Factors Influencing Perioperative Nurse Turnover: A Classic Grounded Theory Study.

Perioperative nurse turnover rates range from 12% to 18.8%, and approximately 75% of perioperative managers reported at least one vacancy in 2021. Perioperative leaders are challenged to mitigate nurse turnover effectively because factors contributing to a nurse's decision to leave their job are not well defined. The purpose of this qualitative study using classic grounded theory was to explore perioperative nurses' turnover decision-making processes. We used social media to recruit participants and then conducted 26 interviews to collect data. We completed comparative analysis of the data and developed the Perioperative Nurse Turnover Decision-Making Theory, which describes the influence of the dimensions of perioperative nurse well-being (ie, physical and emotional well-being, career development, work-life balance, compensation, workplace culture) on their decision to leave an OR position. Perioperative leaders should consider the nurses' decision-making process when developing and implementing interventions aimed at reducing turnover.

Guidelines in Practice: Prevention of Unintentionally Retained Surgical Items.

Retained surgical items (RSIs) are adverse events that can affect patients, surgeons, and nurses. Interdisciplinary teams should work to standardize surgical item accounting processes and help all perioperative team members prevent RSIs. AORN recently revised the "Guideline for prevention of unintentionally retained surgical items," which provides background information on RSIs and ways to prevent them. The revised guideline describes the role of team communication coupled with specific nursing actions aimed at preventing RSIs. This article reviews key concepts from the guideline and discusses new or changed recommendations regarding a consistent interdisciplinary approach and standard counting procedure; accounting for soft goods, sharps and miscellaneous items, instruments, device fragments and explants, and foam pieces; reconciling count discrepancies; adjunct technology; and education. The article also provides a scenario related to implementing adjunct technology to prevent RSIs. Perioperative leaders and nurses should review the guideline in its entirety and apply the recommendations to prevent RSIs.

Can Nurses Self-Assess Fatigue?: Implications for Nurse Leaders.

OBJECTIVE: The aims of this study were to describe nurses' self-perceptions of fatigue and to examine nurses' acceptance of specific fatigue countermeasures. BACKGROUND: The work of nurses places them at a high risk of fatigue. Evidence suggests 75% to 80% of nurses in the United States experience high levels of fatigue. METHODS: This descriptive, cross-sectional correlational study surveyed 279 nurses. RESULTS: Results suggest that almost half of nurses (46%) are not able to accurately self-assess fatigue. Nurses expressed acceptance of several workplace fatigue reduction strategies. CONCLUSIONS: It may be unrealistic to expect nurses to self-assess fatigue levels and make decisions about their ability to safely provide patient care. Reliable methods for assessing fatigue in the workplace are needed. Several strategies exist that may be used to alleviate fatigue, and many were acceptable to nurses. Nurse leaders are well positioned to implement changes that impact the occurrence of nurse fatigue and thereby the quality of patient care.

An Examination of Work Characteristics, Fatigue, and Recovery Among Acute Care Nurses.

OBJECTIVE: To examine self-perceived fatigue among nurses and to quantify levels of fatigue and the ability to recover from fatigue between worked shifts across various work characteristics. BACKGROUND: Fatigue is associated with working long hours, disruption of sleep, and inadequate time to recover between shifts. Fatigue degrades the nurses' performance leading to poorer patient outcomes and increased occupational injuries. METHODS: This quantitative study surveyed 573 nurses across 5 hospitals in the southeastern United States. RESULTS: Significant levels of acute fatigue were associated with working labor and delivery and medical-surgical units and working a 12-hour shift. Nurses working night shift and on the behavioral health unit showed a significantly lower ability to recover between worked shifts. CONCLUSIONS: Fatigue threatens safety and the quality of patient care. Leaders should ensure that nurses take duty-free breaks and schedule adequate time off to recover between worked shifts.