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Background To evaluate the prevalence of work-related musculoskeletal disorders (WRMSDs) in perioperative nurses and to explore their association with personal characteristics. Methods Medline, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, Cochrane Library and Joanna Briggs Institute Database were systematically searched. A meta-analysis calculating event rates, and relative 95% Confidence Intervals (CI) was performed for each musculoskeletal body region. The contribution of perioperative nurses’ sex, age, and BMI was assessed through a meta-regression. Results Twenty-two studies, considering 3590 perioperative nurses, were included in the systematic review. The highest prevalence of WRMSDs was found for the lower-back (62%; 95% CI 0.54–0.70), followed by knee (47%; 95% CI 0.36–0.59), shoulder (44%; 95% CI 0.37–0.51), waist (42%; 95% CI 0.31–0.53), neck (39%; 95% CI 0.29–0.51), ankle-feet (35%; 95% CI 0.22–0.51), upper-back (34%; 95% CI 0.25–0.44), hand-wrist (29%; 95% CI 0.20–0.40), and elbow (18%; 95% CI 0.12–0.26). Meta-regression showed that sex, age, and BMI were not significant predictors of low-back disorders ( p  = 0.69; R 2  = 0). Conclusions WRMSDs represent a high prevalence issue among perioperative nurses. Perioperative nurses, in general, are steadily exposed to both physical and temporal risk factors. Further studies should be addressed to identify specific interventions aimed at reducing the burden of WRMSDs including ergonomic education and physical rehabilitation. Our data could be used in future studies as a reference to assess the risk of WRMSDs in other health-care professionals’ population.

Background Routine assessments of patient safety culture within hospitals have been widely recommended to improve patient safety. Experts suggested that mixed-methods studies can help gain a deeper understanding of the concept. However, studies combining quantitative and qualitative approaches exploring patient safety culture are still lacking. This study aimed to explore patient safety culture as perceived by operating room professionals of two university hospitals in Sousse, Tunisia. Methods Based on a mixed-methods approach, a cross-sectional survey followed by semi-structured interviews were conducted over a period of two months (December 2019 to January 2020). This study took place in all the operating rooms of two public university hospitals in the district of Sousse, Tunisia. To collect data for this survey, the French version of the Hospital Survey On Patient Safety Culture was used. For interviews, 13 participants were selected purposively using a critical case sampling approach and a topic guide was prepared. Anonymity and confidentiality were respected. Results Overall, twelve operating rooms, with different surgical specialties, were included in the study. Survey feedback was provided by 297 professionals representing a response rate of 85.6%. Concerning patient safety culture, the 10 dimensions had low scores (below 50%) and were considered “to be improved”. The highest score was found in ‘teamwork within units’ (45%). Whereas, the lowest scores were allocated to ‘non-punitive response to error’ (22.9%), followed by “frequency of adverse event reported” (25.6%) and “communication openness” (26.3%). Per qualitative data, participants provided a more detailed picture of patient safety issues such as underreporting, absence of an effective reporting system, lack of freedom of expression, and an existing blame culture in operating rooms. Conclusions The findings of this study showed a concerning perception held by participants about the lack of a patient safety culture in their operating rooms. It seems essential to design, implement and evaluate strategies that promote a positive patient safety culture and obliterate punitive climate in operating rooms.

The aim of this study is to examine the opinions and experiences of operating room nurses about ethical sensitivity phemenologically. This phenomenological study, which is in the qualitative research design, was conducted with 14 operating room nurses. Prior to the study, a pilot study was conducted with three nurse families. The interviews were conducted using a face-to-face in-depth semi-structured interview form and the data were analyzed with Colaizzi’s phenomenological method. Interview data were collected between 15 June 2022 and 15 October 2022 in the country. Three categories, seven main themes, and twenty-three sub-themes emerged as a result of the interviews. In the theme of ethical dilemmas experienced by operating room nurses, there are sub-themes of professional ethics, teamwork, and patient dignity and benefit. There are physical and psychological sub-themes in the theme of ethical sensitivity perception and practices of operating room nurses, and among the subthemes, ensuring patient privacy, providing professional competence, providing psychological support to the patient, being friendly and communicating effectively, and respecting the patient’s autonomy come to the fore. Views of operating room nurses on the importance of ethical principles were discussed under the headings of profession and patient. Our results are valuable in that they shed light on the perspectives and experiences of the operating room nurses while maintaining ethical sensitivity. The high ethical sensitivity perceptions of operating room nurses are associated with an increase in the quality of care. It is thought that the high perception of ethical sensitivity of operating room nurses is an important factor that increases the satisfaction of individuals receiving care and the job satisfaction and quality of care of nurses.

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.

The use of robotic-assisted surgery (RAS) is becoming increasingly prevalent across a range of surgical specialties within public hospitals around Australia. As a result, it is critical that organisations consider workplace factors such as staff knowledge, attitudes and behaviours prior to the implementation of such new technology. This study aimed to describe the knowledge and attitudes of operating theatre staff from a large public tertiary referral hospital prior to the commencement of an RAS program. A cross-sectional survey of nursing, medical and support staff working in the operating theatre complex of a large public tertiary referral hospital was completed over a one-week period in June 2016. A 23-item questionnaire was utilised for data collection. 164 (66%) theatre staff returned the surveys and were included in this study. The majority of medical staff reported being knowledgeable about RAS, whilst the majority of nursing and support staff did not. Overall the theatre staff were neutral about the potential benefits of RAS to patients. The majority of medical staff believed the implementation of RAS will increase the value of staff roles and job satisfaction, while nursing and support staff were uncertain about these benefits. All three staff groups were concerned about the impact of an RAS program on Workplace Health and Safety, and care and handling. Operating theatre staff presented different knowledge and attitudes prior to the introduction of RAS. Whilst theatre staff were more favourable towards RAS than negative, they largely reserved their judgement about the new system prior to their own experiences. Collectively, these findings should be taken into consideration for training and support strategies prior to the implementation of a RAS program.

Objective: During the pandemic, operating theaters were considered high-risk areas because of aerosol-generating procedures and devices. Therefore, the surgical team members had to wear multi-component high-level personal protective equipment to prevent occupational exposure. In the current study, we evaluated the side effects of operating room coronavirus disease-2019 (COVID-19) personal protective equipment. Methods: A descriptive and cross-sectional study was conducted with 203 participants. Side effects in six thematic areas (respiration, vision, hearing-communication, thermal stress, movement-occupational skills, neurocognitive-psychological) were evaluated using a questionnaire and face-to-face interview. Results: The mean age was 32.6[+ or -]8.4; 55.7% were women and 43.8% were doctors. Respiratory, vision, hearing, and communication limitations were determined as 91.6%, 94.1%, 61.6%, and 93.6%, respectively. Those who reported an increase in sweating, warmth, thirst and skin problems were 96.1%, 95.1%, 91.6% and 85.2%, respectively. Restrictions in movements and sense of touch were 88.2% and 80.3%, respectively. Decreased visual quality and psychological tolerance and increased thermal stress and sweating were higher in physicians (p<0.05). Hearing limitation was higher in nurses (p<0.05). Conclusion: The results showed that the members of the surgical team experienced serious difficulties while working with the operating room COVID-19 personal protective equipment, and that they were not prepared for strategies to deal with these problems. There must be a balance between the protective effects of this equipment and the user side effects. It is recommended that efforts should be focused on designing and producing new user-friendly and suitable equipment for employee health. Keywords: Operating room, COVID-19, personal protective equipment, side effects Amac: Pandemi doneminde ameliyathaneler, aerosol ureten prosedurler ve cihazlar nedeniyle yuksek riskli alanlar olarak kabul edildi. Bu nedenle, cerrahi ekip uyeleri, mesleki maruziyeti onlemek icin cok bilesenli ust duzey kisisel koruyucu ekipman giymek zorunda kaldi. Bu calismada, ameliyathane koronavirus hastaligi-2019 (COV?D-19) kisisel koruyucu ekipmanlarinin yan etkilerini degerlendirmeyi amacladik. Gerec ve Yontem: Tanimlayici ve kesitsel nitelikteki calisma, 203 katilimciyla yurutuldu. Alti tematik alandaki (solunum, gorme, isitme-iletisim, termal stres, hareket-mesleki beceriler, norokognitif-psikolojik) yan etkiler anket ve yuz yuze gorusme yontemiyle degerlendirildi. Bulgular: Ortalama yas 32,6[+ or -]8,4; %55,7'si kadin, %43,8'i doktordu. Solunum, gorme, isitme ve iletisim kisitliliklari sirasiyla %91,6, %94,1, %61,6 ve %93,6 olarak belirlendi. Terleme, sicaklik, susuzluk ve deri problemlerinde artis bildirenlerin orani sirasiyla %96,1, %95,1, %91,6, %85,2 bulundu. Hareketlerde ve dokunma duyusunda kisitlamalar %88,2 ve %80,3 idi. Gorme kalitesinde azalma, psikolojik toleransta azalma, termal stres ve terlemede artis hekimlerde daha yuksekti (p<0,05). Hemsirelerde isitme kisitliligi daha fazlaydi (p<0,05). Sonuc: Bu calismanin sonuclari, cerrahi ekip uyelerinin ameliyathane COV?D-19 kisisel koruyucu ekipmanlari ile calisirken ciddi zorluklar yasadiklarini ve bu sorunlarla bas etme stratejilerine hazirlikli olmadiklarini gostermistir. Bu ekipmanlarin koruyucu etkileri ile kullanici yan etkileri arasinda bir denge olmalidir. Calisan sagligina uygun, kullanici dostu yeni ekipmanlarin tasarlanmasi ve uretilmesine agirlik verilmesi onerilir. Anahtar Kelimeler: Ameliyathane, COV?D-19, kisisel koruyucu ekipman, yan etkiler

Background Low back pain (LBP) is one of the most common musculoskeletal disorders related to working. Due to the nature of nursing work, this problem is often seen in nurses, including those who work in the operating rooms. Depending on the cause, there are various surgical and non-surgical methods to treat LBP. The present study was aimed to compare the effect of two therapeutic methods of back exercises and transcutaneous electrical nerve stimulation (TENS) on the disability and pain of operating room nurses with LBP. Methods In this clinical trial forty-four eligible operating room nurses (30 women, 14 men, mean age: 37.86 ± 6.74) with chronic nonspecific LBP were randomly assigned to back exercises (including the strengthening and stretching exercise ( n  = 22)) or TENS ( n  = 22) groups by permuted block randomization method. These interventions were performed in both groups three sessions of 15 min per week for 6 weeks. The McGill pain questionnaire for back pain and the Oswestry disability questionnaire for disability assessment were completed immediately before and after the interventions. Results After 6 weeks, the mean of pain and disability decreased significantly in both groups compared to the baseline. Based on the results, significant decreases in the pain score (mean difference (95% CI): − 8.95 (− 12.77 to − 5.14); P -value < 0.001) and disability score (mean difference (95% CI): − 8.73(− 12.42 to − 5.03); P -value < 0.001) were revealed in the back exercises group after the intervention compared to the baseline. In addition, after the intervention in TENS group, the mean pain intensity and disability showed significant decrease, respectively (mean difference (95% CI): − 16.18 (− 19.81 to − 12.55); P -value < 0.001; mean difference (95% CI): − 15.82 (− 19.24 to − 12.40); P -value < 0.001). After adjusting for the baseline values, the TENS group had a significantly higher pain score reduction than the back exercises group (mean difference (95% CI): − 4.23 (− 8.03 to − 0.44); P -value =0.030; Cohen’s d = 0.81). In addition, TENS led to a significant more decrease in the disability scores compared to the back exercises (mean difference (95% CI): − 3.99 (− 7.35 to − 0.64); P -value =0.021; Cohen’s d = 0.73). Furthermore, a statistically significant time by group interaction effect on pain and disability score was found (interaction p  < 0.001). Conclusion Pain and disability were improved in both groups following 18 intervention sessions. However, pain and disability were improved to a greater extent in the TENS group than in the back exercises group. Trial registration The trial was retrospectively registered in the Iranian Registry of Clinical Trials ( www.irct.ir ) on 03/02/2019 as IRCT20180408039227N1 .

Surgical smoke during surgery occurs due to the use of electrical devices working at high temp eratures such as laser, electrocautery, ultrasonic scalpel, bone saw, and drill used during excision, hemostasis, and dissection. Operating room workers are exposed to this harmful smoke in surgeries. No study was found in the literature comparing operating room personnel before and after working in the operating room. This study was conducted to comparison of the effects of exposure to surgical smoke before and after working in the operating room This study was conducted in a descriptive design. The study was performed in the operating room of Atatürk University Research Hospital between the dates January 2021 September 2021. The study was carried out with a total of 87 operating room personnel (surgeons, nurses, anesthesia technicians) who had worked in another clinic or outpatient clinic before working in the operating room. Data were collected using a questionnaire containing the sociodemographic information of the operating room personnel and a data collection form on the risks and symptoms of surgical smoke. In the study, it was determined that 44.8% of the operating room personnel were nurses, 65.5% were female, 51.7% worked in the operating room for 1-5 years, and 46.0% stayed in the surgical operation for 4-6 hours. It was reported that various symptoms related to surgical smoke such as headache (100%), fatigue (95.8%), nervousness (98.3%), muscle pain (98.4%), discomfort (100.0%), amnesia (95.5%), and respiratory tract problems were observed in operating room personnel, especially after working in the operating room. As a result of the study, it was revealed that the operating room personnel experienced various symptoms due to surgical smoke after working in the operating room. This study showed the adverse effects of su rgical smoke on the health of operating room personnel.

Objective To investigate the current state of compassion fatigue among operating room nurses, analyze the factors influencing compassion fatigue (particularly psychological resilience), and provide a basis for developing a compassion fatigue intervention program for operating room nursing managers. Methods This cross-sectional study was conducted in February 2022. A total of 258 operating room nurses were surveyed using the Professional Quality of Life (ProQOL) scale and the Resilience Scale for Adults (RSA). The ProQOL demonstrated internal consistency reliability, with Cronbach’s α values ranging from 0.75 to 0.88 across its three subscales. The Cronbach’s α coefficient for the RSA was 0.91. Results Scores on various dimensions of compassion fatigue among operating room nurses were as follows: the total score was 84.07 (standard deviation [SD] = 7.74), with a mean score of 28.02. 92 nurses (35.5%) had no compassion fatigue or only mild compassion fatigue, whereas 166 nurses (64.3%) experienced moderate or greater compassion fatigue. The total score for psychological resilience was 112.9 (SD = 6.47), with a mean score of 18.82. Factors influencing compassion fatigue included the relationship between labor and personnel, the number of night shifts per week, and mental resilience. The differences were statistically significant ( P  < 0.05). Conclusion Compassion fatigue among nurses in the operating room is severe and is mainly influenced by factors such as night shift work, the relationship between labor and personnel, and mental resilience. Appropriate interventions are recommended to address these factors and reduce nurses’ compassion fatigue. Clinical trial number Not applicable.

Introduction Radiation protection is becoming more important with an ongoing increase in radiation exposure due to the use of X-rays in minimally invasive procedures in orthopaedic and trauma surgeries. However, sufficient education in medical physics and radiation protection can often be improved. Materials and methods A questionnaire consisting of four questions about personal data and ten questions about radiation protection was distributed to lead consultants, consultants, residents, medical students, and medical technical assistants at two institutions, a level 1 trauma center and a children’s hospital. Results This study consisted of 83 participants. The compliance with radiation protection, i.e., usage of a dosimetry, an apron, and a thyroid shield on a regular basis was only seen in 54 %. Participants from the trauma center wore a dosimeter and thyroid shield significantly more often. The regular use of a thyroid shield differed significantly between job positions. It was observed in 80 % of students, but only 15 % of technical assistants. Only 65 % of all knowledge questions were answered correctly. There was a discrepancy between incorrectly answered knowledge questions (35 %) and those marked as uncertain (20 %). Different job positions did not have an impact on the answers to the questions in most instances. Conclusions The compliance with and the knowledge about radiation protection seems to be unnecessarily low in trauma physicians and technical assistants. The discrepancy in falsely answered questions and those marked as uncertain may suggest that participants may overestimate their knowledge about radiation protection, which is potentially harmful due to the increased radiation exposure. Therefore, we advocate a quick and valuable training of trauma surgeons and medical staff addressing the important preventive measures, some of which are illustrated in the present study. These consist of wearing dosimetry and protection devices, reduction in X-ray duration, preferably antero-posterior C-arm positioning with the image intensifier close to the patient and the surgeon, maximal distance, collimation, and increased voltage. Furthermore, the use of visual feedback on complex and potentially hazardous radiation facts may be useful for training purposes. Study design Cross-sectional study with a questionnaire.