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Aims and objectives To explore and explain how nurses minimise risk in the perioperative setting. Background Perioperative nurses care for patients who are having surgery or other invasive explorative procedures. Perioperative care is increasingly focused on how to improve patient safety. Safety and risk management is a global priority for health services in reducing risk. Many studies have explored safety within the healthcare settings. However, little is known about how nurses minimise risk in the perioperative setting. Design Classic grounded theory. Methods Ethical approval was granted for all aspects of the study. Thirty-seven nurses working in 11 different perioperative settings in Ireland were interviewed and 33 hr of nonparticipant observation was undertaken. Concurrent data collection and analysis was undertaken using theoretical sampling. Constant comparative method, coding and memoing and were used to analyse the data. Results Participants' main concern was how to minimise risk. Participants resolved this through engaging in anticipatory vigilance (core category). This strategy consisted of orchestrating, routinising and momentary adapting. Conclusion Understanding the strategies of anticipatory vigilance extends and provides an in-depth explanation of how nurses' behaviour ensures that risk is minimised in a complex high-risk perioperative setting. This is the first theory situated in the perioperative area for nurses. Relevance to clinical practice This theory provides a guide and understanding for nurses working in the perioperative setting on how to minimise risk. It makes perioperative nursing visible enabling positive patient outcomes. This research suggests the need for training and education in maintaining safety and minimising risk in the perioperative setting. [ABSTRACT FROM AUTHOR]

Aim To explore nurses' use of the World Health Organization safety checklist in the perioperative setting. Background Promoting quality and safety in health care has received worldwide attention. The World Health Organization surgical safety checklist (2009) is promoted for reducing postoperative morbidity and mortality. The checklist has been introduced in Irish perioperative settings. Method(s) A descriptive, qualitative approach was utilised. A purposeful sample of ten nurses participated in individual, semi-structured interviews. Results Participants were committed to promoting safety in navigating challenges in introducing, complying and accepting the value of the World Health Organization surgical safety checklist in concordance with best practice. Participants moved from task completion to embracing the checklist as an effective surgical safety checking tool. Challenges were identified around roles and responsibilities in overseeing the completion of the checklist. Conclusion(s) The management of processes is critical when implementing any safety initiative. This paper highlights the complexity and challenges in implementing the World Health Organization surgical safety checklist, contributing to global discussions around translating policy into practice. Implications for nursing management The effective implementation of a checklist requires a coordinated management approach in collaboration with team members. These approaches will support learning experiences contributing to a shared understanding of the change being implemented by all team members. [ABSTRACT FROM AUTHOR]

Parents play a central role in the preparation of their child for hospitalisation and surgery. This research examined the parental perspective on educating their child for an elective admission to hospital for surgery. The study employed a qualitative descriptive design and sampled eight parents from a private hospital in Dublin, Ireland, prior to their child's discharge, after ear, nose and throat surgery. A thematic analysis revealed four themes: how parents educate themselves about surgery and hospital, factors influencing parent's decisions on the quantity of information to share, sources of education about hospitalisation and aspects of hospitalisation not discussed by parents. Findings indicated that although the internet was used as a general source of information, parents relied more on information provided by the hospital. Parents used their child's age, individual needs and level of autonomy to determine what information to communicate. Specific areas that parents found difficult to communicate included pain and fasting. This research highlights the need for hospitals to invest and support the delivery of parental education for children prior to surgery. Clarification of the children's nurses' role in the development, implementation and evaluation of education programmes that support education delivery in the home by parents is also warranted.

Aim: The aim of this study was to explore adult-trained perioperative nurses' practice of family-centered care (FCC). Method: A qualitative research design with a hermeneutic phenomenological approach was used. In-depth interviews were conducted with six adult-trained perioperative nurses. Data analysis was guided by Colaizzi's seven-step framework, resulting in a composite description of perioperative nurses' practice of FCC. Findings: While participants supported the principle of family involvement in care, they found its implementation in practice difficult and stressful. They reported that families often appeared inadequately prepared for the surgical experience, and subsequent poor experiences for families caused feelings of upset and inadequacy for nurses. Conclusion: While some of these findings are similar to those in previous studies of paediatric nurses' practice of FCC, this is the first known study to examine adult-trained perioperative nurses' practice of FCC. Participants articulated an awareness of what constitutes effective FCC and showed the motivation to accomplish the task of improving family-centered practice in their practice area. [ABSTRACT FROM AUTHOR]

Aim: This paper is a report of a study conducted to examine migrant nurses' perceptions and attitudes of integration into the perioperative setting., Background: Adapting to a new culture can be overwhelming for many nurses working in foreign countries. Currently, the Republic of Ireland appears to rely heavily on migrant nurses because of persistent nursing shortages over the last decade. To date, there is little research on how the integration process affects migrant nurses in Ireland., Method: A quantitative descriptive design was used. Data were collected in 2007 using questionnaires distributed to 220 migrant perioperative nurses working in four hospitals in Ireland., Results: There were communication issues between migrant nurses and their work colleagues. Forty-nine percent of migrant nurses found that work practices were different from those in their home countries. Cultural differences were also an issue. Ninety percent of respondents found the support of preceptors beneficial and 96% found hospital orientation programmes valuable., Conclusion: Workshops and in-service education are needed on key practices and procedures performed in the perioperative setting for all new staff. Specific learning outcomes and an achievement timeframe should be developed for each new nurse, based on their previous experience and level of knowledge. Migrant nurses not accustomed to delegating and being assertive need to be supported and given time to acquire these skills and to gain confidence.

The Irish healthcare system is failing to meet the needs of minority ethnic groups. This is a factor that has been attributed to communication barriers and lack of cultural awareness between healthcare providers and recipients of care (O'Connor 2005a). Moreover, with increasing diversity in Ireland, encounters between the healthcare professional and patients from ethnic minorities are becoming more common. Patients bring to the medical encounter different languages, explanatory models concerning treatment and illness, religious beliefs, and ways of understanding the experience of suffering. Thus the risk of misunderstanding and inability to complete appropriate assessments surrounding care and in particular the consent process is a growing concern.