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Background: Semi‐urgent surgery where surgical intervention is required within 48 h of admission and the patient is medically stable is vulnerable to scheduling delays. Given the challenges in accessing health care, there is a need for a detailed understanding of the factors that impact decisions on scheduling semi‐urgent surgeries. Aim: To identify and describe the organisational, departmental and contextual factors that determine healthcare professionals' prioritising patients for semi‐urgent surgeries. Methods: We used the Joanna Briggs Institute guidance for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis extension for scoping reviews (PRISMA‐ScR) checklist. Four online databases were used: EBSCO Academic Search Complete, EBSCO Cumulative Index to Nursing and Allied Health Literature, OVID Embase and EBSCO Medline. Articles were eligible for inclusion if they published in English and focussed on the scheduling of patients for surgery were included. Data were extracted by one author and checked by another and analysed descriptively. Findings were synthesises using the Patterns, Advances, Gaps, Evidence for practice and Research recommendations framework. Results: Twelve articles published between 1999 and 2022 were included. The Patterns, Advances, Gaps, Evidence for practice and Research recommendations framework highlighted themes of emergency surgery scheduling and its impact on operating room utilisation. Gaps in the management of operating room utilisation and the incorporation of semi‐urgent surgeries into operating schedules were also identified. Finally, the lack of consensus on the definition of semi‐urgent surgery and the parameters used to assign surgical acuity to patients was evident. Conclusions: This scoping review identified patterns in the scheduling methods, and involvement of key decision makers. Yet there is limited evidence about how key decision makers reach consensus on prioritising patients for semi‐urgent surgery and its impact on patient experience. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aims: To identify postoperative interventions and quality improvement initiatives used to prevent wound complications in patients undergoing colorectal surgeries, the types of activities nurses undertake in these interventions/initiatives and how these activities align with nurses' scope of practice. Design: A scoping review. Data Sources: Three health databases were searched, and backward and forward citation searching occurred in April 2022. Research and quality improvement initiatives included focussed on adult patients undergoing colorectal surgery, from 2010 onwards. Data were extracted about study characteristics, nursing activities and outcomes. The 'Dimensions of the scope of nursing practice' framework was used to classify nursing activities and then the Patterns, Advances, Gaps, Evidence for practice and Research recommendations framework was used to synthesise the review findings. Results: Thirty‐seven studies were included. These studies often reported negative wound pressure therapy and surgical site infection bundle interventions/initiatives. Nurses' scope of practice was most frequently 'Technical procedure and delegated medical care' meaning nurses frequently acted under doctors' orders, with the most common delegated activity being dressing removal. Conclusion: The full extent of possible interventions nurses could undertake independently in the postoperative period requires further exploration to improve wound outcomes and capitalise on nurses' professional role. Impact Statement: Nurses' role in preventing postoperative wound complications is unclear, which may inhibit their ability to influence postoperative outcomes.In the postoperative period, nurses undertake technical activities, under doctors' orders to prevent wound infections.For practice, nurses need to upkeep and audit their technical skills. New avenues for researchers include exploration of independent activities for postoperative nurses and the outcomes of these activities. Implications for the Profession and/or Patient Care: There may be opportunities to broaden nurses' scope of practice to act more autonomously to prevent wound complication. Reporting Method: Scoping Reviews (PRISMA‐ScR) checklist. Patient or Public Contribution: A health consumer interpreted the data and prepared the manuscript. [ABSTRACT FROM AUTHOR]

Aim Design Methods Results Conclusions Implications for the Profession and/or Patient Care Reporting Method Patient or Public Contribution To describe Australian perioperative nurses' reported frequency and reasons for missed nursing care in the operating room.Cross‐sectional online survey conducted in March–April 2022.A census of Australian perioperative nurses who were members of a national professional body were invited to complete a survey that focussed on their reported frequency of missed nursing care and the reasons for missed nursing care in the operating room using the MISSCare Survey OR.In all, 612 perioperative nurses completed the survey. The perioperative and intraoperative nursing care tasks reported as most frequently missed included time‐intensive tasks and communication with multiple surgical team members present. The most frequently reported reasons for missed care were staffing‐related (e.g. staff number, skill mix, fatigue and complacency) and affected teamwork. There were no significant differences in the frequency of missed care based on perioperative nurse roles. However, there were statistically significant differences between nurse management, circulating/instrument nurses and recovery room nurses in reasons for missed care.Much of the missed care that occurs in the operating room is related to communication practices and processes, which has implications for patient safety.Understanding the types of nursing care tasks being missed and the reasons for this missed care in the operating room may offer nurse managers deeper insights into potential strategies to address this situation.Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: Identify and synthesise the published literature on the approaches and practices nurses use during the delivery of pressure injury prevention (PIP) education to hospitalised medical and surgical patients. Design: An integrated review. Methods: Whitmore and Knaff's (2005) five‐stage methodology guided this review: (1) research problem identification; (2) literature search; (3) data evaluation; (4) data analysis; and (5) results. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (2020) Statement was followed. The quality of included studies was assessed using the Mixed Method Appraisal Tool (2018). Extracted data were analysed using inductive content analysis. Data Sources: Journal publication dates from 1992 to 2022. Systematic searches of CINAHL (Cumulative Index of Nursing and Allied Health Literature) complete, Embase, PsycINFO (via Ovid) and Scopus databases were undertaken. Results: A total of 3892 articles were initially identified, four quantitative and two qualitative studies were included. Articles were published between 2013 and 2022.Two themes were identified: responsibility and workplace culture determine nurses' approach to PIP education delivery; and nurses tailor education strategies to address challenges and opportunities for PIP education delivery. Conclusion: Nurses require resources to facilitate approaches to PIP education with medical and surgical patients. In the absence of clear instruction to support nurses' practice, PIP education for patients is at best delivered in an informal and ad hoc manner. Nurses require accessible education resources to enable them to tailor the content and frequency of PIP education to patients in med‐surg settings. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: The aim of this scoping review was to provide an overview of the literature about the process of obtaining consent from adult patients undergoing planned surgery from the healthcare professionals' perspective and analyse knowledge gaps. Background: The process of obtaining consent for planned elective surgery manifests an individual's fundamental right to decide what happens to their body. The process is often suboptimal and problematic, placing a significant resource burden on health systems globally. Deficiencies in the documentation on consent forms have also been shown to increase the risk of operating room error. Design: Scoping review. Methods: Arksey and O′Malley's (International Journal of Social Research Methodology, 8, 2005 and 19) five‐step scoping review methodology was used. Results: Fifty‐three articles were included; 39 primary and 14 secondary research publications. Three key findings were identified; there is currently low‐level evidence about surgical consent processes to inform clinical practice; junior doctors obtain surgical consent frequently, yet this process was likely undertaken sub‐optimally; and current knowledge gaps include capacity assessment, decision‐making and pre‐procedural consent checks. Conclusion: Planned surgical consent processes are complex, and both surgeons and perioperative nurses are essential during the process. While surgeons have responsibility to obtain consent, perioperative nurses provide a safety net in the surgical consent process checking the surgical consent information is correct and has been understood by the patient. Such actions may influence consent validity and patient safety in the operating room. Knowledge gaps about capacity assessment, decision‐making, pre‐procedural checks and the impact of junior doctors obtaining consent on patient understanding, safety and legal claims are evident. Relevance to clinical practice: This review highlights the importance of the surgical nurse's role in the planned surgical consent process. While the responsibility for obtaining surgical consent lies with the surgeon, the nurse's role verifying consent information is crucial as they act as a safety net and can reduce error in the operating room. No patient or public contribution: The authors declare that no patient or public contribution was made to this review in accordance with the aim to map existing literature from the healthcare professionals' perspective. [ABSTRACT FROM AUTHOR]

Background: Safe medication management is a cornerstone of nursing practice. Nurses prepare patients for discharge which includes the ongoing safe administration of medications. Medication reconciliation at hospital discharge is an interprofessional activity that helps to identify and rectify medication discrepancies or errors to ensure the accuracy and completeness of discharge medications and information. Nurses have a role in medication safety; however, their involvement in medication reconciliation at hospital discharge is poorly described. The study's aim was to describe acute care nurses' perceptions of their roles and responsibilities in medication reconciliation at hospital discharge, including barriers and enablers. Design: Using focus groups, this exploratory descriptive study gathered qualitative data from nurses working in five acute care clinical units (medical, surgical and transit/discharge lounge) at a tertiary Australian hospital. The data were analysed using inductive content analysis and reported following the COREQ checklist. Results: Thirty‐two nurses were recruited. Three themes emerged from the data: nurses' medication reconciliation role involves chasing, checking and educating; burden of undertaking medication reconciliation at hospital discharge; team collaboration and communication in medication reconciliation. Conclusions: Nurses had a minor role in medication reconciliation at hospital discharge due to a lack of organisation clinical practice guidance and specialised training. Standardising interprofessional medication reconciliation processes and increasing nurses' involvement will help to streamline this task, reduce discharge delays, workload pressure and improve patient safety. Relevance to clinical practice: Medication reconciliation at hospital discharge is an interprofessional patient safety activity, however little is known about nurse's role and responsibilities. This study reports nurses' important contribution to patient safety in terms of healthcare team coordination, medication checking and patient education. Supportive organisations and collaborative teams increased nurses' willingness to complete this activity. [ABSTRACT FROM AUTHOR]

Aims and objectives: Describe and compare current surgical wound care practices across two hospitals in two health services districts, Australia. Background: Surgical site infections (SSI) are a complication of surgery and occur in up to 9.5% of surgical procedures, yet they are preventable. Despite the existence of clinical guidelines for SSI prevention, there remains high variation in wound care practice. Design: Prospective comparative design using structured observations and chart audit. Methods: A specifically developed audit tool was used to collect data on observed wound care practices, documentation of wound assessment and practice, and patients' clinical characteristics from patients' electronic medical records. Structured observations of a consecutive sample of surgical patients receiving wound care with a convenience sample of nurses were undertaken. The manuscript adheres to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. Results: In total, 154 nurses undertaking acute wound care and 257 surgical patients who received wound care were observed. Across hospitals, hand hygiene adherence after dressing change was lowest (Hospital A: 8/113, 7%; Hospital B: 16/144, 11%; χ2: 8.93, p =.347). Most wound dressing practices were similar across sites, except hand hygiene prior to dressing change (Hospital A: 107/113, 95%; Hospital B: 131/144, 91%; (χ2: 7.736, p =.021) and use of clean gloves using nontouch technique (Hospital A: 88/113, 78%; Hospital B: 90/144, 63%; χ2: 8.313, p =.016). The most commonly documented wound characteristic was wound type (Hospital A: 43/113, 38%; Hospital B: 70/144, 49%). What nurses documented differed significantly across sites (p <.05). Conclusions: Clinical variations in wound care practice are likely influenced by clinical context. Relevance to clinical practice: Using an evidence‐based approach to surgical wound management will help reduce patients' risk of wound‐related complications. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore adult general surgical patients' perceptions of, and satisfaction with, discharge education provided by healthcare providers. Background: Discharge education is essential for general surgical patients as it equips them with the required knowledge and skills to engage in their care after discharge. Insufficient knowledge to self‐manage or assess their symptoms can result in postdischarge complications, unplanned hospital readmission and overall dissatisfaction with the hospital experience. Design: A constructivist‐interpretivist paradigm using qualitative interviews. Methods: Telephone interviews were conducted with 13 patients between August 2018 and November 2018 and analysed using inductive content analysis. COREQ guidelines were adopted for the conduct and reporting of the study. Results: Four themes were uncovered: (a) The quality of discharge information influences patients' postdischarge experience; (b) The negative impact of contextual influences on delivery of discharge education; (c) Patients actively participating in their surgical journey; (d) Patients' preferences with the delivery of discharge education. Conclusion: Inadequate discharge education leads to patients' inability to self‐manage their recovery process. Information sharing with patients fosters shared understanding towards goals and expectations. Relevance to clinical practice: Understanding patients' view may inform the design of patient‐centred discharge education interventions for patients to self‐manage their recovery postdischarge. [ABSTRACT FROM AUTHOR]

Aims and objective: To describe the prevalence and predictors of pressure injuries among older adults with limited mobility, within the first 36 hr of their hospital admission in Australia. Background: Pressure injuries are significant health, safety and quality of care issues for patients and healthcare organisations. The early implementation of the recommended pressure injury prevention international clinical practice guidelines is a way to reduce hospital‐acquired pressure injuries. There is a paucity of evidence on the number of older persons who are admitted hospital with a pre‐existing pressure injury. Design: Prospective correlational study conducted in eight tertiary referral hospitals across Australia. Our sample comprised of 1,047 participants aged ≥65 years with limited mobility, drawn from a larger Australian pragmatic cluster randomised trial. Methods: Using the STROBE statement, observational data were collected on participants' age, gender, presence of a pressure injury, Body Mass Index score, number of comorbidities and place of residence. These variables were analysed as potential predictors for pressure injuries within the first 36 hr of hospitalisation. Results: From our sample, 113/1047 (10.8%) participants were observed to have a pressure injury within the first 36 hr of hospital admission. Age, multiple comorbidities and living in an aged care facility predicted the prevalence of pressure injury among older people within the first 36 hr of hospitalisation. Conclusions: Our findings confirm that older adults, those with multiple comorbidities and individuals living in aged care facilities are more likely to come to hospital with a pre‐existing pressure injury or develop one soon after admission. Relevance to clinical practice: Many older patients come to hospital with a community‐acquired pressure injury or develop a pressure injury soon after admission. This highlights the importance of the early detection of pressure injuries among older persons so that timely management strategies can be implemented along with the potential to reduce unnecessary financial penalties. [ABSTRACT FROM AUTHOR]

Aims: To identify the facilitators of and barriers to nurses' adherence to evidence‐based wound care clinical practice guidelines (CPGs) in preventing surgical site infections (SSIs) in an Australian tertiary hospital. Background: Current research suggests that up to 50% of nurses are unaware of the evidence‐based recommendations to prevent SSIs and that adherence to evidence‐based CPGs is suboptimal. However, little is known regarding the facilitators and barriers to adherence to evidence‐based CPGs. Design: A qualitative study incorporating ethnographic data collection techniques. Methods: Data collection included semi‐structured individual interviews and focus groups (N = 20), and examination of existing hospital policy and procedure documents. Thematic analysis using inductive and deductive approaches was conducted. This manuscript adheres to the COnsolidated criteria for REporting Qualitative research (COREQ) guidelines. Findings: Data analysis revealed four themes: adhering to aseptic technique, knowledge and information seeking, documenting wound care and educating and involving patients in wound care. Facilitators and barriers within each theme were identified. Facilitators included participants' active information‐seeking behaviour, a clear understanding of the importance of aseptic technique, and patient participation in wound care. Barriers included participants' knowledge and skills deficits regarding application of aseptic technique principles in practice, the availability of the hospital's wound care procedure document, suboptimal wound care documentation and the timing of patient education. Conclusions: There is a need to develop interventions to improve nurses' adherence to recommended CPGs including following aseptic technique principles, hand hygiene, documentation and patient education. Hospital procedure documents that outline wound care need to reflect current recommended CPGs. Relevance to clinical practice: Adhering to evidence‐based CPGs has been found to be effective in reducing and preventing SSIs. Our study provides an in‐depth understanding of the barriers and facilitators to nurses' adherence to recommended CPGs. The findings may inform future practice improvements in wound care. [ABSTRACT FROM AUTHOR]

Aims and Objectives To explore nurses' views of the barriers and facilitators to the use of a newly devised patient-centred pressure ulcer prevention care bundle. Background Given pressure ulcer prevention strategies are not implemented consistently, the use of a pressure ulcer care bundle may improve implementation given bundles generally assist in standardising care. Design A quality improvement project was undertaken after a pressure ulcer prevention care bundle was developed and pilot-tested. Methods Short, conversational interviews with nurse explored their views of a patient-centred pressure ulcer care bundle. Interviews were audio-taped and transcribed. Inductive content analysis was used to analyse the transcripts. Results A total of 20 nurses were interviewed. Five categories with corresponding subcategories emerged from the analysis. They were increasing awareness of pressure ulcer prevention, prompting pressure ulcer prevention activities, promoting active patient participation, barriers to using a pressure ulcer prevention care bundle and enabling integration of the pressure ulcer prevention care bundle into routine practice. Conclusions Benefits of using a patient-centred pressure ulcer prevention care bundle may include prompting patients and staff to implement prevention strategies and promote active patient participation in care. The success of the care bundle relied on both patients' willingness to participate and nurses' willingness to incorporate it into their routine work. Relevance to Clinical Practice A patient-centred pressure ulcer prevention care bundle may facilitate more consistent implementation of pressure ulcer prevention strategies and active patient participation in care. [ABSTRACT FROM AUTHOR]

Aims and Objectives. To examine wound assessment and management in patients following surgery and to compare these practices with current evidence-based guidelines for the prevention of surgical site infection across one healthcare services district in Queensland, Australia. Background. Despite innovations in surgical techniques, technological advances and environmental improvements in the operating room, and the use of prophylactic antibiotics, surgical site infections remain a major source of morbidity and mortality in patients following surgery. Design. A retrospective clinical chart audit Methods. A random sample of 200 medical records of patients who had undergone surgery was undertaken over a two-year period (2010-2012). An audit tool was developed to collect the data on wound assessment and practice. The study was undertaken across one healthcare services district in Australia. Results. Of the 200 records that were randomly identified, 152 (76%) met the inclusion criteria. The excluded records were either miscoded or did not involve a surgical incision. Of the 152 records included, 87 (57.2%) procedures were classified as 'clean' and 106 (69.7%) were elective. Wound assessments were fully documented in 63/152 (41.4%) of cases, and 59/152 (38.8%) charts had assessments documented on a change of patient condition. Of the 15/152 (9.9%) patients with charted postoperative wound complications, 4/15 (26.6%) developed clinical signs of wound infection, which were diagnosed on days 3 to 5. Conclusions. The timing, content and accuracy of wound assessment documentation are variable. Standardising documentation will increase consistency and clarity and contribute to multidisciplinary communication. Relevance to clinical practice. These results suggest that postoperative wound care practices are not consistent with evidence-based guidelines. Consequently, it is important to involve clinicians in identifying possible challenges within the clinical environment that may curtail guideline use. [ABSTRACT FROM AUTHOR]

Aims and objectives To describe the self-reported wound care practices of acute care nurses practising in a large metropolitan hospital in Queensland, Australia. Background Wound infections occur in up to 30% of surgical procedures and are the third most commonly reported hospital-acquired infection. The growing complexity and cost of wound care demand that nurses use wound care knowledge based on best practice guidelines. Design Descriptive cross-sectional survey design. Methods A convenience sample of 250 medical and surgical nurses working in an acute care facility was invited to complete a 42-item survey. The survey was based on an extensive literature review and an environmental scan of wound care issues in major hospitals, Australia. Results The survey was completed by 120 acute care nurses with a response rate of 48%. Ninety (75·6%) respondents reported that 'wound appearance' was the most important factor guiding their choice of dressing product. Only 6 (5·0%) respondents considered the cost of a dressing product 'highly important'. Fifty-nine (50·4%) respondents reported being 'unaware' of the national standards pertaining to wound management, and only 41 (34·7%) respondents reported that their knowledge of wound products was 'good' or 'excellent'. The majority ( n = 89, 75·4%) of respondents used the hospital's wound care specialist nurses as the primary source of information in regard to managing acute wounds. Conclusions Although acute care nurses have a sound knowledge of wound healing processes, it appears that many do not use the recommended clinical guideline pertaining to wound care. Relevance to clinical practice While it is important for nurses to detect early wound complications, treatment plans based on wound assessments need to be informed by current clinical guidelines. In implementing the guideline, it is essential to first identify barriers and facilitators to knowledge transfer. [ABSTRACT FROM AUTHOR]