Nurses keeping patients safe by managing risk in perioperative settings: A classic grounded theory study.

AIM: To develop and expand how nurses promote safety in perioperative settings. BACKGROUND: This article presents orchestrating a sub-core category from the theory of anticipatory vigilance in promoting safety within preoperative settings (Journal of Clinical Nursing, 27, 2018, 247). Orchestrating explains this and involves effective planning, delegating, co-ordinating and communication. METHOD: A classic grounded theory methodology was used. Ethical approval was granted. Data comprised of 37 interviews and 33 hr of non-participant observation. Data analysis followed the principals of classic grounded theory. RESULTS: Orchestrating is fundamental in promoting safety and minimizing risk of errors and adverse events in the perioperative setting. Nurses achieve this through four categories: macro orchestrating, locational orchestrating, situational orchestrating and being in the know. CONCLUSION(S): Nurses minimize risk by fostering a culture of safety, risk awareness, effective management and leadership. IMPLICATIONS: Effective management structures and support systems are essential in promoting a culture of safety in perioperative setting.