Background: Healthcare systems worldwide face critical shortages of perioperative nurses. This study investigated factors influencing undergraduate nursing students’ career decisions in perioperative nursing after completing a mandatory perioperative course and professional practice pathway. Methods and materials: A qualitative descriptive research design with a constructivist epistemology and experiential learning conceptual framework was used to develop six open-ended survey questions. Results: Seventy final-year Bachelor of Nursing students completed the survey with a response rate of 20% (n=70/353). Data were analysed using qualitative content analysis. The results revealed that several perceived enablers and barriers influenced their choice of perioperative nursing as a career. Conclusion: Positive mentoring and supportive environments were enablers, while some negative workplace cultures created barriers that overrode their initial enthusiasm. Voluntary operating theatre (OT) workshops created interest and excitement. Despite some negative placement experiences, most participants preferred the mandatory pathway over an elective option, highlighting the importance of exposure to the specialty regardless of career intentions. The study’s results emphasise the need for cultivating respectful and encouraging clinical settings to help secure our future perioperative nurses.
Background: The global nursing shortage has led many developed countries, including New Zealand, to recruit internationally qualified nurses (IQNs) to meet workforce demands. Despite their critical role, many face challenges in adapting to new professional and social environments. Supporting their integration is vital for retention and optimal workforce utilisation. Aim: To explore the work experiences of IQNs in New Zealand operating theatres (OTs) and identify how healthcare leaders can support their integration and retention. Methods: A descriptive qualitative design was employed. Individual interviews were conducted with six IQNs working in OTs across New Zealand using face-to-face and video conferencing methods. The data were analysed thematically. Results: Four key themes emerged: adjustment and adaptation, working conditions, interpersonal relations, and leadership. Key findings included challenges for IQNs in cultural adaptation, orientation, communication, and team dynamics. Conversely, participants also reported benefits such as improved work‒life balance and greater professional autonomy. Conclusion: The findings of this study point to the urgent need for structured, culturally responsive orientation and support initiatives to improve the experiences of IQNs in the perioperative setting.
Background: The prevention of unintentional retention of surgical items (RSIs) inside a patient’s body is one of the primary responsibilities of operating room nurses. Surgical counting is a simple and efficient method that helps prevent this human error. Aim: To develop and validate a standard operating protocol (SOP) and a checklist for surgical counts conducted during abdominal surgeries. Methods and materials: A methodological study, divided into six phases (2021-2023), was conducted in the paediatric surgery operating theatre of a tertiary care centre in northern India. Initial observations (N = 30), focus group discussions (N = 20) and nurses' knowledge assessment (N = 24) were carried out to explore baseline knowledge and practices related to surgical counts. The first draft of the SOP and checklist was prepared. A three-round Delphi process involving nine experts was employed to ensure content validity. The reliability of the protocol was evaluated across 75 surgical procedures using Cronbach’s alpha coefficient and nurses' acceptance of the protocol was gauged through a structured questionnaire. Results: Content validity was high, with a scale-level content validity index based on the average method (S-CVI/Ave) of 0.98 and a scale-level content validity index based on the universal-agreement method (S-CVI/UA) of 0.80. The mean item-level content validity index (I-CVI) was 0.90. The checklist comprised 37 items covering the key phases of surgery. Internal consistency was strong (Cronbach’s α = 0.82). Following implementation, surgical counting practices improved considerably, and nurses reported greater clarity and confidence. Conclusion: The SOP and checklist were found to be valid, reliable and well accepted in this single-centre study; further multicentre validation is recommended.
Background: The aim of this study is to examine the ethical gaps in surgical consent practices in low- and middle-income countries (LMICs) and identify the challenges in implementing informed consent principles in these settings. The article seeks to propose strategies for improving surgical consent processes specifically in LMICs. Methods: This study follows a narrative literature review approach, synthesizing existing research on informed consent practices in LMICs. A comprehensive search was conducted across databases such as PubMed, Scopus and Web of Science for relevant articles. Inclusion criteria involved qualitative and quantitative studies addressing ethical considerations and systemic and cultural barriers in the surgical consent process. Data were analysed using the four principles of biomedical ethics: autonomy, beneficence, non-maleficence and justice. Findings: The review identifies six key ethical concerns: superficial consent processes, compromised patient understanding, structural and systemic barriers, cultural influences on patient autonomy, consent obtained under emotional duress and institutional culture that perpetuates ethical erosion. Conclusion: In many LMIC settings, the surgical consent process has become more of a procedural task than a meaningful ethical practice. To address this, a shift toward process-based approaches, investment in ethical communication training, localization of consent materials, cultural sensitivity without compromising ethics and strong institutional leadership is essential.
Background: The development of novel assessment methods is imperative to identify the sources of patients' anxiety and facilitate their relaxation. To the best of our knowledge, no studies in Turkey have reported on changes in operative anxiety among adults during surgical procedures. This study used the state-trait operation anxiety (STOA) scale, a questionnaire to measure operation-related anxiety. It has two parts: STOA-S for state anxiety and STOA-T for trait anxiety. The objective of this study was to assess the reliability and validity of the STOA scale in Turkish. Methods: This methodological study included 202 patients with a mean age of 55.58 years (±14.47). The common indicators for surgery were umbilical hernia, cholelithiasis and appendicitis in the hospital. Concurrent validity was evaluated for internal consistency, content validity, construct validity and the reliability of the instrument. Results: The content validity index (CVI) indicated high content consistency for STOA-T items (CVI = 0.92) and STOA-S items (CVI = 0.88) as rated by experts. Factor analysis demonstrated high internal consistency reliability across all models: STOA-T one-factor (Cronbach's alpha = 0.879; item-total correlations 0.60 – 0.71), STOA-T two-factor cognitive anxiety (Cronbach's alpha = 0.806; item–total correlations 0.60–0.79) and emotional anxiety (Cronbach's alpha = 0.821; item-total correlations 0.54 – 0.78) and STOA-S (Cronbach's alpha = 0.879; item-total correlations 0.51– 0.79). Conclusion: The Turkish version of the STOA scale demonstrated high validity and reliability. Healthcare professionals in Turkey should use this scale to evaluate perioperative anxiety in adults.
