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ABSTRACT Objective: To evaluate how job satisfaction and motivation impact the perception of occupational stress among operating room nursing professionals. Methods: This observational cross-sectional study was conducted at a major federal university hospital in Northeast Brazil, with data collection occurring in May and June of 2023. Results: Among the 92 respondents, which included nurses (35; 38.1%) and technicians (52; 61.9%), high stress scores were reported along with median or neutral levels of satisfaction and motivation. The primary factors affecting the perception of occupational stress in the sample were satisfaction with promotions, satisfaction with management, and the Hygiene Index of motivation. Conclusions: Dimensions of satisfaction and motivation can significantly impact the perception of occupational stress among operating room nursing professionals. RESUMEN Objetivo: Evaluar cómo la satisfacción y la motivación laboral influyen en la percepción del estrés laboral de los profesionales de enfermería del quirófano. Métodos: Estudio transversal observacional realizado en un hospital universitario federal de gran tamaño en el Noreste de Brasil, con recolección de datos en mayo y junio de 2023. Resultados: 92 encuestados, entre enfermeros (35; 38.1%) y técnicos (52; 61.9%), mostraron altos puntajes de estrés y niveles medianos o indiferentes de satisfacción y motivación. Los principales factores que afectaron la percepción del estrés laboral en la muestra fueron la satisfacción con las promociones, la satisfacción con el liderazgo y el Índice higiénico de motivación. Conclusiones: Las dimensiones de la satisfacción y la motivación pueden impactar en la percepción del estrés laboral de los profesionales de enfermería del quirófano. RESUMO Objetivo: Avaliar como a satisfação e a motivação para o trabalho impactam na percepção de estresse laboral de profissionais de enfermagem de bloco operatório. Métodos: Estudo transversal observacional realizado em um hospital universitário federal de grande porte do Nordeste do Brasil, com coleta de dados em maio e junho de 2023. Resultados: 92 respondentes, entre enfermeiros (35; 38,1%) e técnicos (52; 61,9%), apresentaram elevados escores de estresse e satisfação e motivação medianas ou indiferentes. Os principais fatores que afetaram a percepção do estresse laboral na amostra foram a satisfação com promoções, a satisfação com a chefia e o Índice higiênico da motivação. Conclusões: Dimensões da satisfação e da motivação podem impactar na percepção do estresse laboral de profissionais de enfermagem do bloco operatório.

Two approaches prevail for reserving operating room (OR) capacity for emergency surgery: (1) dedicated emergency ORs and (2) evenly allocating capacity to all elective ORs, thereby creating a virtual emergency team. Previous studies contradict which approach leads to the best performance in OR utilization. Quasi-experimental controlled time-series design with empirical data from 3 university medical centers. Four different time periods were compared with analysis of variance with contrasts. Performance was measured based on 467,522 surgical cases. After closing the dedicated emergency OR, utilization slightly increased; overtime also increased. This was in contrast to earlier simulated results. The 2 control centers, maintaining a dedicated emergency OR, showed a higher increase in utilization and a decrease in overtime, along with a smaller ratio of case cancellations because of emergency surgery. This study shows that in daily practice a dedicated emergency OR is the preferred approach in performance terms regarding utilization, overtime, and case cancellations. •Two approaches for reserving OR capacity were evaluated.•Performance was measured in this multicenter study comprising 467,522 surgical cases.•A dedicated emergency OR generates more utilization, less overtime, and less cancellations.

Perception of a surgeon based on physical attributes in the operating room (OR) environment has not been assessed, which was our primary goal. A common OR scenario was simulated using 8 different actors as a lead surgeon with combinations of age (<40 vs. >55), race (white vs. black), and gender (male vs. female). One video scenario with a survey was electronically distributed to surgeons, residents, and OR nurses/staff. The overall rating, assessment, and perception of the lead surgeon were assessed. Of 974 respondents, 64.5% were females. There were significant differences in the rating and assessment based upon surgeon's age (p = .01) favoring older surgeons. There were significant differences in the assessments of surgeons by the study group (p = .03). The positive assessments as well as perceptions trended highest towards male, older, and white surgeons, especially in the stressful situation. While perception of gender bias may be widespread, age and race biases may also play a role in the OR. Inter-professional education training for OR teams could be developed to help alleviate such biases. •In addition to widespread phenomenon of gender bias, age bias may also play a role in the operative environment.•Perception towards the lead surgeon changes in operating room especially when situation gets stressful.•Assessment and perception of the surgeon from fellow surgeons vs. OR staff varies significantly; staff being more negative.

As the only largest source of revenue and cost in a hospital, the operation room (OR) scheduling problem is a hot research topic. Nonetheless, an integrated model is the missing key to managing and improving the efficiency of ORs. This paper presents a fully integrated model regarding three concepts: meditating elective patients and emergency patients together, considering ORs and downstream units, and proposing hierarchical weekly, daily, and rescheduling models. Due to the inherent randomness in emergency patient arrival, a random forest machine learning model and geographical information systems are used to obtain the emergency patient surgery duration and arrival time, respectively. According to the machine learning model in weekly and daily scheduling, initially, fixed capacity is reserved for emergency patients. When an emergency patient arrives, the surgery starts if a reserved OR is available. Otherwise, the first available OR will be dedicated to the patient due to an emergency patient's higher priority than an elective patient. In this case, it is needed to reschedule the OT schedule for the remaining patient. Moreover, the three-phase model guarantees that an emergency patient assigns to an OR within a specific time limit. To solve the models, genetic algorithm and particle swarm optimization are developed and compared. In addition, a real-world case study is undertaken at a hospital. The results of comparing the proposed approach to the hospital's current scheduling show that the three-phase model had a considerable positive effect on the ORs schedule.

Background Clinical work in the operating room (OR) is considered challenging as it is complex, dynamic, and often time- and resource-constrained. Important characteristics for successful management of complexity include adaptations and adaptive coordination when managing expected and unexpected events. However, there is a lack of explorative research addressing what makes things go well and how OR staff describe they do when responding to challenges and compensating for constraints. The aim of this study was therefore to explore how complexity is managed as expressed by operating room nurses, registered nurse anesthetists, and surgeons, and how these professionals adapt to create safe care in the OR. Method Data for this qualitative explorative study were collected via group interviews with three professional groups of the OR-team, including operating room nurses, registered nurse anesthetists and operating and assisting surgeons in four group interview sessions, one for each profession except for ORNs for which two separate interviews were performed. The audio-taped transcripts were transcribed verbatim and analyzed by inductive qualitative content analysis. Results The findings revealed three generic categories covering ways of creating safe care in the OR: preconditions and resources , planning and preparing for the expected and unexpected , and adapting to the unexpected . In each generic category, one sub-category emerged that was common to all three professions: coordinating and reaffirming information , creating a plan for the patient and undergoing mental preparation , and prioritizing and solving upcoming problems , respectively. Conclusion Creating safe care in the OR should be understood as a process of planning and preparing in order to manage challenging and complex work processes. OR staff need preconditions and resources such as having experience and coordinating and reaffirming information, to make sense of different situations. This requires a mental model, which is created through planning and preparing in different ways. Some situations are repetitive and easier to plan for but planning for the unexpected requires anticipation from experience. The main results strengthen that abilities described in the theory of resilience are used by OR staff as a strategy to manage complexity in the OR.

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.

How to improve the efficiency of operating rooms (ORs) has always been a challenging problem in the context of healthcare operations management. This paper focuses on the research of operating room scheduling under non-operatingroomanesthesia (NORA) mechanism, in the presence of the uncertainty of emergency arrivals. In particular, we examine the advantages of the NORA mechanism in comparison with traditional surgical anesthesia practice under different operating room settings. Operationally, the process is comprised of two stages: (1) initial scheduling and (2) rescheduling. In the first stage, the initial schedule for elective surgeries under NORA is first performed through our developed model. With experiments, it is shown that for different operating room settings, the NORA mechanism can significantly improve the operating room utilization in comparison with the traditional OR anesthesia process. In the second stage of rescheduling, our experiment results show that the rescheduling model can effectively address the disruptions caused by the random arrival of emergency patients.

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.

We present a freely available data set of surgical case mixes and surgery process duration distributions based on processed data from the German Operating Room Benchmarking initiative. This initiative collects surgical process data from over 320 German, Austrian, and Swiss hospitals. The data exhibits high levels of quantity, quality, standardization, and multi-dimensionality, making it especially valuable for operating room planning in Operations Research. We consider detailed steps of the perioperative process and group the data with respect to the hospital’s level of care, the surgery specialty, and the type of surgery patient. We compare case mixes for different subgroups and conclude that they differ significantly, demonstrating that it is necessary to test operating room planning methods in different settings, e.g., using data sets like ours. Further, we discuss limitations and future research directions. Finally, we encourage the extension and foundation of new operating room benchmarking initiatives and their usage for operating room planning.

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.