Aholaakko (2011), Finland | Explorative interview study | To explore aseptic practise-related stress among surgery nurses | Setting: One surgery department of Helsinki University Central Hospital. Sample: 31 intraoperative surgery nurses* *= The nurses varied their roles so that in every other operation they worked as a ‘scrub nurse’. | Stimulated -recall interviews 31 operations were videotaped and used as stimuli. | A membership categorization device analysis by Baker | …as novis surgical nurses was afraid of not knowing what to do, they want to perform as good as more experienced colleagues, stressed when they need to do instruments counts and have environmental control at the same time Time stress (need to focus on the next surgery) Need to control persons with “aseptic looseness”. Persons with limitations on taking feedback or following recommendations for aseptic practise …stress was present when a hot-tempered surgeon; fussy co-worker; either nurse or surgeon with limitations on taking feedback or following recommendations for aseptic practise participated in the team Patient-related stress in aseptic practise was visible during operations, for example as a need to document the obesity of the patient as a potential risk for infection A young nurse was worried about harming an old patient’s thin skin or had problems with patients’ anatomical variances Power-related feedback as being afraid to give feedback about aseptic practise to the surgeon, afraid to make them angry, surgical field being a battlefield …stress was felt as positive when a surgery nurse was an Aseptic Practise specialist being in a “dream surgery team” A nurse has to be independent and, sometimes, quite headstrong to have the right to work properly” |
Alfredsdottir and Bjornsdottir (2008), Iceland | Explorative interview study | To identify what threatens and enhances patient safety and how operating room nurses see their role in ensuring safety | Setting: OR-nurses at one university hospital in Iceland. Sample: I14 OR nurses* *=8 OR nurses in individual interviews and 2 focus group. (Two OR nurses participated in both individual and focus groups) | Individual & focus group interviews A study in two stages, stage two is included in this integrative review. | Interpretive content analysis | All participants described how prevention is always at the core of their work They also described how they had to know the background of the patient, and their vulnerability and fragility that might increase risk during the operation They rely on information from the patients’ records, particularly from the anaesthesia team A number of participants said that in some situations they do not have all the information required preoperatively, especially in cases of specific patient needs …better preoperative information would ensure patient-centred nursing, continuity of care, and better and more efficient preparation for the surgical operation The teams are often unequally staffed; some are under-staffed and often need support from other teams. Participants felt that this needed to be attended to by managers Participants described how imbalance in staffing, which may be either under- or over-staffing, may lead to unsystematic preparation or distraction The work processes are timed and, while the surgical procedure cannot be rushed, the nurses sense pressure to reduce time for preparation and time between operations |
Bastami, Imani et al. (2022), Iran | Phenomenological study | To explain the lived experiences of operating room nurses experiences with patient cares for laparotomy surgeries | Setting: A public educational hospital, Hamedan. Sample: 10 OR nurses | In-depth and semi-structured interviews | Analytical phenomenological method | Aseptic technique observance in the operating room is a fundamental factor in providing indirect care for patients under surgical operation “I always gloves and gown changed. Because leakage into the peritoneal cavity can be a source of generalized peritoneal sepsis” “I always wear two gloves before beginning a surgical operation. For dressing the wound, I take off the upper gloves so that the dressing does not get dirty” According to the participants’ experiences, inadequate sterilization of the skin and drape of the surgical site was one of the leading causes of hospital infections after the surgery “One of our colleagues preps the surgical site within less than 1 min, fills the gallipot with 7.5% betadine, but never uses it. I have noted several times, but he never pays attention and does not care about the patient’s life” |
Björn and Lindberg-Boström (2008), Sweden | Descriptive study with Phenomenographic approach | To describe the theatre nurses’ work from their own perspective. | Setting: OR nurses from two hospitals in Sweden. Sample: 15 OR nurses | Interviews with open-ended questions | Phenomenographic technique | Theatre nurses achieve control of the situation by advanced planning and being ‘one step ahead’ The most important thing for a nurse is to be prepared for the operation The lack of respect for their practice that they sometimes experienced from colleagues in other disciplines and which had a negative impact on teamwork |
Holmes, Vifladt et al. (2020), Norway | Descriptive interview study | To explore Norwegian operating room nurses’ perceptions of how team skills in the inter-professional operating room team influence perioperative nursing in relation to patient safety. | Setting: Operating departments at three general hospitals and one university hospital in the south-east of Norway. Sample: 10 operating room nurses | Semi-structed Interviews | Inductive content analysis | …the OR nurses’ perception that the performance of perioperative nursing is better when there are good team skills …OR nurses strive to do their tasks in a good way, even though this might be time-consuming and tiring: “My standard is the same, independent of who the patient is, or who I’m working together with. But it’s easier to achieve this if communication is good” The OR nurses perceived constructive criticism, willingness to learn, planning and a good tone as resulting in better performance of perioperative nursing The participants perceived that poor communication or situation monitoring, along with experiencing a lack of mutual support or leadership, can lead to intraoperative events such as faulty positioning or draping, lacking equipment, or forgetting a catheter or warming blanket Unnecessary communication, noise, loss of concentration, stress, insecurity and irritation have a negative influence on the performance of perioperative nursing Good communication makes it easier for OR nurses to speak up about risks to patient safety. They perceived that adverse event such as hypothermia, injury due to positioning, infection and extensive blood loss might occur partly because of poor team skills Poor communication, for example lack of information, inappropriate or unnecessary remarks, poor leadership and situation monitoring, or having to take on others’ tasks, can result in delays because they lose focus on their own task “You lose some focus when you have to watch what is going on around you at the same time” “If you aren’t good at leading the OR team, it can result in misunderstandings, which can have serious consequences, complications, for the patient” “in big operations it is good when the surgeon comes in early to see everything is okay. To help find equipment, hold up the leg for skin disinfection … and at least offer to help” Poor team skills such as misunderstandings, interruptions and not being able to trust others to do their job properly can create stress, which again can increase the risk of making mistakes |
Kaldheim and Slettebø (2016), Norway | Explorative interview study | To acquire knowledge about what theatre nurses, perceive as important factors in collaboration with other team members to see what factors are needed to strengthen interdisciplinary cooperation. | Setting: Four Norwegian operational units Sample: 8 OR nurses | Semi–structured interviews | Constant comparative inductive analysis | The theatre nurses want to be accepted as having skills and duties that are equal to the other members in the team They want to be seen and heard by the others in the team as people with tasks that are meaningful They often experience working situations where there is not always so much tolerance for having to wait for each other, and that their task must be done “quickly and invisibly” The participants want others to understand the importance of their job and to recognise that it also requires time When team members have knowledge and understanding of each other’s work, it is also easier to help each other The participants describe how a surgeon may help them to open and cover sterile equipment preoperatively, while he/she waits to be ready for the operation It may be the way in which things are said, or someone raising their voice and shouting. It affects the concentration and focus of the participants in the situation, and this affects the quality of the performance of theatre nursing There are some situations like that where, for me at least, there will be poorer cooperation when someone gets scolded. For then you will be a little preoccupied in your head that there is a bad atmosphere here. In addition, I lose a little of my concentration The leader should have insight into the team members’ tasks and communicate the need for resources upward in the organisation |
Lingard, Garwood et al. (2004), Canada | Explorative validation study | To determine to what extent documented tension patterns are transferable to other institutional contexts. | Setting: Two small academic hospitals in in Canada. Sample 1: 22 OR nurses, (5 anaesthesiologists, 10 trainees, 6 surgeons) Sample; phase 2 10 surgeons (and fluctuating team members) | Data were collected in two phases: Phase 1: 8 focus group, 8 individual interviews Phase 2: Field observations | Modified grounded theory approach | …issues of aseptic technique and patient safety influenced team communication. Nurses were almost always participants in these communication exchanges, perhaps reflecting their professional responsibility for aseptic technique For instance: Senior resident enters OR not scrubbed, stands inches from the sterile field. Circulating nurse turns towards resident, watches intently, frowns disapprovingly. With only 6 of 28 observed instances (21%) involving higher tension levels, the theme of safety and sterility was not a prominent catalyst for tension |
Nordström and Wihlborg (2019), Sweden | Phenomenographic interview study | To describe the work experiences of nurse anaesthetists and OR nurses in the OR. | Setting: One university hospital and one regional hospital in Sweden. Sample: 6 OR nurses (6 anaesthetic nurses) | Interviews | Phenomenographic analysis | An important aspect was to be acknowledged as integral members of the OR team and the recognition that every profession in the OR is a valuable part of this team Another aspect of responsibility is that all professionals must be given sufficient time to conduct their specific individual tasks They expressed a desire to be well prepared and have enough time to perform their work to the best of their ability Students and new colleagues should be given extra time to perform their tasks. When a new colleague attends, you have to tell everybody to slow down a bit so he or she has a chance [to perform their part] |
Nyberg, Olofsson et al. (2021), Sweden | Explorative interview study | To explore aspects of patient safety practice during joint replacement surgery through assessment of operating room nurses experiences. | Setting: Three hospitals in Sweden; one university, one public general and one private orthopaedic hospital. Sample: 21 OR nurses | Semi structured interviews | Inductive qualitative content analysis | Stated their need for a reliable preoperative plan to ensure a safe procedure. By planning and preparing well for the procedure, they attempted to reduce the time for surgical procedure Before preparing for the procedure, they often needed to confirm the information from a computerised surgical planning system with the orthopaedic surgeon, due to occurrence of failure in updating the plan. This need to confirm the plan was perceived as unsatisfying and experienced as time- consuming For some participants, the main source of patientrelated information was derived from the surgical planning system and the anaesthesia preoperative assessment They did not find time to get information from the main health records and were thereby not routinely accessing information There was no systematic feedback on results or complications. For example, some participants emphasised that they wanted to know the infection rates for their specific department OR management sent information about new routines and incidents by email, and these were sometimes perceived to not reach the appropriate OR personnel Established safety controls and compliance with aseptic principles were stated as important aspects for safety practice within the team Compliance with aseptic principles was considered to vary among different professions within the team. The ORNs were expecting all team members to perform responsibly, and when this was not the case, it became a strain in the workplace for them In situations where two ORNs collaborated during surgery, they had opportunities to support and learn from each other, and thereby improve their work They kept guarding sterility throughout the entire surgical procedure by keeping an eye on the activities of other team members, which sometimes could be challenging Participants noted that the prerequisites for work in an aseptic environment were present National guidelines for preventing PJIs were established, and there was most often compliance with these One example given was a guideline to control the traffic and avoid disturbance of the ventilation by opening the doors and trying to minimise the number of persons in the OR Participants experienced that compliance with guidelines varied within the team. For example, some orthopaedic surgeons followed the guidelines more strictly than others. With an interesting surgical case, minimising the amount of personnel in the OR was disregarded by some surgeons The ORNs also emphasised a need to improve staff behaviour regarding adherence to the aseptic principles When they insisted on observing aseptic protocols, it sometimes was considered a disturbance of the flow, affecting both the surgical procedure and the whole day operation schedule When notifying others on breaks of aseptic principles, some participants perceived that they were seen as annoying …Even if people might think you're irritating, I think you still get some kind of respect in that you have competence and can see that this is important. Even if you are considered awkward, you are trusted as the person who also is competent and good, good for the group and for the patient Although the ORNs were well aware that many factors could have led to an infection, they felt accountable for it if a patient acquired a surgical site infection or a periprosthetic joint infection |
Prati and Pietrantoni (2014), Italy | Descriptive cross-sectional (pilot) study | To assess attitudes about teamwork and safety among Italian surgeons and operating room nurses. | Setting: One hospital in the centre of Italy Sample: 48 OR nurses (55 surgeons) | Operating Room Management Attitudes Questionnaire (ORMAQ) | Parametric statistics | The majority of the OR nurses agreed to the statement: It bothers me when others do not respect my professional capabilities (94% agreed) More than half of the OR nurses did not agree to the statement that team members frequently disregard rules or guidelines (e.g., hand washing, treatment protocols/clinical pathways, sterile field) developed for our Operating Theatre (69% disagreed) |
Qvistgaard et al. (2019), Sweden | Reflective Lifeworld Research approach | How OR nurses experience intraoperative prevention of SSIs. | Setting: Seven hospitals in Sweden Sample: 15 OR nurses | Interviews | Phenomenological analysis | …further competencies such as experience and courage are needed to ensure prevention Prevention of SSIs depends on an open and honest atmosphere within the team, a team that allows different professionals to contribute with their unique competencies ...the team members should adhere to the guidelines regarding OR hygiene “Everybody has their own responsibility inside the OR, but my job is to tell you when you are too close, when you have to change gloves, or when you need to adjust your surgical gown. You are trying to have an overview of everything that happens inside the OR and simultaneously keep the focus on what is going on during the surgical procedure” The absence of structured feedback makes it difficult when the profession seeks arguments for strengthening routines related to preventing SSIs. Therefore, measures intended to combat this invisible threat are difficult to evaluate and analyse. This lack of evidence for the effectiveness of routines results in insecurity and doubt connected to SSIs prevention measures “Sterility is the alpha and omega to me; here is where my occupational pride is at stake and I cannot look the other way” Awareness of risks related to SSIs is carried out by individuals who have confidence in each other and dare to confront human shortcomings Confident relations and resolute communication within the team generate favourable conditions for preventing SSIs The invisible threat of microorganisms can be made visible to others if OR nurses use their profound knowledge to explain the connection between bacterial load and the risk of SSIs a lack of trust in one’s colleagues creates anxiety among the team, a milieu that will not benefit the patient: “You really need your team and it’s important that everybody understands why we do certain things, not just doing it because I say so” Friction among team members is evident when one or several team members are unwilling to understand other professionals’ responsibilities and competencies Some people are more or less frightened of some surgeons and then you become nervous and that leads to insecurity and mistakes. For example, if a surgeon is intimidating, I might make mistakes, get nervous and take the surgical towel that I had for cleaning instruments and put it in an open wound during hip replacement Confronting colleagues irrespective of their position requires a security in one’s own competence and a security in the team’s willingness to hear potentially uncomfortable feedback, competencies that develop with experience Effective leadership helps team members develop confidence in organizational structures and offers stability for the team members. Managing both team collaboration and organisation are intertwined and clearly related to intraoperative prevention of SSIs Traditionally, the head surgeon is the team leader and this person’s effectiveness as a leader ensures the effectiveness of the preventive work. Both formal and informal leaders dictate the terms of the preventive work; if they aim for the same goal, it is possible to reach mutual strategies OR nurses often feel their contributions are minimised. The balance between the legitimacy of OR nurses and the authority of the traditional hierarchy, which places surgeons at the top, is fragile Prevention of SSIs often end up being a secondary priority, a lack of commitment that often leaves OR nurses feeling ignored “You can get so tired of yourself and you feel like a disc that repeats itself over and over again, but you can’t give up and capitulate to what you believe is correct. Who will take an interest in SSI prevention if not me, no one would care about that” OR nurses reside in their responsibility to ensure that team members follow hygienic guidelines inside the OR |
Sandelin and Gustafsson (2015), Sweden | Descriptive interview study | To describe operating theatre nurses’ experiences of teamwork within the surgical team in regard to achieving patient safety. | Setting: Four hospitals in Sweden; two urban and two hospitals in rural regions. Sample: 16 OR nurses | Interviews | Content analysis | A brief meeting (with the patient before surgery) facilitated OTNs to be better prepared for safe nursing care Interdependent collaboration with surgeons was reached when OTNs experienced respect as equal co-workers and were involved and engaged as key partners, and spoken to with respect for their professional skills OTNs were totally dependent on nurse assistant (NAs) willingness to collaborate. The collaboration of the OTNs and NA was characterized by leadership and the NA was perceived as the OTNs’ ‘right hand’ OTNs believed that friendly leadership was necessary in the collaboration as this would generate a willingness to follow OTNs’ instructions efficiently the nursing care-plan was based on OTNs’ personal experience, general routines and a brief reading of each patient’s medical record Sometimes surgeons were unable to control their tantrums with consequences of other team-members’ knowledge and skills tended to decrease because of the strained atmosphere In order to be able to trust unfamiliar or inexperienced NAs, OTNs interrogated them about nursing knowledge and skills. This was necessary for the planning and the performance of nursing care, and involved guiding in a polite and friendly way to do the right thing at the right |
Sandelin, Gustafsson et al. (2019), Sweden | Descriptive interview study | To describe operating theatre nurses’ experience of preconditions for safe intraoperative nursing care and teamwork. | Setting: Four hospitals in Sweden; two urban and two hospitals in rural regions. Sample: 16 OR-nurses | Interviews (reanalysed data) | Content analysis | …operating theatre nurses (OTN) met patients preoperatively for a conversation about their health status and needs, as well as details about the surgical intervention. In these cases, OTNs expressed that they were well prepared with adequate information from the primary source for decision-making of care activities for safe intraoperative nursing care OTNs’ described frequent experiences of obtaining only brief, incomplete and fragmented information about the patients’ health situations and their upcoming surgical interventions The documentation in the computerised systems was not complete, due to restrictions from codes and measures in the systems when not informed, they had to phone the surgeon in orderto be properly prepared for the intervention they preferably wanted to be prepared for each patient's operation the day before For the most part, because they were moved around between different surgeries in their daily work, OTNs would not read the patient's record until the patient was confirmed and transported to the OT department. This meant that they did not have a chance to be completely prepared for each patient's surgery “Also, even when an operation was delayed because of an anaesthesia procedure, OTNs felt they were the ones to blame. Sometimes it takes time for the anaesthesia personnel, when the patient has a complex health situation, and I feel stressed doing the skin disinfection and the sterile draping …and the surgeons enter and wonder what you are doing and why it has taken such a long time” OTNs explained they needed to have high standards of personal professional skills and knowledge to be able to offer patients safe perioperative nursing care They also depicted their responsibility for the hygiene and aseptic care environment as well as, security controls of the sterile surgical equipment and the patient's well-being and safety. OTNs’ best experience of safe and efficient work occurred in situations where two colleague OTNs collaborated during surgery OTNs described the importance for ensuring patient safety of nurse leadership holding clear standards, routines and operational goals. When first-line managers were invisible and uncommitted, the OT department was described as lacking standards and routines |
Silén-Lipponen (2005), Finland, United Kingdom & Unites states of America | Critical incident study | OR nurses’ experiences about potential errors and error prevention in operating room | Setting: OR departments in Finland, UK and USA. Part of larger international research project Sample: 30 OR nurses Finnish (n = 10), American (n = 10) British (n = 10) | Audio-taped interviews | Qualitative content analysis | The need to manage multiple, simultaneous demands while providing high-quality care imposed a continuous pressure on nurses “You know, people cannot work or even think if they are constantly worried about their own or others’ mistakes” Arguments during operations could lead to overheated feelings and, thus, jeopardize patients’ safety by causing errors. Therefore, nurses forced themselves to remain undisturbed and to keep up sustained working Confidence about the individual team members’ skills made advanced preparation Teams familiar with their members could pool their strengths, anticipate each other’s needs (even from gestures), exchange roles across professional boundaries and, thus, minimize the occurrence of errors Contact with careless or risky behaviour: “The instrument was gas-sterilized but had not been aerated. I told him [the surgeon] that you cannot use it because of what it causes to human tissues is the same as a microwave oven. Still, the surgeon insisted on having it. Then the situation was taken out of my hands, and I had to write a case report about serious misbehaviour that compromised the safety of a human being” |
Timmons and Tanner (2005), United Kingdom | Ethnographic study | To explore the emotional labour in an operating theatre nurses context | Setting: Five hospitals in UK Sample: 12 OR nurses (8 other professions) | Observations n = 20 & individual interviews n = 20 | Not known | …it was their responsibility to ‘look after’ the surgeons rather like an air hostess or a party hostess Not upsetting surgeons describes actions which nurses refrained from undertaking to prevent antagonizing surgeons …nurses might have tolerated poor practice rather than antagonize surgeons even though the poor practice was to the detriment of unconscious patients The surgeon walks into the theatre. He is carrying his coffee mug and eating a roll. This contravenes theatre infection control policies. None of the nurses say anything to him Surgeon comes into theatre, he is not wearing a hat. This contravenes the theatre dress code and presents a risk of infection. The nurses, including Nurse W, don’t say anything. Another surgeon comes in, looks at the surgeon with no hat and says ‘What, no hat, is this a new rule?’ In the following example, the interviewer asked a nurse why she poured ether over some swabs for a surgeon? (Ether, a hazardous substance, is banned from theatre departments): He likes using [ether]. We have to get pharmacy to supply it especially for him. Yes, I know we shouldn’t be using it The nurses would accommodate surgeons’ demands even if they did not agree with them: The instruments had been set up and we had to wait about 30 min for the patient. When the patient came in and they were about to start operating, the surgeon asked the Sister if these were the same instruments? She said ‘Yes, but they are all right’. The surgeon said ‘I want fresh instruments’. The nurse got new instrument trays out. Later, the nurse said to me ‘I didn’t need to change them but I wasn’t going to argue with him’ |
Wistrand, Falk-Brynhildsen et al. (2018), Sweden | Descriptive cross-sectional study | To describe the daily interventions Swedish operating room nurses perform to prevent SSIs following national guidelines | Setting: OR-nurses from 64 hospitals in Sweden. Sample: N = 890 OR- nurses | Web-based questionnaire | Descriptive statistics | The majority of the interventions recommended by the national guidelines were implemented in daily work and that the interventions were performed fairly consistently nationally When guidelines were lacking, variation in the intervention used increased, for example, the application of adhesive plastic drapes Most, 41.1% (n = 366), often let the skin dry before draping; and to enhance adherence of the drapes to the patient’s skin, 34% (n = 303) of the nurses often wiped the skin dry in the site where the drapes should adhere using sterile paper towels Most of the nurses responded that they had learned to perform patient skin disinfection from their supervisors (another OR nurse) or at the clinical practice during in-service education (48.9%; n = 435), while 41.7% n = 371) learned the technique from the educator at a university. The remaining 9.4% of the nurses stated either that they had learned it from colleagues or the Handbook for Healthcare Workers or that they did not remember Sterile gowns for single use were employed by 83.8% (746/890) of the nurses The reasons for changing the outer gloves differed, but the most dominant reasons were puncture of the glove or the wearing of the outer glove for a long time The majority of the nurses reported that they performed the pre-operative disinfection of the patient for two to five minutes |
Wistrand, Falk-Brynhildsen et al. (2021), Sweden | Descriptive cross-sectional study | To explore interventions that Swedish operating room nurses considered important for the prevention of bacterial contamination and surgical site infections. | Sample: N = 890 OR- nurses | Web-based questionnaire with an open-ended question From part II, analysis of the open-ended question. | Summative content analysis and descriptive statistics | Infection control included 57.7% of the total number of codes (n = 2033), it was considered the most important way for the nurses to prevent bacterial contamination and SSI Skin disinfection is the most important intervention in order to prevent bacterial contamination and surgical site infection Aseptic technique was maintained during surgery by keeping the sterile goods sterile, removing the draping after the dressing was applied, supervising other persons in the surgical team to ensure that they did not contaminate anything in the sterile field, and quickly replacing any contaminated item with a new, sterile one Along with this, the nurses described additional interventions that they performed in order to uphold an aseptic technique: the use of antibacterial sutures, avoiding touching implants, a thorough preoperative hand disinfection of their own hands including the checking of other team members’ hand disinfection, and cleaning the sterile goods during surgery in order to avoid bacterial growth The use of incision drapes to protect the surgical area and transparent plastic film to cover open wounds was considered important It was important that the draping was employed correctly, and that it should stay in place throughout the procedure Important aspects included choosing a dressing suitable for that specific surgery, applying the dressing in a sterile manner, and applying the dressing closely and tightly against the skin ...the importance of choosing a dressing that was gentle and appropriate for sensitive skin, and that would not cause blisters or eczema … a lack of an instrument in the OR, the personnel in the OR should use the phone to ask someone outside the OR to bring the missing instrument instead of opening the doors important for the hygiene level in the OR to be satisfactory and the doors of the OR to be kept closed; or, at least, opened only when absolutely necessary during preparation for surgery and the surgery itself “Use the phone in the OR as your means of communication [with staff outside of the OR], do not run in and out. Plan your work and make sure that the equipment you might need is in the OR, use reach-through cabinets as much as possible” The nurses described a calm environment, few people, and no opening of doors as important factors in order to minimize bacterial air contamination Aseptic technique was also considered important. This was described in many ways, for example in terms of making sure to change gloves with holes or gloves that were damaged in some way The nurses believed that it was important for all personnel working in the OR to be dressed appropriately in tightly woven clothes or clean air suits, including using a mask and helmet, with sterile gowns and gloves for the personnel actively working with or around the surgical area… The nurses stated that they felt it best to set up and cover the sterile goods before the patient arrived at the OR if possible, and that it was important for the preparation to be done in a sterile manner Connected to preparation, such as checking that the instruments were sterilized before taking them out of their packaging The nurses stated that it was important for basic hygiene to be upheld by all members of the OR staff “The importance of sterility throughout the surgery, and being responsible for ensuring that everyone in the OR follows the hygiene regulations” “Being well informed regarding the patient by reading their medical chart” One nurse stated that it was important to have “knowledge of postoperative wound infections in order to be able to prepare oneself properly” Two of the nurses stated that they needed to be given the proper amount of time to prepare the skin disinfection of the surgical area, in order to allow them to perform their work well and without stress |