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Surgical attire can be an emotional and controversial topic among health care providers. The reality, however, is that exposing perioperative patients to the skin and hair of the perioperative team members may be putting patients at risk for a surgical site infection.

Despite the substantial risks posed in the surgical environment, compliance in wearing appropriate personal protective equipment (PPE) in the operating room (OR) and the post-anaesthetic care unit (PACU) amongst health care workers is considered poor globally. Lack of awareness and limited access to information about the appropriate precautions to prevent exposure contribute to continued high-risk behaviours amongst the team in the perioperative setting.The aim of this project was to assess current compliance rates of staff in the use of PPE and to develop and implement an educational program to increase staff compliance in the perioperative setting of a large, private hospital (450 beds).A convenience sample of perioperative nurses were invited to complete a questionnaire.Eighty (80) registered nurses RNs) were invited to participate response rate of 69%), giving a sample size of n = 55. Questionnaires not completed in full were not included in the final analysis, leaving n = 31 fully completed questionnaires. There was an education group (n = 14) and a control group (n = 17). Between the groups, educational background, type of work and patient contact were very similar. Of those that did respond regarding exposure, only 20% reported the incident. Both groups identified their manager and team as frequently discussing safer work practices and being supportive. PPE was identified as essential; however, participants reported not enough time to always follow standard precautions (education 15%; control 25%).Team and good leadership was identified as essential to ongoing professional knowledge and support with regard to risk minimisation in the perioperative setting.

The operating room can be home to many different types of nursing errors due to the invasiveness of OR procedures. The nurses' reactions towards errors can be a key factor in patient safety. This article is based on a study, with the aim of investigating nurses' reactions toward nursing errors and the various contributing and resulting factors, conducted at Kurdistan University of Medical Sciences in Sanandaj, Iran in 2014. The goal of the study was to determine how OR nurses' reacted to nursing errors with the goal of having this information used to improve patient safety. Research was conducted as a cross-sectional descriptive study. The participants were all nurses employed in the operating rooms of the teaching hospitals of Kurdistan University of Medical Sciences, which was selected by a consensus method (170 persons). The information was gathered through questionnaires that focused on demographic information, error definition, reasons for error occurrence, and emotional reactions for error occurrence, and emotional reactions toward the errors. 153 questionnaires were completed and analyzed by SPSS software version 16.0. "Not following sterile technique" (82.4 percent) was the most reported nursing error, "tiredness" (92.8 percent) was the most reported reason for the error occurrence, "being upset at having harmed the patient" (85.6 percent) was the most reported emotional reaction after error occurrence", with "decision making for a better approach to tasks the next time" (97.7 percent) as the most common goal and "paying more attention to details" (98 percent) was the most reported planned strategy for future improved outcomes. While healthcare facilities are focused on planning for the prevention and elimination of errors it was shown that nurses can also benefit from support after error occurrence. Their reactions, and coping strategies, need guidance and, with both individual and organizational support, can be a factor in improving patient safety.

Providing rapid response is a primary goal when caring for surgical patients with injuries involving massive blood loss. Massive transfusion protocols have been developed in some tertiary care health care facilities to ensure a rapid and efficient response in the provision of care to patients with a massive and uncontrolled hemorrhage. The purpose of this article is to discuss a massive transfusion protocol and to describe the process used to implement a massive transfusion protocol at Winnipeg's Health Sciences Centre (the site) as well as to describe its impact in the operating room department.

To assess, a year after the deployment of the check-list in the centre hospitalier Lyon Sud (CHLS - HCL), the perception of medical and nursing staff regarding the advantages of the check-list and its level of integration within the overall organization of the operating room.Descriptive study, questionnaires and audits.Distribution of individual questionnaires to the entire operating room staff, and observational audits in the operating room, to objectively assess the quality of implementation of the check-list (level II of the HAS - French National Autority of Health).The medical and nursing staff participated equally in using the check-list. This was derived from the individual questionnaires and reinforced by the observational audit; they also revealed an uneven implementation of the three phases, with phase 3 almost never performed. In two-third of the cases, the time-out requirements did not comply with HAS instructions. Nurses and physicians perceived the check-list differently. Even though they agreed that the check-list should be a team effort and is useful, nurses noted a lack of investment and leadership from doctors, in addition to communication problems, which led to a feeling of disrespect towards them when they play the role of the check-list coordinator.The questionnaire and the audit of practice showed strong adherence to the concept in that the surgical check-list was considered useful by all staff. However, it was also considered to be an added formality and its full implementation was rare in practice. There was a problem of distribution and acceptance of roles with nurses often observing that they were the only ones strictly following the check-list due to a lack of medical investment.

Unease at work is the consequence of a growing difficulty in carrying out high quality work based on performance criteria. Healthcare professionals are well placed to highlight these criteria which can be discussed within work groups. The aim of these groups is to work towards compromises combining efficiency and health.

To investigate of predictor's factors of difficult venous access device in the operating room in elective surgery.In a prospective study in central operating room, were included all patients scheduled for a surgical or diagnostic intervention. Were excluded all patients admitted with functional venous access. For each, were recorded patient's demographic characteristics (age, gender, ASA class, BMI), history (chemotherapy, prolonged ICU stay, hospitalization for more than five days), data from the clinical examination (presence of skin lesions, arteriovenous fistulas, burns, neurological deficits) and the type of operator (trainee, nurse, resident, senior). The difficulty was judged on the number of attempts required for successful venous access. Puncture was considered easier for a number of attempts to one to two and difficult if the number of attempts was greater than two. Predictor's factors were identified after univariate and multivariate analysis.During one year (March 2008 to February 2009), form returns in 1500 were met, 1325 were usable. Venous catheterization was successful in 50.9% at the first attempt in 24.2% of patients at the second attempt and after three attempts in 18% of patients. Only 6.8% of patients required more than three attempts. A central venous catheter was required in seven patients. In multivariate analysis, chemotherapy (OR=4.54, 95% CI [2.92 to 7.03]; P0.001), a nurse in training (OR=2.27, 95% CI [1.40 to 3.63]; P=0.001), a resident in training (OR=2.14, 95% CI [1.29 to 3.58]; P=0.003) and the presence of burns (OR=3.59, 95% CI [2.44 to 5.27]; P0.001) were identified as independent predictors of difficulty of peripheral venous access.The optimization of venous access devices in the operating room through the search for predictors of difficulty.

The advantages of ambulatory surgery and anaesthesia are widely recognised. Apart from their interest in terms of reducing hospital costs, they are overwhelmingly preferred by patients. Of all patients, it is children who can benefit the most.

The law n 2002-73, dated 17 January 2002, of social modernisation, as it is called, reformed continuing professional training in France. It established a new system of professional certification, the validation of the knowledge acquired from experience (VAE in French). Since 2003, the Health Ministry has been studying a project to set up the VAE for health professions, among which, in particular, the profession of the state registered nurse working in operating theatres (IBODES in French). A state diploma sanctions the training enabling to practise this profession. In the future, the VAE will open a new access way to this diploma. Does this evolution constitute a threat for the profession, and a risk or an opportunity for individual people? The aim of this thesis is to characterise the impacts of the VAE on the IBODE profession and its current system of training. Two sociological and educational approaches are comforted by a field survey. A historical background of the IBODE profession develops the evolution of the caring practices, and presents the evolution of the training systems. A sociological approach enables to analyse the vocational focus of the IBODE on looking at functionalist theories. Therefore, the study enables to think that the VAE will have no consequences on the vocational focus of the IBODE. The VAE is then the object of an educational approach within the context of continuing professional training. The topics on which it could apply and the resistances it causes are studied. Some examples are taken within other Ministries. This study shows that the VAE involves an adaptation of training centres. The VAE constitutes a genuine opportunity for the IBODE profession. However, to manage its setting up in a delicate human context, the field professionals should be involved as early as possible in the reflection initiated by the Ministry.

Operation anxiety constitutes a significant phenomenon, detectable in numerous sleep related and psychological symptoms, as in its impact on the patient's health, the operation and post-operation process. For decades this problem (almost unknown in Lebanese scientific research), was the object of a vast theoretical project and numerous North American and European studies. Within the framework of this investigation, we studied the influence of structured information, provided by operating room nurses, on the patient's anxiety during the preparatory stage. The problem is all the more significant and relevant given that it is all but ignored in Lebanese hospitals. By adopting the basic hypothesis that "structured preparatory information diminishes the patient's anxiety" we wanted to examine the eventual links between the patient's anxiety level and his/her personal, socio-cultural and psycho-medical characteristics (sex, age, marital status, education, standard of living, medical history, type of surgery, type of anesthesia, etc.). Using the same methodological approach, we adopted Spielberger's steps in measuring anxiety after having acquired the proper authorization from Professor Spielberger himself, who furnished us with the certified Arabic version of these steps and their interpretation. A questionnaire allowed the identification of test groups' characteristics. We chose our setting the operating theatre at the Nini hospital in Tripoli, North Lebanon. Our investigation essentially began in September/October 2003. We formulated a sample of sixty patients within the operating community by means of a random sampling technique and a well-defined exclusion criteria. With the same technique we divided two groups of thirty patients: group A1 which was informed and A2 which was uninformed and used as test subjects. The data gathered by the investigation was incorporated into the SPSS software. The results of the comparative analysis operating between the two groups' anxiety scores confirmed the afore-mentioned hypothesis. However, these results did not establish any significant links between anxiety levels and the majority of the test groups' characteristics. By confirming the hypothesis that preparatory information reduces the patient's anxiety, this investigation has opened the door to important practical consequences leading to the following recommmendation: quality health-care in Lebanese hospitals would greatly improve by adopting a protocol of information booklets and preparatory meetings with the patient, with the added benefit of valorizing the role of the operating room nurse. At present, the absence of any structured preparatory information represents a significant deficiency in Lebanese hospitals.

Changes in the work environment, quotas imposed on the number of resident physicians, scientific and technological advances, and nurses having to play two roles, that of scrub nurse and of nurse first assistant, have all contributed to the development of a new role, that of nurse first assistant. For the purpose of providing optimal quality care to patients and at the request of its surgeons, the Montreal Heart Institute has presented a project to the Ordre des infirmières et infirmiers du Québec and the Professional Corporation of Physicians of Québec. The project was accepted by both bodies. The OIIQ moved in favour of recognizing the function of nurse first assistant in September, 1994, and the PCPQ gave its approval for the project on March 30, 1995. A 186 hour training program was developed. The two selected nurses have been trained and have been integrated into a medico-surgical team since February, 1996. The Nurse First Assistant pilot project will be evaluated in February, 1997.