Patient safety competence is a fundamental prerequisite for safe, high-quality healthcare. However, less is known about how healthcare professionals perceive their competence and how it develops.This study examined self-assessed patient safety competence of healthcare professionals working in orthopaedic care, across the WHO patient safety competence domains, perceived sources of competence development, and views on future learning needs. A cross-sectional survey was conducted among healthcare professionals working in outpatient, ward, perioperative, anesthesia, rehabilitation, and managerial roles in a specialized orthopedic hospital in Finland.Self-assessed patient safety competence was relatively high across all domains. The highest ratings were observed in teamwork, infection prevention and control, and patient safety in invasive procedures, whereas systems thinking and understanding the impact of complexity on patient care received the lowest ratings. Significant differences were identified in patient, client, and family involvement, with the highest ratings reported by outpatient clinic nurses, and in infection prevention and control, where scrub nurses reported the highest competence.Practical clinical work and workplace orientation were perceived as the primary sources of competence, while formal continuing education played a less prominent role. Despite high competence ratings, respondents expressed substantial interest in further competence development, particularly through workplace-based learning and unit-level training.The findings suggest that patient safety competence develops primarily through experiential learning and workplace-based socialization rather than through formal education alone. Patient safety competence should therefore be understood not only as an individual capability but also as an organizational resource embedded in learning processes, knowledge sharing, and patient safety culture.
Background Unilateral biportal endoscopic spine surgery (UBE) is a minimally invasive technique associated with reduced surgical trauma. However, postoperative rehabilitation presents challenges including pain management and functional recovery, with significant variation in individual rehabilitation needs. Traditional standardised patient education approaches struggle to meet these diverse requirements. The CICARE (Connect, Introduce, Communicate, Ask, Respond, and Exit) communication model provides a structured approach to patient-centred communication, while comprehensive personalised health education tailors information and guidance to patients’ individual needs throughout the care process. This study aimed to evaluate the effects of combining these two approaches on postoperative rehabilitation outcomes in patients undergoing unilateral biportal endoscopic spine surgery (UBE). Methods This study employed a randomised controlled design, enrolling 120 patients undergoing UBE surgery at a tertiary hospital in Henan Province between June 2024 and March 2025. Participants were allocated to an intervention group and a control group using a random number table. The control group received routine care, while the observation group underwent a comprehensive personalised education programme combined with CICARE communication intervention. The General Self-Efficacy Scale (GSES), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Short-Form McGill Pain Questionnaire (SF-MPQ), and Oswestry Disability Index (ODI) scores were compared between the two groups preoperatively and at 1 and 12 weeks postoperatively. Postoperative time to ambulation, length of hospital stay, and patient satisfaction with health education were also compared between the groups. Results Preoperative data between the two groups showed no statistically significant differences(p > 0.05). Following intervention, the intervention group demonstrated significantly superior GSES, SAS, SDS, SF-MPQ, and ODI scores compared to the control group (p < 0.05). Postoperative time to ambulation and hospital stay were significantly shorter than in the control group (p < 0.05) while patient satisfaction was higher than in the control group(p = 0.04). Conclusion The implementation of full-process personalised health education nursing integrated with the CICARE communication model enhances patients' general self-efficacy, reduces the occurrence of anxiety, depression and pain, promotes patients' functional recovery, shortens time to ambulation and hospital stay, and improves patient satisfaction.
Background Postoperative constipation is a common complication after orthopaedic surgery that adversely affects recovery and quality of life. Evidence on nurse-led, non-pharmacological interventions remains limited. Aim To evaluate the effectiveness of a nurse-led postoperative care package on constipation severity, time to first defecation, and stool consistency in orthopaedic surgery patients. Method In this single-centre randomised controlled trial, conducted in an orthopaedic clinic of a state hospital between September 2022 and April 2023, patients were randomly assigned to the intervention (IG, n = 51) or control group (CG, n = 51). The CG received routine care, whereas the IG received a care package comprising a single 200 mL dose of warm water at postoperative hour 4, a 15-min abdominal massage twice daily on postoperative days 1–4, and a 30 g/day fibre diet. Data were collected using the Constipation Risk Assessment Scale, Visual Analogue Scale Questionnaire (VASQ), and Bristol Stool Form Scale (BSFS) preoperatively (T0) and on postoperative days 1–4 (T1–T4). Results Demographic and clinical characteristics were similar between groups (p > 0.05). Time to first defecation was shorter in the IG than in the CG (18.73 ± 10.79 vs. 29.59 ± 17.47 h, p = 0.001). Constipation severity was significantly lower in the IG on postoperative days 2–4 (p < 0.001). Constipated stool (BSFS Types 1–2) was significantly less frequent in the IG from T1 onward (p < 0.05). Conclusion This nurse-led care package shortened time to first defecation and reduced constipation severity and the incidence of constipated stool in orthopaedic surgery patients. Its integration into clinical practice may improve patient outcomes and support evidence-based nursing care. Trial registration NCT06399133 (https://www.clinicaltrials.gov/).
Aim To evaluate the impact of Virtual Reality (VR) interventions on pain in elective orthopaedic patients. Background VR is an immersive tool that modulates nociceptive perception, potentially alleviating acute pain and perioperative distress. Design Systematic review and meta-analysis of randomised controlled trials (RCTs) following PRISMA 2020 guidelines. Methods Seven electronic databases (PubMed, Scopus, Cochrane Library, CINAHL, MEDLINE, Embase, and APA PsycINFO) were searched from inception to November 2025. RCTs comparing VR with control conditions on pain using validated assessment tools in adult elective orthopaedic procedures were included. Methodological quality was appraised using Cochrane RoB2, and evidence certainty was evaluated using the GRADE approach. Quantitative data analysis utilised RevMan software. Results Twenty-three RCTs met inclusion criteria (N = 1224; median study sample size 48, IQR 30-60), with 21 studies (n = 1169) quantitatively synthesised. VR was associated with a statistically significant reduction in acute postoperative pain compared to control (MD -0.59, 95% CI [-0.92, −0.26], p = 0.0005; I2 = 79%). Subgroup analysis indicated benefits were restricted to major surgeries (MD –0.71, 95% CI [-1.22, −0.20], p = 0.007), but not minor procedures (p = 0.11). VR was also associated with a decreased in perioperative anxiety (MD -0.90, 95% CI [-1.75, −0.06], p = 0.04). Narrative synthesis indicated reduced rescue opioid requirements and high patient satisfaction. Conclusions VR may moderately reduce acute pain and anxiety in major orthopaedic surgery. However, given substantial heterogeneity, alongside overall low-certainty evidence and high risk of bias, standardised VR intervention protocols and rigorous trials are required.
