Nurses' experiences of moral distress and how it affects daily work in surgical care-a qualitative study.

AIM: To describe nurses' and specialist nurses' experiences of moral distress and how it affects daily work in surgical care. DESIGN: A qualitative descriptive study design was used. METHODS: A qualitative study with 12 interviews with nurses and specialist nurses working in surgical care. All interviews were conducted during October and November 2022 in two hospitals in southeastern Sweden. Data were analysed using conventional qualitative content analysis. FINDINGS: Three categories and seven subcategories generated from the data analysis. The three categories generated from the analysis were Experiences that lead to moral distress, Perceived consequences of moral distress and Strategies in case of moral distress. The results show that a lack of personnel in combination with people with complex surgical needs is the main source of moral distress. Both high demands on nurses as individuals and the teamwork are factors that generate moral distress and can have severe consequences for the safety of patients, individual nurses and future care. CONCLUSIONS: The results show that moral distress is a problem for today's nurses and specialist nurses in surgical care. Action is necessary to prevent nurses from leaving surgical care. Prioritizing tasks is perceived as challenging for the profession, and moral distress can pose a patient safety risk. IMPACT: Surgical care departments should design support structures for nurses, give nurses an authentic voice to express ethical concerns and allow them to practice surgical nursing in a way that does not violate their core professional values. Healthcare organizations should take this seriously and work strategically to make the nursing profession more attractive. PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public contribution.

Postgraduate Developments Among Perianesthesia-Trained Nursing Graduates in Japan: A Cross-Sectional Survey.

PURPOSE: To elucidate the postgraduation situation of those who have completed a perianesthesia nurse (PAN) educational course offered in master's degree programs in Japan. DESIGN: This cross-sectional study used an anonymous self-administered questionnaire. METHODS: Of the 42 individuals who completed a PAN educational course offered in master's degree programs in Japan by March 2021, 41 were targeted, excluding the author of this study. The questionnaire was distributed by mail between November 20, 2021, and January 14, 2022, and the participants were asked to return the completed questionnaire by mail. Those working as PANs were asked about their work content, work satisfaction, and thoughts on their prospects in the perianesthesia nursing field. Those not working as a PAN were asked about their future intentions to do so. FINDINGS: The response rate was 95.1% (39/41). PANs are involved in various perianesthesia tasks, and there were no respondents who answered "No" to the question of whether they were glad to have become a PAN. However, of those working as PANs, only 16 (53.3%) indicated that they would like to continue working in that role. Few respondents (n = 3; 10.0%) considered future PAN prospects to be "good," while eight (26.7%) respondents answered "poor," and many (n = 19; 63.3%) stated "neither." CONCLUSIONS: Under the current situation, PANs in Japan do not necessarily have a positive outlook for the future, the causes for which must be analyzed to make the necessary improvements.

Effects of operating room nursing intervention on wound infection in patients undergoing ovarian cysts surgery: A meta-analysis.

We conducted this study aimed to explore the effect of operating room nursing intervention on wound infection in patients undergoing ovarian cysts surgery. A computer system was used to search PubMed, Web of Science, EMBASE, Cochrane Library, Wanfang, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure databases, from database inception to October 2023, for randomised controlled trials (RCTs) on the application of operating room nursing intervention to ovarian cyst surgery. Literature that met the requirements was independently screened by two researchers, and data were extracted and assessed for literature quality. RevMan 5.4 software was applied for data analysis. Fifteen RCTs involving 1187 patients were finally included. The analyses revealed that, compared with routine nursing, the implementation of operating room nursing intervention had a significant advantage in reducing the incidence of wound infections (1.17% vs. 5.44%, odds ratio [OR]: 0.30, 95% confidence interval [CI]: 0.15-0.58, p = 0.0004) and postoperative complications (6.34% vs. 25.17%, OR: 0.20, 95%CI: 0.13-0.29, p < 0.00001), as well as being able to shorten the operative time (standardised mean difference [SMD]: -3.93, 95%CI: -5.67 to -2.20, p < 0.00001), hospital length of stay (SMD: -2.54, 95%CI: -3.19 to -1.89, p < 0.00001) and gastrointestinal recovery time (SMD: -1.61, 95%CI: -2.24 to -0.98, p < 0.00001) in patients undergoing ovarian cysts surgery. This study confirmed by meta-analysis that the operating room nursing intervention can significantly reduce the incidence of wound infection and complications, shorten the operative time, gastrointestinal recovery time, and hospital length of stay after ovarian cyst surgery.

Overall Description and Predictors of Disruptive Behavior Toward Nurses in the Perioperative Arena.

PURPOSE: To investigate the prevalence, characteristics, causes, consequences, and predictors of and responses to disruptive behavior toward nurses in the perioperative arena. DESIGN: A cross-sectional design using a network questionnaire platform. METHODS: Nurses in the perioperative arena were recruited online in March 2020. Data on disruptive behavior toward nurses in the past 6 months and nurses' sociodemographic and environmental factors were collected. FINDINGS: Nurses (N = 496) responded validly to the survey. In total, 82.1% of participants experienced disruptive behavior. Assignment of overwhelming workloads and verbal aggression were the most common behaviors, and surgeons were the major perpetrators. Perpetrators' intrapersonal issues were the most commonly perceived causes. A positive strategy was the most common strategy adopted by participants. Further, 80.8% of participants recounted their negative experiences, and more than half of respondents (59.9%) talked with their nursing colleagues. Nearly half of respondents (45.9%) did not report disruptive behavior. Negative emotions as an immediate effect were reported by 53.1% of the participants, and the most common long-term impact was decreased passion for work. Middle age, job position, practice environment, and system help were risk factors for experiencing disruptive behavior. CONCLUSIONS: The prevalence of disruptive behavior toward nurses in the perioperative arena is high, and its ramifications should not be ignored. Health care institutions should urgently implement intervention strategies to reduce disruptive behavior toward nurses.

The effect of enhanced recovery after lung cancer surgery combined with fine surgical nursing on rehabilitation.

Objectives: To analyse the enhanced recovery after surgery approach combined with fine surgical nursing on recovery time, pain, sleep quality and satisfaction with care after lung cancer surgery. METHODS: The cross-sectional study was conducted at the Nanjing Chest Hospital, China, from October 2019 to March 2022, and comprised non-small cell lung cancer patients undergoing single-port video-assisted thoracoscopic surgery. Patients receiving fine surgical nursing in addition to conventional enhanced recovery after surgery formed the intervention group A, while those receiving the conventional enhanced recovery after surgery care alone formed control group B. Intraoperative blood loss, operative time, extubation time and length of stay values were noted for both the groups using standard scales. Nursing satisfaction and the incidence of adverse reactions in the two groups were also noted. Data was analysed using SPSS 23. RESULTS: Of the 99 patients, 46(46.5%) were in group A; 23(50%) males and 23(50%) females with mean age 70.3±4.8 years and mean body mass index 26.76±2.55kg/m2. There were 53(53.5%) patients in group B: 16(30.2%) males and 37(69.8%) females with mean age 69.9±4.4 years and mean body mass index 25.93±2.40kg/m2 (p>0.05). Intraoperative blood loss, operative time, postoperative extubation time and length of stay in group A were lower than those in group B (p<0.05). Pain and sleep quality values in group A were lower, while health status value was higher than group B (p<0.05). Group A had significantly higher nursing satisfaction compared to group B (p<0.05). Conclusion: The use of enhanced recovery after surgery combined with fine surgical nursing in patients with nonsmall cell lung cancer after video-assisted thoracoscopic surgery promoted postoperative recovery.

Effect of Roy's Adaptation, Model-based, Perioperative Nursing Service on Patients: A Clinical Observational Study.

Context: Surgery for early-stage lung carcinoma (LC) is invasive and most patients will experience psychological disorders, such as depression and anxiety. Accumulating evidence has shown that a nursing intervention can exert significant improvements in clinical efficacy for perioperative patients. Objective: The study intended to investigate the clinical value during the perioperative period of a nursing service based on Roy's Adaptation Model (RAM), for patients undergoing radical resection for early-stage LC, to provide accurate guidance and reference for a future clinical nursing intervention for LC patients. Design: The research team designed a retrospective analysis, controlled study. Setting: The study took place at Jiangsu Cancer Hospital in Nanjing, Jiangsu, China. Participants: Participants were 69 patients with early-stage LC who had been admitted to the hospital between March 2018 and March 2020. Intervention: The research team assigned participants to an intervention or a control group, with 42 participants in the intervention group receiving RAM nursing during hospitalization, and 27 participants in the control group receiving routine nursing care. Outcome Measures: The study measured the alterations in pulmonary function (PF) pre- and postoperatively and assessed the incidence of complications postintervention. At baseline and postintervention, the research team also assessed participants' psychological states using the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS) and their pain levels using a visual analogue scale (VAS). Postintervention, participants competed a nursing satisfaction survey. At baseline and postintervention, the participants completed the Karnofsky Performance Status (KPS) scale for functional status, the Self-Perceived Burden Scale in Cancer Patients (SPBS-CP), the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, and the WHO-QOL-BREF questionnaire. Results: Postoperatively, the PF indexes had decreased significantly for both groups, but the intervention group's value were significantly higher postoperatively than those in the control group (P < .05). No differences existed in the incidence of adverse reactions between the groups (P > .05). The intervention group had significantly lower SAS and SDS scores, pain scores, and SPBS-CP scores than the control group postintervention but had significantly higher KPS scores (all P < .05). The intervention group significantly higher nursing satisfaction, sleep quality, and quality of life than the control group did (P < .05). Conclusions: RAM nursing can significantly protect the PF of patients with early-stage LC who are undergoing a radical resection and can effectively improve patients' psychological states, sleep quality, and nursing satisfaction, which makes it worthy of clinical reference and popularization.

Pain Management Knowledge and Attitudes for Surgical Nursing Students.

BACKGROUND: Pain is considered as one of the most common factors that cause people to seek medical care. An important responsibility of health professionals is to manage pain, and nurses play a crucial role in it. Therefore, nursing students must have pain management knowledge and skills to fulfill this role. AIM: The objective of the study was to examine pain management knowledge and attitudes of nursing students who had taken a surgical nursing course. METHODS: This descriptive, cross-sectional study was conducted with volunteer second-year undergraduate nursing students (n = 260) from two universities in Turkey. The Knowledge and Attitudes Survey Regarding Pain and a student demographic information form were used for data collection. Data were analyzed with descriptive statistics, t test and variance analysis. RESULTS: The mean score on the Knowledge and Attitudes Survey Regarding Pain was 6.78 ± 2.23. Of all the students, 48.8% reported that they only preferred pharmacologic treatments for pain management. The mean score on the Knowledge and Attitudes Survey Regarding Pain significantly differed in terms of the type of high school (p = .044) and the unit for clinical education (p = .025). CONCLUSIONS: The students had a moderate mean score on the Knowledge and Attitudes Survey Regarding Pain. The students who graduated from high school and those who received their clinical education in cardiovascular and thoracic surgery units had significantly higher mean scores on pain management knowledge and attitudes.

Transcutaneous electrical acupoint stimulation combined with an integrated perioperative nursing program prevents subsyndromal delirium in older patients after joint replacement.

OBJECTIVES: This study aimed to develop transcutaneous electrical acupoint stimulation combined with an integrated perioperative nursing program and evaluate its effects on preventing subsyndromal delirium (SSD) and postoperative delirium (POD) in older patients after joint replacement surgery. METHODS: Participants were randomly divided into two groups, the experimental group (n = 48) was given transcutaneous electrical acupoint stimulation combined with an integrated perioperative nursing program based on the routine care of the control group (n = 49). The incidence of SSD and POD in a week after surgery was recorded. Assessments of delirium severity, cognition, anxiety, and depression were also conducted at baseline and on postoperative day 7. RESULTS: The findings indicate that the intervention program had significant advances in alleviating the severity of delirium, cognitive impairment, anxiety, and depression but failed to reduce the incidence of SSD and POD. CONCLUSIONS: Our study indicated that TEAS combined with an integrated perioperative nursing program has a beneficial effect on alleviating symptoms of delirium, cognitive dysfunction, anxiety, and depression in older adults after joint replacement surgery.

Perioperative Nursing Role in Robotic Surgery: An Integrative Review.

PURPOSE: Robotic surgery is an increasingly popular approach across surgical specialties in several countries. Nurses embedded in this highly technological environment, however, could excessively center their attention to the robot, deviating their focus from the patient. The Perioperative Patient Focused Model is proposed as a theoretical framework to guide nursing perioperative care toward a patient-centered approach based on 4 dimensions: Health System, Safety, Behavioral Responses and Physiological Responses. This review aimed to understand the role of perioperative nursing in robotic surgery according to the Perioperative Patient Focused Model. DESIGN: An integrative review. METHODS: The Whittemore and Knafl methodology guided this review. The following databases were searched: PubMed, Cochrane Library, ProQuest, Scielo, and LILACS. The keywords used were "Robotic Surgical Procedures" and "Nursing" and their equivalents in Spanish, Portuguese, and French, using the Boolean operator "AND," within the time frame of 2010-2021. FINDINGS: A total of 1,695 articles were retrieved, of which 26 were retained for the final analysis. The majority (n = 17) were written in English, with a level of evidence between 4 and 5. The main actions performed by nursing professionals were retrieved in the Health Systems, Safety, and Behavioral Responses dimensions, focusing on the intraoperative and postoperative period. However, most of the patient's responses were presented in the postoperative stage, even after discharge. Encompassing these findings, a theoretical framework is proposed. CONCLUSIONS: Nursing professional duties are diverse within the course of robotic surgery. It is necessary to expand the Perioperative Nursing specialty toward an extended care, encompassing even the community settings.

First in Japan: Training Curriculum for Perianesthesia Nurses and Their Clinical Practice.

PROBLEM DEFINITION: Japan is dealing with a superageing society found nowhere else in the world. This problem is provoking other complex issues such as aggravation of patients' condition, and a shortage of anesthesiologists leading to overwork. STRATEGIES TO ADDRESS THE PROBLEM: As a solution, our hospital established the PeriAnesthesia Nurse (PAN) for the first time in Japan. Unlike the United States and other developed countries in Europe, Japan did not have a license for nurses specialized in anesthesia. Thus, in collaboration with a graduate school of nursing, our hospital started a perianesthesia nursing course within the advanced practice nurse's training curriculum in 2010. At the graduate school, students take specialized lectures on anesthesia with a curriculum that focuses on risk management. On graduation, they work together with anesthesiologists in the department of anesthesiology and perform anesthesia-related tasks under the medical specialist's supervision. Their main duties include preoperative anesthesiology outpatient, surgical anesthesia, acute pain service (APS) for postoperative periods, and labor analgesia, and they collaborate with various specialists inside and outside of the operating room. EVALUATION AND RESULTS: Outcomes of patient care after the introduction of PAN have been observed. PAN provides persuasive explanations and guidance seamlessly to the patients by taking advantage of their experience in anesthesia and the scientific thinking they've acquired in graduate school. This paper reports on the training and clinical practice of perianesthesia nurses in Japan as a measure to improve the quality of perioperative medical care as well as the safety of patients.

The Relationship Between Perioperative Care Quality and Postoperative Comfort Level in Patients With Hip Replacement Surgery.

PURPOSE: To examine the relationship between perioperative care quality and postoperative comfort level of patients undergoing hip replacement surgery. DESIGN: This is a descriptive study. METHODS: This study was conducted with 90 patients between February and September 2021 in a training and research hospital in Turkey. Data were collected from Information Form, the Good Perioperative Nursing Care Scale (for Patients) (GPNCS), and the Post Hip Replacement Comfort Scale (PHRCS). FINDINGS: The mean age of the patients was 65.58 ± 15.10 years. The mean total scores of the patients in GPNCS and PHRCS were 134.61 ± 16.29 and 3.58 ± 0.40, respectively. In the correlation analysis, a statistically significant and positive weak relationship was determined between GPNCS and PHRCS, and as the quality of care during the surgery increases, the postoperative comfort levels increase (r = 0.253, P < .05). CONCLUSIONS: Ensuring the comfort of patients during the surgery as well as in the pre-, intra- and postoperative period is necessary and important for the quality of care. In addition, since the quality of the care during surgery is effective on the postoperative comfort levels of the patients, quality nursing care is required pre-, intra-, and postoperative periods.

[The application study of Electrophysiological appropriate technology in perioperative nursing of patients undergoing microdissection testicular sperm extraction].

Obstract: To explore the application of electrophysiological appropriate technology in perioperative nursing of patients undergoing microdissection testicular sperm extraction. METHODS: A retrospective analysis was conducted on the medical records of 108 patients who underwent testicular incision and sperm extraction under a microscope at our center from May 2022 to June 2023. Among them, 51 patients received routine care and 57 patients received electrophysiological treatment. Evaluate the perioperative nursing effects of appropriate electrophysiological techniques through VAS pain score, Self Rating Anxiety Scale (SAS) score, Pittsburgh Sleep Quality Score, and Kolcaba Comfort Scale. RESULT: Patients who received appropriate electrophysiological interventions had lower VAS pain scores (2.36 ± 1.37 vs 4.16 ± 1.38, P<0.001) than the control group, and higher KOLCABA comfort scale scores than the control group (70.73 ± 19.46 vs 52.06 ± 17.50, P<0.001); There was no statistically significant difference in the Self Rating Anxiety Scale (SAS) score and Pittsburgh Sleep Quality Score. CONCLUSION: Electrophysiological techniques can effectively improve postoperative pain and comfort in patients undergoing testicular incision and sperm extraction under a microscope, and have clinical application value.

Adoption of Novel Nano Bio-vascular Stent in Carotid Artery Stenosis Stent Intervention and Perioperative Nursing Analysis.

This work was developed to explore the adoption value of bacterial cellulose (BC) and heparin (He) combined with novel nano bio-vascular stents in carotid artery stent implantation, as well as the nursing methods and effects during the perioperative period. Based on the BC artificial blood vessel preparation method, the BC-He novel nano bio-vascular stent was fabricated after the modification of the medium method. Infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), and X-ray electron diffraction (XRD) were performed to analyze the crystal structure and chemical structure of the material. In addition, scanning electron microscope (SEM) and transmission electron microscope (TEM) were employed to observe the micro-morphology of the stent. The mechanical properties and thermal stability of the materials were also characterized. Then, with 98 patients undergoing carotid artery stenting (CAS) as the research object, BC-He novel nano bio-vascular stent was applied to treat patients with arterial stenosis. According to different nursing methods, patients were assigned to the conventional nursing group (group A) and perioperative nursing group (group B). The postoperative complications, nursing effect, and satisfaction degree of the two groups were compared. It turned out that the BC-He novel nano bio-vascular stent was a kind of micro-mesh structure. There were characteristic absorption peaks of BC and He in BC-He, and there were N and S from He. Moreover, it also contained BC and He characteristic diffraction peaks, its tensile strength was significantly lower than BC, and its thermal stability was higher than BC. The preoperative carotid artery stenosis ranged from 50 % to 75 %, and the postoperative stenosis rate of restenosis patients treated with BC-He novel nano bio-vascular stent was less than 10 %. In addition, there were 92 patients (93.88 %) whose symptoms improved or markedly improved within 1 to 2 weeks after the operation, and 78 patients (79.6 %) had improved hemodynamic parameters. The incidence of postoperative complications in group A was dramatically superior to that in group B (P < 0.05). The total effective rate of nursing care and the degree of nursing satisfaction in group B were better than those in group A (P < 0.05). In short, BC-He novel nano bio-vascular stent had good mechanical properties and thermal stability, which was a safe and effective material for the treatment of carotid artery stenosis. In addition, the perioperative nursing method was effective and was of certain clinical adoption value.

Impact of rapid rehabilitation surgery on perioperative nursing in patients undergoing cardiac surgery: A meta-analysis.

OBJECTIVE: To systematically evaluate the effect of enhanced recovery after surgery (ERAS) on perioperative nursing of patients undergoing cardiac surgery. METHODS: A systematic literature search was performed in PubMed, Embase, Web of science, Cochrane, CNKI, Wanfang, and VIP using predefined search strings from inception of database to May 2021. Randomized control trials (RCTs) with sample size >40 on cardiac surgery with either ERAS nursing or routine nursing reporting extubation (trachea) time, length of stay, out of bed activity time, and nursing satisfaction were included in the analysis. Stata SE 12.0 software was used for statistical analysis. RESULTS: A total of 27 RCTs were included. All the included studies were Chinese due to lack of studies in English. The results of meta-analysis showed that the extubation time standardized mean difference ([SMD] = -3.11; 95% confidence interval [CI]: -3.77, -2.45; p < .001), out of bed activity time (SMD = -2.89; 95% CI: -3.34, -2.44; p < .001), and hospitalization time (SMD = -2.08; 95% CI: -2.37, -1.79; p < .001) of cardiac surgery patients with ERAS nursing was significantly shorter than those with routine nursing. The patient's satisfaction after surgery with ERAS was higher than that of routine nursing relative risk ([RR] = 1.24; 95% CI: 1.18, 1.30; p < .001). CONCLUSION: ERAS nursing can accelerate perioperative rehabilitation of patients undergoing cardiac surgery and highly accepted by patients.

Efficiency evaluation of surgical nursing wards based on data envelopment analysis.

AIMS: This study aimed to evaluate the efficiency and influencing factors of surgical ward nursing. BACKGROUND: High-quality development of public hospitals and implementation of nursing fine management require improvements to promote nursing efficiency. METHOD: This study examined input data, such as number of beds, nurses, and nursing hours, and output data on discharged person-times, surgical output, and case mix index of released patients, in 40 surgical wards in China between September 2020 and August 2021. Nursing efficiency was assessed and analysed using data envelopment analysis, and changes in efficiency were dynamically evaluated using the Malmquist index analysis. RESULTS: The average total technical efficiency, pure technical efficiency, and scale efficiency were 78%, 94%, and 82%, respectively. In addition, 81% and 67% of surgical wards had input redundancy and output insufficiency, respectively. The monthly average total factor productivity was 118%, and the overall efficiency increased month after month. CONCLUSION: Overall, nursing service efficiency was low, which was limited by scale efficiency, pure technical efficiency, or both. IMPLICATIONS FOR NURSING MANAGEMENT: Data envelopment analysis could help nursing managers optimize nursing human resource allocation and nursing performance allocation.

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.

Operation Allies Refuge and Operation Allies Welcome: Military Perioperative and Perianesthesia Nursing Support to the Afghan Evacuation Mission.

Nursing has a long and celebrated history of providing life-saving care during crises and periods of great need. Following the government collapse in Afghanistan and the withdrawal of US troops, a severe humanitarian and human rights crisis emerged. The US military participated in one of the largest and most complex humanitarian missions in history to aid Afghan relief efforts. US and coalition forces evacuated more than 130,000 people in the chaotic Allied airlift from the Kabul Airport. The overarching missions, Operation Allies Refuge and Operation Allies Welcome, provided humanitarian support to at-risk Afghan nationals who contributed to the Global War on Terrorism efforts, as well as US citizens living in Afghanistan. Landstuhl Regional Medical Center (LRMC), an overseas military treatment facility located in Germany, supported the healthcare needs of Afghan evacuees and injured US service members during the humanitarian crisis. LRMC clinicians provided emergent, urgent, and specialty care while advocating for evacuee health, wellness, and living conditions. Perioperative and perianesthesia nurses were essential to the humanitarian response, as many evacuees and injured US service members arrived in Germany requiring immediate surgical interventions. In this article, we describe the vital contributions of military perioperative and perianesthesia nurses to the Operation Allies Refuge and Operation Allies Welcome missions, and share our experiences providing humanitarian relief. Military and civilian healthcare planners can learn from our humanitarian relief contributions, experiences, and lessons to strategically prepare their health systems to respond to future crises.

Student Perioperative Experience Supports Recognition of Safety Concepts.

PURPOSE: This study aimed to evaluate student perception of knowledge gained and intent to apply perioperative safety concepts. DESIGN: A mixed-method design analyzed themes from student reflections as well as frequencies of student survey responses after a one day, 10-hour, perioperative observational experience. METHODS: Students participated in a one day, 10-hour, observational clinical experience following patients from the preoperative area to the operating room, postanesthesia care unit, and discharge from a surgery center or admission to a hospital room. After the experience, students completed a survey and a reflection assignment. A modified Delphi method was used for thematic analysis. Frequencies and averages were used to analyze the survey items. FINDINGS: Students gained knowledge of and reported intent to apply perioperative safety concepts within their nursing practice. Some students noted an interest in perioperative nursing as a career choice. CONCLUSIONS: These findings provide evidence to support implementation of perioperative experiences in nursing programs and reinforce the role of the registered nurse (RN) to ensure safe and quality care. In addition, the perioperative experience may be a recruitment tool for enhancing the perioperative workforce.

Adaptation of the Person-Centered Perioperative Nursing Scale to Turkish: A Validity and Reliability Analysis.

PURPOSE: This study aims to perform a detailed analysis of the validity and reliability of the Turkish version of the Person-Centered Perioperative Nursing Scale (PCPON). DESIGN: Methodological and descriptive study. METHOD: This study was conducted online between December 2020 and February 2021, with 240 nurses working in the surgical wards of private hospitals in Istanbul, Turkey. Individual Characteristics Questionnaire and PCPON were used to collect data. Cronbach Alpha reliability analysis and Confirmatory Factor Analysis (CFA) were applied using R Project software to the data. FINDINGS: As a result of the analysis, all corrected item correlation values for compassionate interaction, respect, comfort, sharing information, and expertise were found to be positive following the original factors structure of the scale. According to reliability analysis statistics, Cronbach's Alpha coefficients were calculated as 0.781, 0.758, 0.780, 0.750 and 0.808 for compassionate interaction, respect, comfort, sharing information, and expertise sub-dimensions, respectively. According to these findings, all five sub-dimensions had high reliability levels. As a result of CFA, the items in all sub-dimensions were statistically significant. Standardized factor loads were also positive in the five sub-dimensions of the scale. Based on these results, all PCPON items were under appropriate sub-dimensions. CONCLUSIONS: PCPON as adapted from English to Turkish had high levels of validity and reliability. It was concluded to be a valid and reliable scale, which we believe will be useful for our country in the fields of education, practice, and research to evaluate the attitudes and behaviors of surgical nurses towards the care-oriented nurse-patient relationship.

Using Evidence to Prevent Risk Associated With Perioperative Pressure Injuries.

Pressure injuries (PI) are a significant concern for surgical patients due to prolonged immobility and potential exposure to other risk factors associated with procedures. PI prevention strategies should begin early in the patient's surgical encounter starting with preoperative assessment. Much literature has been published to discuss PI risk factors, assessment tools, and evidence-based prevention measures. The purpose of this article is to critically review current best evidence to holistically assess patient risk for Hospital Acquired Pressure Injuries (HAPI) and review current tools used for risk assessment, interventions to combat skin injuries, and discuss implications for practice in perioperative nursing.