Prerequisites for infection prevention interventions during the intraoperative phase from the perspective of operating room nurses, An integrative review

Abstract

Background Surgical site infections pose a significant threat to patient safety, causing morbidity and mortality. Preventing surgical site infections through infection prevention interventions during surgery is crucial in limiting the risk of contamination from environmental microorganisms or skin flora. In many countries, operating room nurses are responsible for the aseptic environment and the performing of preventive interventions during the intraoperative phase. For patient safety, optimal prerequisites should be present for the operating room nurses’ performance of infection prevention interventions. This integrative review was conducted to explore the prerequisites for operating room nurses to effectively carry out infection prevention interventions during the intraoperative phase. Method Whittemore and Knafl´s review method guided this integrative review. The search strategy includes multiple academic databases, backward and forward chaining, and targeted internet searches. The constant comparative method was used to analyse and synthesise data from 17 studies. Results This review identified several key factors that affect operating room nurses' ability to perform safe infection prevention interventions. These factors included intrapersonal prerequisites of the operating room nurses, interpersonal prerequisites within the operating room team, external conditions, and both facilitating prerequisites and barriers to implementing evidence-based practice. The intrapersonal category emerges from the subcategories: have control, planning ahead, competency, and occupational stress. The interpersonal category originates from the subcategories: cooperative behaviour and respect. The conditions category emerges from the subcategories: management and communication systems. The evidence-based practice category includes prerequisites for the use of scientific evidence. Conclusions This study highlights the need to improve the prerequisites to effectively execute safe preventive infection interventions. The team's lack of commitment to preventing surgical site infections raises concerns for patient safety and leaves operating room nurses feeling disrespected. Operating room nurses should assume leadership responsibilities and be supported by management, with access to necessary prerequisites such as information, education, and sufficient time for preparation and implementation. Regular feedback on infection rates and complications is crucial. The study highlights the significance of well-staffed and familiar teams and the urgency of zero tolerance for abusive behaviour. Resilience is essential for operating room nurses' well-being and optimal patient care.