The Meaning of Intraoperative Errors: Perioperative Nurse Perspectives.

Medical errors involve different health care professionals, are multifaceted, and can occur at the individual practitioner or system level. The conditions for errors vary in the health care environment; some practice areas may be more vulnerable to errors than others. Limited research exists that explores perioperative nursing errors. The purpose of this study was to describe and interpret the experiences of perioperative nurses related to intraoperative errors. We used the hermeneutic phenomenological method. Ten perioperative RNs participated in focus group interviews that we audio-recorded and transcribed. We analyzed data using thematic analysis, and three themes emerged that represent the essence of the experience of nurses involved in intraoperative errors: environment, being human, and moving forward. The findings support efforts to improve quality care and foster a culture of safety in the OR through strategies such as perioperative staff training, interprofessional team building, and controlling environmental factors that are distracting.

Transfer-of-Care Communication: Nursing Best Practices.

The successful and safe transfer of the patient from one phase of care to another is contingent on optimal communication by all team members. Nurses are often in a natural leadership position to improve safe practices during hand overs. A holistic understanding of the patient allows the perioperative nurse the opportunity to identify issues and choose a nursing diagnosis based on key elements of a patient's needs and goals--information that should be relayed during patient transfers. This article reviews best practices in transfer-of-care communication to enable perioperative RNs to take an active, leading role in hand-over processes.

The personal and professional impact of the future of nursing report.

Perioperative nurses can apply the four key messages outlined in the Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health from personal and professional perspectives. Advocating to remove barriers to practice and educating the public about the perioperative nurse's role can help nurses practice to the full extent of their education and training. Nurses can achieve higher levels of education and training by taking advantage of new educational opportunities that offer a more seamless progression to an advanced degree. To act as full partners with other health professionals, nurses can participate in interdisciplinary teams and implement evidence-based practice, and they can contribute to effective workforce planning and policy making by helping to collect and analyze data that will improve practice environments. The key messages of the report address all nurses, whether they are direct care providers, advanced practice RNs, educators, or administrators.

Validation of the data elements for the health system domain of the PNDS.

This research study established the data elements for the health system domain in the Perioperative Nursing Data Set. A sample of AORN members were asked to confirm the clarity, necessity, measurability, and accuracy of each proposed data element. As a result of this study, the health system domain contains 114 data elements with definitions. When integrated into an electronic health record, data elements can be used to identify, compare, and evaluate the context in which patient care is delivered across settings.

AORN and University of Michigan School of nursing research alliance.

Research related to perioperative care requires advanced training and is well suited to take place at a research-intensive university. A recent research alliance established between AORN and the University of Michigan School of Nursing, Ann Arbor, uses the strengths of both a robust perioperative professional organization and a research-intensive university to make progress toward improving patient safety and transforming the perioperative work environment. Research activities undertaken by this alliance include investigating nurse staffing characteristics and patient outcomes, as well as evaluating the congruence and definitions of data elements contained in AORN's SYNTEGRITY™ Standardized Perioperative Framework. Disseminating the findings of the alliance is expected to facilitate the communication and application of new knowledge to nursing practice and help advance the perioperative nursing profession.

How perioperative nurses define, attribute causes of, and react to intraoperative nursing errors.

Errors in nursing practice pose a continuing threat to patient safety. A descriptive, correlational study was conducted to examine the definitions, circumstances, and perceived causes of intraoperative nursing errors; reactions of perioperative nurses to intraoperative nursing errors; and the relationships among coping with intraoperative nursing errors, emotional distress, and changes in practice made as a result of error. The results indicate that strategies of accepting responsibility and using self-control are significant predictors of emotional distress. Seeking social support and planful problem solving emerged as significant predictors of constructive changes in practice. Most predictive of defensive changes was the strategy of escape/avoidance.