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BackgroundWith the introduction of robot-assisted surgery, the role and responsibility of the operating room nurses have been expanded. The surgical team for robotic-assisted surgery depends on the ability of the operating room nurses to operate and handle the robotic system before, during, and after procedures. However, operating room nurses must acquire the necessary competencies for robotic-assisted surgery.MethodWe performed a systematic review using the databases MEDLINE and EMBASE to review the evidence on educating and training operating room nurses in robot-assisted surgery. Studies describing operating room nurses’ training and team-training with operating room nurses for robot-assisted surgery were included. The Medical Education Research Study Quality Instrument (MERSQI) and the Newcastle–Ottawa Scale-Education (NOS-E) were used to evaluate the quality of the included studies.ResultsWe identified 3351 potential studies and included 16 in the final synthesis. Nine studies focused on team-training in robot-assisted surgery: four focused solely on training for operating room nurses, and only three on operating room nurses as first assistants in robot-assisted surgery. Most studies examined team-training in RAS, including OR nurses, focused on emergency situations and conversion to an open procedure. Only a few studies addressed other competencies relevant to OR nurses in RAS. No randomized controlled trials were identified. Only a few studies used pre- and post-testing, and only one examined clinical outcomes. The quality assessment of the included studies was moderate to low, with a median MERSQI score of 10.3 and a median NOS-E score of 2.ConclusionThere is sparse research on the education of operating room nurses in robot-assisted surgery, and the literature emphasizes the training of surgeons. More research is needed to develop evidence-based training for operating room nurses in robot-assisted surgery.

Background Approximately half of all adverse events occur in the operating room, highlighting the critical role of non-technical skills in operating rooms. Effective non-technical skills among operating room nurses can significantly reduce the occurrence of such events. Moreover, self-efficacy in non-technical skills may directly impact professional performance and patient safety. Therefore, this study aimed to investigate the impact of intraoperative non-technical skills training on scrub practitioners' self-efficacy. Methods In a randomized controlled trial, 30 scrub practitioners were assigned to the intervention group and 30 to the control group through random allocation. The intervention group underwent training in non-technical skills using a combined technique of lectures and simulated video scenarios delivered in two two-hour training sessions. Meanwhile, the control group received no training. The data collection tool was a two-part questionnaire. The first part collected demographic data (age, gender, work experience, and educational level), while the second part assessed scrub practitioners' self-efficacy in intraoperative non-technical skills. The questionnaire was administered online in two phases, with a one-month interval between them, through the Telegram application to the participants in both groups. The data were analyzed using descriptive statistics, independent t-tests, and paired t-tests. Results The demographic variables of the intervention group did not show significant differences compared to the control group. The independent t-test revealed no significant difference in overall self-efficacy between the intervention and control groups before the training ( P  = 0.513). However, after the training, a statistically significant difference was observed ( P  = 0.025). There were no significant differences among the self-efficacy components between the intervention and control groups before the training ( P  > 0.05). However, after the training, self-efficacy in the two skills of situation awareness and communication and teamwork showed statistically significant differences ( P  < 0.05). Conclusion Non-technical skills are crucial for scrub practitioners to perform their tasks safely and efficiently. Training can enhance the self-efficacy of scrub practitioners in their non-technical skills. Therefore, it is necessary to incorporate non-technical skills training into the educational curriculum and continuing education programs for scrub practitioners. Trial registration The IRCT code (IRCT20150715023216N15) was obtained from the Iranian Clinical Trials Registry website on 2023/08/05 before sampling.

ABSTRACTThis article discusses the implementation and enhancement of an OR nurse residency program at a health care system in North Carolina. Recognizing the unique challenges and skills required in perioperative nursing, program coordinators aimed to support new nurses transitioning into the OR setting. Key enhancements included incorporating AORN's Periop 101: A Core Curriculum to provide consistent, evidence‐based perioperative education and pursuing accreditation through the Commission on Collegiate Nursing Education to ensure the highest standards of excellence. The program also emphasizes simulation training, preceptor guidance, and continuous feedback to increase residents’ proficiency and confidence. The integration of Periop 101 has led to successful outcomes, including high pass rates on comprehensive exams and residents achieving the Certified Foundational Perioperative Nurse credential offered by the Competency & Credentialing Institute. This article highlights the importance of structured education, leadership involvement, and continuous improvement to develop competent and skilled OR nurses.

Evidence-based practice (EBP) is a clinical decision-making process that is grounded in the utilization of the most reliable and up-to-date evidence. It involves utilizing resources and evidence to enhance patient management. The application of evidence-based decisions in patient care and education is of utmost importance in the performance of health sciences students. However, the emphasis on this concept among operating room nursing students has been lacking. Hence, the objective of this research is to assess the implementation of evidence-based practice among operating room nursing students studying in the operating room department at the Shiraz University of Medical Sciences in Iran. The study follows a descriptive, cross-sectional design, with a sample of 148 operating room nursing students selected through census sampling based on the student list. After obtaining informed consent, participants completed a demographic information form and the Rubin–Parrish evidence-based practice questionnaire. The data that were gathered underwent analysis through the utilization of SPSS version 22 software, employing descriptive statistics, T-tests, and Pearson correlation coefficient tests. The results revealed that the overall average score of evidence-based practice among the students exceeded the standard scores (172.66 ± 14.74). There was a significant association between the evidence-based practice score and prior familiarity with evidence-based practice, interest in the field of study, research experience, intention to participate in the Master’s exam, and the participants’ grade point average (GPA) (p<0.05). These findings indicate that operating room nursing students displayed an average level of evidence-based practice, emphasizing the need for effective plans and strategies to improve their performance. Addressing the identified factors from this study becomes crucial in this regard.

Background The operating room is a high-risk environment where proper patient positioning is crucial for minimizing injury and ensuring optimal access to surgical sites. This process requires effective collaboration among surgical team members, particularly operating room nurses who play a vital role in patient safety. Despite advancements in technology, challenges such as pressure injuries persist, with a significant incidence rate. Video-based training (VBT) emerges as a promising educational tool, enhancing knowledge retention and fostering a learner-centered approach. This study aims to evaluate the impact of VBT on adherence to surgical positioning standards, highlighting its potential to improve safety protocols in the operating room. Methods In this clinical trial, 62 qualified operating room nurses (50 women, 12 men, average age: 28.90 ± 3.75 years) were randomly divided into control and intervention group ( n  = 31 in each group). The control group only received positioning recommendations, but in the intervention group, in addition to the recommendations, video-based surgical positioning training was performed for 1 month, at least 3 times a week. The performance of nurses in both groups was evaluated through a researcher-made checklist at baseline and post-intervention. Results Based on findings, there was no significant difference between the two groups in compliance with surgical positioning standards at baseline ( p  = 0.07). However, after the intervention, compliance scores significantly improved in the VBT group compared to the control group ( p  < 0.001). The VBT group showed a mean improvement of 62.12 points, while the control group improved by 10.77 points ( p  < 0.001). Conclusions This preliminary study demonstrated a notable improvement in compliance with surgical positioning standards among operating room nurses following VBT intervention. Despite the promising results, the small sample size and preliminary nature of the research necessitate further studies to confirm these findings and assess long-term outcomes. These initial insights highlight the potential of innovative training methods in enhancing surgical practices.

The professional literature predicts worldwide perioperative nursing shortages. Compounding this is the absence of perioperative curricula in most nursing programs, which reduces new graduate interest in and awareness of employment opportunities in the OR environment. Educators at a university and a large hospital system formed an innovative partnership to create a pilot undergraduate nursing course to better prepare nurses for the surgical setting. The course was offered in a condensed-semester format and included online activities, simulation experiences, classroom discussions, and clinical experiences in a small group setting. Two of the four nursing students in the course were hired directly into the perioperative setting after graduation, decreasing hospital costs related to recruitment and orientation. The success of the course led to its integration into the undergraduate curriculum, thus providing a valuable elective option for junior and senior nursing students, as well as achieving a new model for perioperative nursing education.

Background The present study was designed to implement an interprofessional simulation-based education program for nursing students and evaluate the influence of this program on nursing students’ attitudes toward interprofessional education and knowledge about operating room nursing. Methods Nursing students were randomly assigned to either the interprofessional simulation-based education or traditional course group. A before-and-after study of nursing students’ attitudes toward the program was conducted using the Readiness for Interprofessional Learning Scale. Responses to an open-ended question were categorized using thematic content analysis. Nursing students’ knowledge about operating room nursing was measured. Results Nursing students from the interprofessional simulation-based education group showed statistically different responses to four of the nineteen questions in the Readiness for Interprofessional Learning Scale, reflecting a more positive attitude toward interprofessional learning. This was also supported by thematic content analysis of the open-ended responses. Furthermore, nursing students in the simulation-based education group had a significant improvement in knowledge about operating room nursing. Conclusions The integrated course with interprofessional education and simulation provided a positive impact on undergraduate nursing students’ perceptions toward interprofessional learning and knowledge about operating room nursing. Our study demonstrated that this course may be a valuable elective option for undergraduate nursing students in operating room nursing education.

Authors commonly agree that the clinical learning environment significantly affects student learning. Studies of how operating room nurses perceive the clinical learning environment during their specialist studies are sparse. This study aimed to examine newly graduated operating room nurses' perceptions of the clinical learning environment during their specialist education. Fifty newly graduated operating room nurses answered a questionnaire gaging their perceptions of clinical education. Most participants perceived the clinical learning environment as good and highly associated with the supervisor's ability to supervise, enjoy supervision, and show interest in the participants' degree project. The management at the clinical setting, which was perceived to emphasize the importance of supervision, time allocated especially for supervision, and perceived cooperation between the University and hospital, also had an impact. Social interactions and structures within the operating room affect how the clinical learning environment is perceived. J Contin Educ Nurs. 2018;49(9):416-423.

It is challenging for OR educators and leaders to create a realistic fire in a simulation center in a shared building attached to a medical center. The production of smoke and flames can activate heat and smoke detectors in the building. Small smoke generators, such as those for model trains, produce enough smoke to activate fire alarms. Any plan either to build a fire or to generate smoke needs the advice and permission of the fire and safety officers at the facility. At our facility, we developed a few methods for producing realistic but fake smoke that we can use in almost all of our fire scenarios. One of these methods consists of a saline nebulizer that is positioned under a surgical drape to simulate an airway or drape fire. To start the mock fire, the oxygen flow is increased to 15 L/min. Almost immediately, the nebulizer begins to emit clearly visible “smoke.” For more extensive fire scenarios, we project the video image of flames onto drapes or surgical supplies. This technique is more dramatic in low light conditions, such as during laparoscopic or bronchoscopic procedures. We also have used the projected flames to depict a rapidly spreading fire. The combination of a small amount of simulated smoke plus the projected image can result in a realistic depiction of what perioperative personnel may experience during an OR fire.

The quality of teamwork among health care professionals is known to affect patient outcomes. In the OR, surgeons report more favorable perceptions of communication during procedures and of teamwork effectiveness than do nurses. We undertook a quality improvement project in the Veterans Health Administration to confirm reported teamwork differences between perioperative nurses and surgeons and to examine the implications of these differences for improving practice patterns in the OR. The Safety Attitudes Questionnaire, which measures safety culture, including the quality of communication and collaboration among health care providers who routinely work together, was administered in 34 hospitals. Perioperative nurses who participated in the survey rated teamwork higher with other nurses than with surgeons, but surgeons rated teamwork high with each other and with nurses. On five of six communication and collaboration items, surgeons had a significantly more favorable perception than did perioperative nurses. To increase the likelihood of success when implementing the use of checklist-based crew resource management tools, such as the World Health Organization's Surgical Safety Checklist, project leaders should anticipate differences in perception between members of the different professions that must be overcome if teamwork is to be improved.