitudes and levels of knowledge related to pressure injury (PI) prevention among operating room nurses and identify associated factors. METHODS: This descriptive, cross-sectional study was conducted in Turkey with a sample of 112 operating room nurses recruited by the snowball method of convenience sampling. Data were collected online via Google Forms using a nurse data collection form, the Knowledge of Operating Room Nurses about Pressure Injuries Form, and the Attitude Towards Pressure Ulcer Prevention Instrument (APuP). RESULTS: The operating room nurses' mean score for PI knowledge was 52.19 ± 17.01 out of 100, and their mean total APuP score was 42.28 ± 5.19 out of 52. Knowledge about PIs was negatively associated with being male (ß = -0.287, p < 0.001) and positively associated with intervening to prevent PIs during surgery (ß = 0.214, p = 0.008), using international PI guidelines as a reference in the operating room (ß = -0.225, p = 0.005), and APuP score (ß=.415, p < 0.001). Intervening to prevent PIs during surgery (ß = 0.294, p = 0.003) was a significant predictor of attitude toward PI prevention. CONCLUSION: Our results indicate that overall, operating room nurses have insufficient knowledge but positive attitudes about PI prevention. Female gender, using international PI reference guides in the operating room, and positive attitude toward PI prevention were identified as factors associated with higher PI knowledge level, while intervening to prevent PIs during surgery was positively associated with both knowledge level and attitude toward PI prevention.

Can artificial intelligence and robotic nurses replace operating room nurses? The quasi-experimental research.

Operating room nurses, who have an important place in the professional healthcare team, should be able to use technology effectively and adapt to innovations. This study is expected to shed light on how effective the development of robotic technologies and artificial intelligence and their integration into operating room nursing will be in fulfilling the requirements of contemporary nursing philosophy. This study was designed as a single group pre- and post-test quasi-experimental study. The quasi-experimental (pretest-posttest) research design was utilized to conduct the study in a Training and Research Hospital in Western Turkey. The nurses (n = 35) working in the operating room of the aforementioned hospital were included in the study. In this study, we aimed to determine whether operating room nurses experienced anxiety due to the use of artificial intelligence and robotic nurses, and the effectiveness of the training given to them in order to raise their awareness. The following three tools were used for data collection: The Nurses' Descriptive Characteristics Form, Artificial Intelligence Knowledge Questionnaire, and Artificial Intelligence Anxiety Scale. Data extraction and analysis were performed in a narrative and tabular way. According to this study, the training given to the operating room nurses significantly increased their knowledge levels about artificial intelligence and robotic nurses, and increased their artificial intelligence- and robotic nurse-related anxiety significantly (p < 0.05). The participating operating room nurses experienced limitations regarding current information, training programs and learning opportunities on robotic surgery. We recommend that the operating room nurses should be provided with trainings on artificial intelligence technologies and robotic nurses, and that they should be enabled to use these information technologies regarding future technologies actively.

Comparison of operating room nurses' satisfaction and preferences in using personal protective equipment for eye protection in the COVID-19 pandemic.

Objectives. This study aimed to compare the problems, satisfaction and preferences of operating room nurses about the use of personal protective equipment (PPE) for eye protection during operations in the COVID-19 pandemic. Methods. This prospective quasi-experimental study was conducted in April 2021 in the operating room of a hospital in Turkey. The sample of this study consisted of 35 nurses who met the inclusion criteria. The evaluation of three types of eye protection equipment (goggles, goggle-type face shield and face shield) was repeated in the same group on consecutive days. Results. The comparison of the problems related to the use of PPE indicated that the highest rate of fogging (91.4%) was observed in goggles (p < 0.001), and skin injuries (28.6%) were experienced in goggles and face shields (p = 0.002). It was observed that operating room nurses were most satisfied (7.2 ± 1.4) with goggle-type face shields and ranked them in first place (80%) (p < 0.001). Conclusion. According to the results of this research, it was found that the PPE for eye protection that was the least problematic, provided the most satisfaction and was ranked in first place during the pandemic was the goggle-type face shield.

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.

Protocol for scoping review on well-being among theatre nurses in large public hospitals in low-income and middle-income countries.

INTRODUCTION: Theatre nurses report higher levels of stress and burn-out due to the nature of their work environment. Workplace stress among nurses is associated with decreased well-being resulting is poor health outcomes for patients. However, evidence on well-being among nurses varies considerably, due to the multiple perspectives, definitions and focus on different aspects of well-being. Existing literature has not been consolidated to map out well-being concepts and instruments. In addition, due to limited research in low-income and middle-income countries, the most contextually relevant instruments for this context has not been identified. The aim of this scoping review is to map out existing literature on well-being, key concepts and instruments used to measure well-being among theatre nurses working in public hospitals in low-income and middle-income countries. METHODS AND ANALYSIS: A scoping review guided by the Joanna Briggs Institute's methodological approach will be used. PubMed, Scopus, Ebscohost, Web of Science, Emerald Insight, Informa World, Oxford Journals, ScienceDirect and Google scholar will be searched for literature published from 2000 to date. Reference lists of selected articles will also be reviewed. Two reviewers will conduct the screening of articles and data extraction independently and differences will be resolved through a discussion. Data analysis will be guided by both qualitative and quantitative methods.The scoping review will take place from 1 May 2022 to 1 November 2022, completing the screening, data extraction and analysis phases. ETHICS AND DISSEMINATION: The study does not require ethical approval. Findings will be published and shared at events to raise awareness on the importance of monitoring well-being among theatre nurses as a strategy to improve surgical outcomes. The review could shed light on an instrument most suitable for low-income and middle-income contexts.

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.

Core competency scale for operating room nurses in China: Scale development, reliability and validity evaluation.

AIMS: To develop a competency scale for operating room nurses and test its reliability and validity. BACKGROUND: The existing Chinese Registered Nurse Competency Scale and the core competency scale for operating room nurses developed abroad cannot fully meet the capacity needs of Chinese operating room nurses. METHODS: The scale was developed based on the results of qualitative interview and the Delphi method. Ten experts were selected for expert consultation, and 300 operating room nurses were recruited by convenience sampling for a cross-sectional survey to test the reliability and validity of instrument.The reliability and validity of the scale was assessed based on internal consistency reliability, test-retest reliability and confirmatory factor analysis. Data collection was conducted between March to July, 2015. RESULTS: An initial scale with 42 items was confirmed, and 36 items remained. The internal consistency Cronbach's α was 0.97 for the overall scale and 0.88-0.94 for the subscales. The retest reliability ranged from 0.55-0.96. Five factors were extracted by exploratory factor analysis, and they explained 66% of the total variance. The fitting indices of the confirmatory factor analysis were as follows: χ2/df = 3.47, CFI = 0.83, TLI = 0.81, SRMR = 0.06 and RMSEA = 0.09. CONCLUSIONS: The core competency scale for operating room nurses with 5 components and 36 items had acceptable reliability and validity. The scale could continue to be optimized in the future.

Potential effects of the nursing work environment on the work-family conflict in operating room nurses.

BACKGROUND: The nursing working environment is an important subsystem in the hospital environment. A good working environment could have a positive impact on nurses. However, the work-family conflict and unsatisfactory working environment could significantly reduce their working enthusiasm, efficacy as well as the overall quality of the nursing, increase their fatigue, and thereby compromise their career status. AIM: To explore the possible status quo and to analyze the correlation between work environment perception and the work-family conflict among nurses in the operating room. METHODS: A total of 312 operating room nurses from two first-class hospitals at Grade 2 and two first-class hospitals at Grade 3 in China from May to September 2017 were included in this research using the cluster sampling method. The data, including the general information questionnaire, the practice environment scale of the nursing work index (PES-NWI), and the work-family conflict scale, were systematically collected. Pearson correlation analysis was applied to analyze the correlation between the two scores, with influencing factors analyzed by hierarchical regression analysis. RESULTS: A total of 312 questionnaires were issued, and the response rate and effective questionnaire rate were both 96.15% (300/312). The total scores of the PES-NWI scale and the work-family conflict scale were 3.07 ± 0.43 (vs maximum up to 4 points) and 52.32 ± 8.79 (vs maximum up to 90 points), respectively. The scores of the PES-NWI scale were negatively correlated with that of work-family conflict scale (all P < 0.05). The perception of the nursing work environment and the number of night shifts per month were the major factors contributing to the work-family conflict (all P < 0.05). CONCLUSION: The nursing work environment and the work-family conflict among nurses in the operating room were both found at a medium level with a negative correlation between the two.

A comparative study of the opinions, experiences and individual innovativeness characteristics of operating room nurses on robotic surgery.

AIM: To compare and evaluate operating room nurses' opinions about robotic surgery with their individual innovativeness metric scores. The aim was also to identify the experiences, adaptation processes and influencing factors of operating room nurses working in robotic surgery rooms in Turkey. DESIGN: This was a comparative descriptive study. METHODS: The sample included 114 operating room nurses working in 12 institutions that performed robotic surgery in Turkey. Data were collected between January 2018 and September 2019 using the Demographic Characteristics of Nurses and Robotic Surgery Evaluation Form and the Individual Innovativeness Scale, and were analysed using a quantitative statistical approach (independent samples t-test, one-way analysis of variance and Kruskal-Wallis H test). The data obtained from the Robotic Surgery Evaluation section, which consisted of open-ended and closed-ended questions, were analysed with appropriate steps. In particular, answers to open-ended questions were grouped and coded according to their content. RESULTS: Operating room nurses held positive opinions about robotic surgery. Only 35.8% of the nurses had received training before joining the robotic team, while 55.2% had individually searched for information. Operating room nurses with robotic surgery experience had significantly higher (p < .001) individual innovativeness scores. Over 85% of nurses who received training adapted to robotic surgery in 3 months or less, while nurses with higher individual innovativeness scores adapted in a statistically significantly (p < .05) shorter period. Training, teamwork, and practical experience were mentioned as facilitating factors; inadequate training and technical problems were reported as obstructing factors. CONCLUSION: Operating room nurses hold positive opinions about robotic surgery; nurses with robotic surgery experience have higher levels of individual innovativeness; and nurses who have received training are significantly better adapted. IMPACT: What problem did the study address? This study addresses the need for a better understanding of operating room nurses' opinions and experiences about robotic surgery and the influencing factors of adapting to it. This study also offers an evaluation and comparison of the nurses' individual innovativeness characteristics and the correlation with their adaptation processes to the new role. What were the main findings? The main findings show a correlation between specific education/training and nurses' adaptation to the new role of robotic surgery, the individual innovativeness characteristics metric of nurses with or without robotic surgery experience and the time frame of their adaptation. Where and on whom will the research have an impact? This research traces the profile of current operating room nurses working in the robotic surgery field and the factors influencing their experience. These findings and conclusions have a much broader impact than in Turkey alone. The findings raise awareness of the importance of educating and preparing operating room nurses before introducing them to the new roles and responsibilities inherent to robotic surgery.

Correlation between monoamine neurotransmitter and cytokine levels and the occurrence of post-traumatic stress disorder among operating room nurses.

BACKGROUND: The aim of the present study was to investigate the correlation between monoamine neurotransmitter and cytokine levels and the occurrence of post-traumatic stress disorder (PTSD) among operating room nurses. METHODS: A total of 131 nursing staff were selected and assigned into the PTSD, non-PTSD, and control group. Enzyme-linked immunosorbent assay was applied to determine the monoamine neurotransmitters in plasma and serum cytokines. Receiver-operating characteristic curve analysis was conducted to assess the sensitivity and specificity of neurotransmitters and cytokines in the clinical detection of PTSD among operating room nurses. Addenbrooke's Cognitive Examination-Revised and the Connor-Davidson Resilience Scale were used to evaluate the correlation between neurotransmitter and cytokine levels and the clinical characteristics of operating room nurses with PTSD. RESULTS: Our study found that the monoamine neurotransmitters and cytokines among nurses in the PTSD group were significantly higher than those in the non-PTSD and control group. Neurotransmitter and cytokine levels as clinical predictors of PTSD among operating room nurses have good sensitivity and specificity, and were negatively correlated with cognitive function and resilience. CONCLUSIONS: The findings of the present study confirm that monoamine neurotransmitter and cytokine levels are correlated with the occurrence of PTSD among operating room nurses.

[Psychological health of nurses in operating room participating in organ donation and intervention effect].

Objective: To understand the effect of organ donation surgery on the mental health of nurses in operating room, and to explore the intervention effects. Methods: From Jan.2015 to Dec. 2018, 60 operating room nurses in our hospital participating in organ donation surgery were selected for investigation of mental health, and were intervened by group psychological training, positive psychological intervention, improving shift arrangement system and financial support. The SCL-90 scale and DAP-R scale were used to evaluate before and after intervention. Results: The mean scores of somatization, interpersonal sensitivity, depression, anxiety, terror, paranoia and psychoticism in SCL-90 scale of 60 operating room nurses were (2.07±0.63) , (2.07±0.69) , (1.88±0.62) , (1.71±0.57) , (1.78±0.67) , (1.71±0.68) , (1.73±0.60) before intervention respectively, which were significantly higher than the Chinese norm (P<0.01) and those[ (1.64±0.60) , (1.46±0.57) , (1.53±0.62) , (1.48±0.60) , (1.28±0.50) , (1.45±0.56) , (1.43±0.52) ] after intervention were lower than before (P<0.01) . Before and after the intervention, the scores of DAP-R scale tended to be death fear dimension and acceptance dimension, the proportion of the death fear dimension was 16.7% (10/60) and 6.7% (4/60) , respectively, and the approaching acceptance dimension was 83.3% (50/60) and 93.3% (56/60) . The proportion of the nurses with scores of SCL-90 scale ≥160 after the intervention was significantly lower than that before the intervention (χ(2)=5.82, P<0.05) . Conclusion: The mental health of nurses in the operating room participating in organ donation surgery is lower; After intervention, the investigated nurses present improved mental health and positively emotional attitude towards death.

Operating-room nurses' classifications in job satisfaction.

Purpose : The purpose of this study was to investigate the operating environment, degree of operating-room nurses', and to clarify the job satisfaction, experience, and emotions categorized characteristics operating-room nurses. Method : The study surveyed 1177 operating-room nurses. For 38 questionnaire items, a 5-point Likert scale was applied regarding job satisfaction, workplace environment, experiences, and emotions. Classification was performed by cluster analysis based on operating-room nurses' job satisfaction. Results : Results of cluster analysis were classified into five groups with unique characteristics based on factors such as age, years of nursing experience, years of operating-room nursing experience, workplace environment, experience, and emotion. Conclusion: Results suggest providing support tailored to characteristics of each of the five groups to optimize their job satisfaction. J. Med. Invest. 67 : 113-123, February, 2020.

International Operating Room Nurses' Challenges in Providing Person-Centered Care During Organ Procurement Surgery.

PURPOSE: International operating room (OR) nurses assisting in organ procurement surgery believe that it is their responsibility to provide continued and comprehensive person-centered care to donors through their surgical journeys. This study explored the challenges these nurses encountered in providing person-centered care during surgical care stages of organ procurement surgery in Australia. DESIGN: The phenomenological approach by van Manen was used to portray 18 OR nurses' organ procurement experiences. METHODS: Semistructured interview data were transcribed verbatim. FINDINGS: International OR nurses encountered challenges in providing person-centered care during organ procurement surgery, which were described in different surgical care stages. They faced emotional challenges in handling family grief and clinical challenges in interacting with other health professionals. These challenges could cause personal distress and affect their professional practice. CONCLUSIONS: Recognizing and managing these challenges is essential for supporting staff and providing quality person-centered care to deceased donors and their families during the organ procurement process.

Effect of an educational programme on the attitudes towards patient safety of operation room nurses.

BACKGROUND: A culture of patient safety is one of the cornerstones of good-quality healthcare, and its provision is one of the significant challenges in healthcare environments. AIM: The purpose of this study was to evaluate the effect of a surgical safety educational programme on the attitudes of nurses to patient safety in operating rooms (OR). DESIGN: An interventional one-group pre-/post-test design, which sought to measure changes in OR nurses' attitudes toward patient safety culture. METHODS: A simple random sampling technique was used to recruit 66 OR nurses working at six Royal Medical Service hospitals in Amman, Jordan. All participants took part in a 4-hour educational workshop. Pre-tests and post-tests were done. RESULTS: The results of this study showed that OR nurses' attitudes towards a culture of patient safety was originally negative; significant improvement after attending the programme was found (3.3 ± 0.20 versus 3.8 ± 0.30). There was a negative correlation between years of experience and nurses' attitudes towards patient safety. CONCLUSIONS: Incorporating courses about safety culture into continuing education programmes may improve nurses' attitudes towards patient safety. Nurses should be qualified to play an important role in creating a culture of patient safety.

Operating room nurses' self-reported knowledge and attitude on perioperative pressure injury.

Surgical patients are at risk of developing a perioperative pressure injury (ORPI) during surgery. Accurate assessment and prompt implementation of prevention strategies or treatment of ORPI are dependent on knowledge and skills of operating room (OR) nurses. The study examined the knowledge and attitude of OR nurses in identifying at-risk patients. A cross-sectional, prospective, descriptive study was adopted. OR nurses were invited to complete the survey using the attitude towards pressure ulcer prevention instrument (Cronbach α of 0.79) and pressure ulcer knowledge assessment tool (Cronbach α of 0.77). Approximately, 28% of OR nurses took part in the survey. Most of them were females (99%) with a mean age of 38.4 ± 12.9 years old. Of these, 73% of the nurses described not having adequate experience in preventing ORPI, and 88% of them were uncertain about the treatment strategies. The mean overall knowledge score was 47.8 ± 9.1% for this cohort. The study demonstrated that approximately 8.9% of OR nurses passed with a score ≥ 60% for knowledge. The mean overall attitude score was 74.6 ± 6.1% for this cohort. About 35.6% of these nurses gave positive scores of greater than 75% for attitudes. The knowledge scores have no relationship with the working experience, role responsibility, academic qualification, ethnicity, nationality, and gender except for age 35 years older or equal and younger. Still, both the knowledge and attitude scores obtained have a strong relationship with the nurses' experiences with PI prevention. Personal competency to prevent PI has a strong correlation with risk identifying and preventing PI. There are strong associations between being responsible for PI development and the knowledge on risk identification and prevention of PI. The attitude regarding the prioritisation of PI prevention is also strongly correlated to the nurses' knowledge in preventing PI. Positive attitudes of OR nurses have no relationship with the overall knowledge scores. The prevention of ORPI is not on the list of priorities among OR nurses. The knowledge of preventive measures and risk identification of PI was limited among local OR nurses. Incorporating a standard screening and assessment tool within the current assessment list will support and promote ORPI risk assessment and continuous assessment. Contextualised education on ORPI prevention and management should be considered part of the training for OR nurses.

Effect of problem and scripting-based learning combining wearable technology on orthopedic operating room nurses' learning outcomes.

BACKGROUND: Orthopedic operating room (OR) nurses entail specialized skills and training, which are not part of the regular curricula at most nursing college. Instead, many nursing students' exposure to orthopedic care in the orthopedic range is limited to occasional observational assignments. Additionally, teamwork is an important factor affecting the performance of the orthopedic OR nurses. This results in a knowledge gap in clinical nursing education. Problem and scripting based learning (PSBL) method is a crucial tool of pre-operative prepared improvement. It is easy for surgeon to record surgical video from his own field of vision by wearable technology (WT). Nevertheless, few studies related to combine WT and PSBL been done to investigate features underlying efficiency in training of novice orthopedic OR nurses. OBJECTIVE: This study aimed to evaluate the feasibility of combining WT with PSBL in training of novice orthopedic OR nurses. METHODS: 20 operating room post-graduate-year-1 nurses from the First Hospital of China Medical University were randomly divided into two groups ("conventional training (CT)" group and "WT combining with PSBL" group). Initially the superior orthopedic operating room nurses who immediately followed each procedure filled out a feedback questionnaire of the novice nurses. After finished procedure, novice nurses had a basic understanding of each training method benefits and then filled out the questionnaires. Statistical analysis of the results was performed. RESULTS: Novice nurses of WT&PSBL Group got the better score in most of the preparedness and performance feedback statement. Mean scores of overall total preparedness and performance feedback statement of WT&PSBL Group was higher than CT Group (P ≤ 0.05). Based on summarizing the questionnaires, the novice nurse in WT- PSBL Group also made significantly better total score than "Conventional training" Group (P ≤ 0.05). CONCLUSIONS: WT&PSBL method, as a crucial tool for improving pre-operative preparedness and intra-operative performance, can cultivate novice orthopedic operating room nurses' ability to use prior knowledge and cognitive frameworks flexibly to deal with problems during performance. It plays a crucial role in training confident and safe orthopedic operating room nurses. DESIGN: Randomized controlled trial (RCT).