Journal des soins infirmiers périopératoires et intensifs en soins intensifs
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A Study of Nursing Practices of Operating Room Circulating Nurses in Japan: A Focus on Patient Support

Ai Matsuzaki, Mihoko Miyawaki

Background: In Japan, in 1999, there was a "patient mix-up" in which two patients undergoing surgery had their lung and heart operations mistaken for each other. This medical malpractice triggered a growing concern for patient safety and became a social issue as the cause of the accident and the fragility of the medical care delivery system were revealed. Subsequently, the sedatives that had been administered preoperatively were no longer used, and patients began to walk into the operating room. With these changes, circulating nurses are expected to do their best to identify patients and care for them so that they can safely, and faces their surgeries in peace of mind.

Objective: This study aims to describe how circulating nurses in the OR (Operating Room) determine patients’ needs and provide care from the time a patient enters the OR to when they undergo general anesthesia. Methods: Fourteen OR nurses were observed during interactions with their respective patient and were later interviewed after the surgery. Data were analysed using thematic analysis.

Results: The analysis revealed that the circulating nurses spent approximately 30 minutes with patients, doing their best to create an environment in which patients felt safe and peace of mind during the surgical procedure. Two major themes emerged in the analysis, including {Supporting patients with expressing their thoughts about surgery} until they entered the surgical room as well as when they were in the surgical room, and {Supporting patients by patient advocacy as a bridge between the patients and medical staff so that patients are not left behind}.

Conclusion: The OR (Operating Room) is an extraordinary place for patients that creates tension and anxiety, however for OR nurses it is an everyday space. Nurses need to be aware of this temperature difference in patient care. Nurses' interest in, and detailed observations of patients based on their professional knowledge and experience enable them to provide appropriate care, even within a limited period.