EORNA2022_Abstract Book

1 #EORNA2022 www.eorna-congress.eu ABSTRACT BOOK 10th EORNA CONGRESS WINDS OF CHANGE 12 - 15 May 2022 | Stavanger, Norway

10th EORNA Congress Stavanger, Norway | 12 - 15 May 2022 2 Content Priority Sessions 3 Symposia - Invited speakers 4 Symposia 7 Parallel Sessions 12 Round Table Sessions 25 Clinical Case Studies 35 Guided Poster Walks 39 ePosters 49 Author Index 60

Stavanger, Norway | 12 - 15 May 2022 10th EORNA Congress Priority Sessions 3 Priority Sessions PR01 How Norway handled the COVID Pandemic O. Kacelnik1 1Norwegian Institute of Public Health, Norway Like many other countries, Norway was forced onto a very quick and steep learning curve when faced with the challenges of the COVID-19 pandemic. I will detail some of these obstacles, the roles of the main actors, and the way decisions were made. Whilst considering society as a whole, I plan to focus mostly on the decision-making, information gathering and implementation practices concerning guidelines for the Norwegian health service and how we attempted to balance the protection for staff, patients and treatment. Finally, I will end by looking at some of the lessons we have learnt, and how we are trying to benefit from the work that has been done. PR02 Operating room of the future; from scrubs to self-contained operating table N. Bitterman1 1Technion, Israel Institute of Technology, Israel Operating rooms are becoming more complex and dynamic, containing advanced technologies including robotic systems, image guided surgery, remote surgery, 3D images, virtual reality, holograms, hybrid systems, a variety of data display and information screens, and more, and with them the workload and congestion increases. Despite these great technological developments, design issues and human factors considerations at the operating room, are still lagging behind. The lecture will present three research projects concerning the diverse users, the platform (equipment), and the environment of the operating room: A. All-inclusive operating table, to overcome the clutter, congestion, restriction, and blockage of cables, tubes, lines and wires resulting from the radial configuration of operating rooms. B. Design and ergonomic concepts of operating room clothing (scrubs), C. A multi-sensory approach for data and information displays in operating rooms. Future directions indicate the importance of a multidisciplinary team in designing future operating room, that will be people centred and not only technology driven, responding to the dynamic and changeable needs of the patient and the surgical team. PR03 Professional ethics in nursing - Stable or changing? M. Kangasniemi1 1University of Turku, Finland This presentation addresses professional ethics from different perspectives, such as professional rights and responsibilities as well as collegiality. Professional ethics will be reflected in relation to worker’s personal values, shared values in the intraprofessional and multi-professional collaboration and the history of nursing profession. PR04 Artificial intelligence in the management of perioperative services P. Voight1 1International Federation of Perioperative Nurses, United States

10th EORNA Congress Stavanger, Norway | 12 - 15 May 2022 Symposia - Invited speakers 4 Symposium: Effective management in the OR IS01 Nurse managers’ decision making and information needs in perioperative settings E. Siirala1 1University of Turku, Finland The aim of this study was to describe the nurse managers’ decision making, information needs and role in daily unit operation. The study consisted of three phases. First, the decisions made by the nurse managers (n=20) were described. The data was collected with think aloud method. During their shift the nurse managers made ad hoc, near future and long-term decisions. They made operational and tactical decisions and they were repeatedly interrupted in their decision making. Second, nurse managers’ essential information needs in decision making were defined, described and identified. The survey was addressed to nurse managers (N=412, n=288). The survey consisted of 76 information needs consisting of four main themes: “Patient’s care process”, “Surgical procedure”, “Human resources”, and “Tangible resources”. Based on the results, the nurse managers valued 41 information needs as essential. The most essential information needs focused on shift and strength of the nursing staff during the shift, the form and need for patient’s isolation and patient’s surgical procedure. Third phase focused on describing the nurse managers’ role by conducting an integrative literature review (n=9). Based on the literature, nurse managers’ role can be divided into three themes: 1) education and experience, 2) skills and 3) tasks. The results can be used when developing the content of information systems supporting knowledge management and decision making of nurse managers in hospitals. Finally, these results can be used in orientation and when clarifying the nurse managers’ role. KEYWORDS: daily unit operation, decision making, information needs, nurse manager and perioperative settings Symposium: Competences for future nurses IS02 How competent are graduating nursing students in Europe? Findings from the European crosscultural study project, COMPEUnurse S. Kajander-Unkuri1 1Diaconia University of Applied Science and University of Turku, Finland Competence of nurses is an important issue in health care as it is related to professional standards, patient safety and the quality of nursing care. In Europe, there are several issues, which will increase the importance of nurse competence of graduating nursing students (GNS) as they are in an essential role in taking the place of retiring nursing staff and meet the increasing need for care. The purpose of this study project is to assess and compare the level of competence of graduating nursing students at the point of graduation and in early years of practice in Europe based on their self-assessment. In addition, the purpose is to identify and analyse the factors (individual, organisational) related to the level of competence. The data were collected between February 2018-September 2019 from GNSs in six European countries (Czech Republic, Finland, Italy, Portugal, Slovakia, and Spain). GNSs (N=4,135) were invited to respond to the research instruments (the Nurse Competence Scale, the Clinical Learning Environment and Supervision scale, the Self-Rating Scale of Self-Directed Learning scale and the Essential Elements of Nurse Empowerment) with VAS 0–100 scale and several background questions at graduation. In all countries, GNSs’ (n=1,746) assessed their competence on a good level (VAS mean 64.5, SD 14.8), albeit with statistically significant differences between countries. Competence correlated statistically significantly and positively with GNSs’ perceptions of their clinical learning environment, self-directed learning abilities and nurse empowerment. The results can be utilised for the development of nurse education and successful beginning of the nursing career.

Stavanger, Norway | 12 - 15 May 2022 10th EORNA Congress Symposia - Invited speakers 5 IS03 The integrated Masters’ degree (MSc) – An OR nurse education for the future I. Sirevåg1 1University of Stavanger, Faculty of Health Sciences, Department of Caring and Ethics, Stavanger, Norway In Norway, registered nurses with two years of experience have been offered formalised OR nurse education since 1952. Initially, it was hospital driven with a duration of 12 months. In 1998 the responsibility for the education was moved to the universities/colleges and the duration was increased to 18 months (90 European Credit Transfer and Accumulation system (ECTS) credits). Following the Bologna process for higher education, an optional master’s degree (120 ECTS) was introduced in 2012. The University of Stavanger enrolled the first students to the master’s programme in 2014, and five students completed their degree of MSc in operating room nursing in 2016. Since 2018), all our OR nursing students graduate with masters’ degree. Including the graduates of 2022, a total of 57 students have completed their thesis. These OR nurses have thorough clinical qualifications for delivering high quality OR nursing, and the scientific competence to further develop the profession in accordance with future needs. IS04 Operating room nursing certificate education in Turkey M. Yavuz van Giersbergen1 1Ege University, Nursing Faculty, İzmir, Turkey Operating room nurses become certified for a variety of reasons, including professional validation, personal achievement, and career advancement. Becoming a certified operating room nurse is a mark of distinction and demonstrates a commitment to maintaining the highest standards in patient safety. Operating room nursing certificate training program in Turkey started in 2015 and is approved by the Ministry of Health. Nurses who have worked in the operating room for at least 2 (two) years can participate in the certificate program. The certificate program includes 96 hours of intensive theory and 80 hours of clinical practice courses, lasting a total of 22 days. Up to 30 (thirty) participants can be trained in a training. A person who gets 70 (seventy) points out of 100 (one hundred) is considered successful. The participant who is successful in the theoretical examination and clinical evaluation is entitled to receive a certificate. Operating room nursing certified training programs are implemented in 70 centres in Turkey. More than a hundred operating room nursing certified training programs have been given in different institutions in Turkey. 68.3% of the training was given in training and research hospitals. The provinces where operating room nursing certified training programs are frequently organized are 16.9% Istanbul (n=42), 14.5% Ankara (n=36), 8.0% İzmir (n=20). In this presentation, information will be given about the operating room nursing certificate training and evaluation in Turkey and the results of the research on this subject. Symposium: Robotics - Who will be the next nurses? IS05 RONNA G4 robotic system in neurosurgical operation theatre from development to realization and prospective study on robot-assisted brain biopsies performed on 32 patients D. Dlaka1, M. Švaco1,2, D. Chudy1,3,4, B. Jerbić1,2, B. Šekoranja1,2, F. Šuligoj1,2, J. Vidaković1,2, D. Romić1, M. Raguž1,3 1Department of Neurosurgery, University Hospital Dubrava, Zagreb, Croatia, 2Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia, 3Croatian Institute for Brain Research, School of Medicine University of Zagreb, Zagreb, Croatia, 4Department of Surgery, School of Medicine University of Zagreb, Zagreb, Croatia We present a novel robotic neuronavigation system, RONNA G4, used for precise preoperative planning and frameless neuronavigation. The system has been developed by a research group from the Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb and a team of neurosurgeons from the University Hospital Dubrava, Zagreb, Croatia. Frameless stereotactic robot-assisted biopsies were performed on thirty-two consecutive patients. Post-operative computerized tomography (CT) and magnetic resonance imaging (MRI) scans were assessed to precisely calculate the

6 target point error (TPE) and the entry point error (EPE). All clinical data, the learning curve, and the influence of the trajectory angle on targeting accuracy were measured and evaluated. The application accuracy of the RONNA system for the TPE was 1.95 ± 1.11 mm, while for the EPE was 1.42 ± 0.74 mm. In our cohort, only one pathohistological diagnosis was inconclusive; thus, the total diagnostic yield was 96.87%. Linear regression showed statistical significance between the TPE and EPE and the angle of the trajectory on the bone (p=0.026, p=0.010). The learning curve analysis showed statistical significance, especially for one neurosurgeon who performed most of the procedures (p<0.001). The operation duration was significantly reduced over time, as shown by comparing the first ten procedures with the last ten procedures (p=0.0007). We also used RONNA G4 for cyst evacuation and ventricular drainage placement. The RONNA G4 robotic system is a precise and highly accurate autonomous neurosurgical assistant for performing frameless brain biopsies. In the future we plan to perform other neurosurgical operation such as deep brain stimulation, stereo EEG implantation and navigation to deep located intracranial lesions. Symposia: Leadership skills: Shift the focus on resilience IS06 Ways to strengthen the OR nurses´ resilience in their role as leaders in the OR nursing context K. Falk-Brynhildsen1 1Örebro University, Faculty of Medicine and Health, Örebro, Sweden The OR nurse’s competence is indispensable for ensuring patient safety during surgery. They are also expected to manage demanding situations by using diverse strategies to restore patient safety and they must be prepared to make quick decisions. The OR nursing profession includes knowledge of both technical and non-technical skills and participation in the surgical teamwork. There are however several areas for which OR nurses possess specialist knowledge and skills and therefore they have special responsibilities. Such an area is the prevention of postoperative surgical site infections. The OR nurse also guarantees a hygienic and aseptic environment throughout the operation by creating a safe and sterile working surface. To demonstrate leadership in the surgical team and to stand up for the patient using the application of different knowledge and skills can be challenging given the demands imposed by the requirement of evidence-based practice. This complex vocational role can lead to a lot of pressure and it can affect the OR nurse’s resilience in putting the patient at the centre. What can be done to strengthen the resilience of the OR nurse? IS07 Operating theatre: leadership at the service of performance S. Toussaint1 1Hospital Center Verdun/Saint-Mihiel, France Hospital reforms and current health policies are leading operating theatre organisations to evolve in a logic of increasing rationalisation. Subject to management indicators, the surgical activity cannot be improvised, at a time of efficiency and productivity where quality and safety of care must be guaranteed to the persons treated. Exercising managerial functions at the heart of an operating theatre, with these performance objectives, suggests strong personal and professional qualities to build a cooperative advantage. Leadership, adapted to the situation, is one of the keys to success with an appropriate situational approach where effective communication, trust and dynamism are undeniable advantages for the health actors making up the multidisciplinary wealth. The block manager is an actor, pilot and conductor of a collective with strong individualities in an environment where power issues are high. The managerial strategies exercised in a participatory logic allow to conduct the operational activity by mobilising each actor. The guarantee of its mission is individual but also institutional by building governance with shared responsibilities. 10th EORNA Congress Stavanger, Norway | 12 - 15 May 2022 Symposia - Invited speakers

7 Symposium: Effective management in the OR S01 Crew resource management in the OR H. Folkertsma1 1Medical Centre Leeuwarden, OR, Drachten, Netherlands Failure of communication between the crew in the cockpit was one of the main causes of the airplane crash in Tenerife in 1977 involving a KLM and PanAM airplane with 583 dead passengers. Shortly thereafter, NASA has developed the CRM safety training, now a concept in aviation. CRM focuses on making and strictly adhering to communications and collaboration agreements, eliminating traditional authority relationships. Professional leadership, mutual communication, knowing how each team member is “in his skin”, and taking into account, are conditions for safe collaboration and therefore for safe patient care in the OR. We know that it can be wrong in the OR if cooperation or communication between disciplines and individual caregivers is not good enough. Therefore, the CRM system has been translated from aviation to healthcare. Highly complex technology is no longer thought out of hospitals, but it has its own security risks. As technology becomes more advanced, systems become increasingly insensitive to healthcare providers. Certainly, there is a risk of malfunctions in the equipment. Also, systematics and standardization in, for example, alarms of medical equipment are not very much the case, as opposed to aviation. This increases the risks of the care process. More attention to the “human-machine interaction” is urgently needed. In this presentation I will discuss in detail the aspects of the briefing OR and the debriefing OR at the three aspects: Patient, Personnel and Planning. S02 Guidelines and recommendations in Sweden – a development project on patient safety in perioperative nursing care by the Quality Council of SEORNA, Swedish Operating Room Nurses Association A. Ekepil1 1Quality Council of SEORNA, Visby, Sweden Background: In 2008, the National Board of Health and Welfare in Sweden decided to withdraw regulations of importance to the operating room nurse practice regarding count procedures and patient identification. This was the start of the foundation of a Quality Council within SEORNA, Swedish Operating Room Nurses Association. The vision of the Quality Council is to promote high quality and patient safety in perioperative nursing care. The goal is to cover and share knowledge of significance for the operating room nurses’ professional practice in the perioperative environment. Aim: The aim was to produce evidence-based national guidelines for high quality and safe perioperative nursing care in Sweden. Method: The work process for producing guidelines is based on an evidence-based model of five steps described by The National Board of Health and Welfare. Data was collected through systematic reviews of literature, local routines and standards collected through members in SEORNA, advice from experts in perioperative nursing, published adverse events and risks in the work environment, and reviews of international guidelines. Result: The Quality Council has produced evidence based guidelines for the operating room on the following topics; patient identification, count procedure and unintentionally retained surgical items, safe use of tourniquet, protection of surgical smoke, handling of specimen, safe handling of medications, routines for product specialist visiting the operating room, surgical procedures during the COVID-19 pandemic, establishing and maintaining a sterile field for surgical items and use of surgical gloves during invasive surgery. Conclusion: Evidence based guidelines were produced to support the Swedish operating room nurses’ daily work. The guidelines have been published on the SEORNA website www.rfop.se and have also been distributed in booklets to all members in SEORNA. Stavanger, Norway | 12 - 15 May 2022 10th EORNA Congress Symposia

8 10th EORNA Congress Stavanger, Norway | 12 - 15 May 2022 Symposia Symposium: Robotics - Who will be the next nurses? S03 Educational software for handling the Da Vinci Robot in the process of teaching-learning of the operating nurse in training C.K. Romero Orozco1, J. Molina Romero, E. Vasquez Avendaño 1Universidad Libre Seccional Baranquilla, Atlántico, Barranquilla, Colombia This document brings important arguments where the lack of training in the branch of robotic surgery with the operating nurse is evidenced, this being of great relevance in the development of the surgical act due to its knowledge, who seeks to minimize the pathways entry of pathogenic microorganisms that disturb the physical well-being of the patient. In addition, there is evidence of the lack of educational material that allows the operating nurse to obtain knowledge in their teachinglearning process in their academic stay in higher education institutions and also shows how to correct this problem with the firm intention of designing educational software accompanied by the use of augmented reality. It has been developed in the period of time between 2020-1 and 2021-1, applying the instrument to directors or coordinators of operating nurse programs in Colombia. Objective: Design educational software for handling the Da Vinci Robot in the teaching-learning process of the operating nurse in training. Methodology: It is a descriptive and cross-sectional quantitative study because it requires identifying the need for the software, in addition, the content of the software within the document will be detailed and also corresponds to a specific period of time. Results: 77% affirm not to know pedagogical strategies that facilitate the teaching-learning process of robotic surgery in the training of the Surgical Instrumenter, on the other hand, 69% affirm not to know pedagogical strategies for the manipulation of the Da Vinci Robot, 100% ratify the need to create software that facilitates the teaching-learning process in the handling of the Da Vinci Robot, likewise, it is recognized that through the design of the pedagogical strategy the performance capacity of the Surgical Instrumenter is strengthened. Finally, the content of the software was addressed, where the inclusion of theoretical content, its evaluation and interactive resources stands out with 85%. S04 “Techno-Stress”: the influence of new technologies on the OR nursing team M. Zini1, I. Leibovich Nassi2 1Barzilai Medical Center, OR, Ashkelon, Israel, 2Barzilai Medical Center, Nursing Administration, Ashkelon, Israel Background: The process of adopting and implementing novel technologies in medicine is crucial for their optimal utilization. During the last two decades, surgical technologies have much evolved thus, contributing to better and faster patient recovery. However, it appears that the OR nursing team is subjected to frustration, stress and anxiety due to difficulties in running these new technologies. Aim of the study: To assess whether extensive usage of new technologies in the OR, increases “Techno-stress among the nursing staff. Methods: The cohort included nurses who worked in OR. THE Research tools included two questionnaires: sociodemographic and Environmental questionnaires. Results: The study included 39 members (28 Female), age 43 years (24-64), seniority 12 y (1.5-42). High level of Technostress was identified among the participants (4.1 mean; max is 5). Statistically strong associations were found between Techno-stress and peer support (p<0.01, r=0.37), Tecno-stress and use of jargon (p<0.001, r=0.46) and peer support and use of jargon (p<0.001, r=0.47). Techno-stress level (high) was inversely proportional to peer support and use of jargon (low). Conclusions: The results of the present study shed light on a “weak spot”, which is crucial to smooth functioning of the OR, specially designed training programs are needed for integrating new technologies thus, supporting the wellbeing of the nursing teams as well as improving OR efficiency.

9 Stavanger, Norway | 12 - 15 May 2022 10th EORNA Congress Symposia Symposium: Quality of care: No room for compromise S05 The importance of the operating room reception for patient care Y. Edry1, OR nurses advisory committee, Israel national nursing administration - the professional guidance committee 1IPNA- PRESIDENT, Tirat Carmel, Israel The reception room unit in the operating room department is a crucial point for the quality of care and patient safety. It’s the first meeting of the patient and families with perioperative staff, the point of checking the patient preparation for the operation and the last place that we can fix problems or stop a mistake. In 2018 the national nursing administration of Israel decided to work together with the professional associations to promote the quality of care and patients’ safety of patients who need to be operated on. IPNA - Israeli Perioperative Nurses Association took part in that project and we decided to create guidelines for the Perioperative reception units, not only a list of doing or not to do, we wrote the Reception Unit Nurses professional job description. We start our project by collecting data from most of the Israeli operating room departments. we create a questionary that included the question: 1. reception room nurse’s education? 2. the nurse’s professional experience? 3. how many shifts are the reception unite is staffed? 4. do you have guidelines for the reception unite nurses? 5. Do you think that only perioperative nurses must work in the reception unite? We found that in half of the reception room units the nurses are not perioperative nurses. In most hospitals, the reception rooms not working afternoon and night shifts, in 50% of hospitals they don’t have guidelines for the reception unit. Results: In cooperation with our association and the national nursing administration, we created the official guidelines for the operating department’s reception room, including an education program for nurses that working in the reception units. In August 2021, the guideline was published to all the hospitals. Next year we attending to check the implementation of the guidelines in the operating room department in Israel. S06 Brief and debrief: an essential exercise to promote quality and safety in the operating room L. Lynch1 1Sligo University Hospital, General Theatre, Sligo, Ireland As a manager and a leader, the presenter considers the implementation of briefings and debriefings as core elements in the delivery of safe and quality care in the OR. This led the presenter to explore what qualities are needed as a leader to become an effective change agent. In addition to possessing knowledge, eagerness and enthusiasm to drive change effective leaders must have the ability to motivate and empower colleagues to develop and express their own ideas (Glenn, 2010). Bassett and Westmore (2012) advise that if there is poor leadership within an organisation it leads to inadequate and poor performance. To implement any change effectively the change agent requires two leadership styles. Transactional and transformational. Collins (2005) outlines five levels in a hierarchy of leadership. He suggests that the Level five leader is on top of a hierarchy of abilities and is an essential requisite for transforming an organisation from good to great. Sadri (2012) reports that leadership may be enhanced if individuals Emotional Intelligence (EI) is developed and augmented. The presenter suggests that leadership in the OR is essential and needs to be fostered to ensure safe quality care. What my presentation will do: Recognise the necessity of briefing and debriefing in the OR. Identify skills that need to be cultivated to implement any change in practice in the OR. Understand leadership, styles and traits of effective leaders. Improve the overall quality and safety of care delivered in the OR. What I want: I feel this is a very pertinent patient safety topic and I would be delighted to get the opportunity to present my work at an AORN conference. As a leader implementing change continuously, I would like to share my expertise. As I am travelling from abroad assistance with travel would be gratefully appreciated.

10 10th EORNA Congress Stavanger, Norway | 12 - 15 May 2022 Symposia S07 Sailing the unprecedented winds of global perioperative practice D. Peneza1 1Memorial Hermann Hospital - Texas Medical Center, Houston, United States As the multiple global crises emerge leaders continue to race against time, clinical safety, and finding balance. This presentation outlines the journey of an internationally educated clinical and volunteer leader as she journeys the tides of the global pandemic and other unforeseen crises while boosting team dynamics, ensuring success in professional involvements, and finding one’s true power as a novice nurse - a leader in the frontline. Successful global strategies on innovative leadership and creative education will be shared to illustrate and paint the trend of the future. Symposium: Leadership skills: Shift the focus on resilience S08 Assessment of factors that affect stress level on operating room nurses M. Elin1 1HaEmeck Medical Center, Operation Room, Afula, Israel Background: It’s a well-known fact that nurses are suffering from stress in their workplace. This especially shows up in such departments as emergency, intensive care units and operation theaters. There is no evidence of what primarily cause stress in operating room nurses and which nurses are especially influenced by these factors. Aim: This paper provides a study exploring factors that affect the stress level on operating room nurses and compares the reaction to stressful situations of well-experienced and less-experienced nurses. Methods: The focus group was conducted with 74 operating theatre nurses in three public hospitals in Israel. The paper version of the questionnaire that was designed by the researcher, based on the STAI questionnaire, was distributed to operating room nurses. The research data were collected in a computer database and statistical survey was performed using the IBM SPSS Statistics 23. Findings: From the analysis of the collected data, three themes were identified: 1. The operating room nurses with experience of 6 years and less in OR, has a higher level of stress. 2. The highest level of stress was shown in those situations in which professional skills are necessary for quick and effective action. 3. The general level of stress in the Environment category of stressful situations was higher for nurses with more than 6 years of OR experience. Conclusions: The most obvious finding to emerge from this study is that nurses with experience in operating theater of 6 years and fewer have a higher level of stress in comparison to their more experienced colleagues. The highest level of stress was reported on professional issues are related to the lack of knowledge of equipment or complex operations with an unexpected scenario. Also, urgent emergency operations and multi-trauma can cause an extremely high level of stress in less experienced nurses. S09 How to keep your head when all around you are losing theirs. Resilience skills. Can we learn them? T. Donnelly1,2 1Sligo University Hospital, Nurse Practice Development Unit, Sligo, Ireland, 2Sligo University Hospital, Sligo, Ireland Resilience is a concept that refers to an individual’s ability to bounce back or positively respond to adversity. Psychological characteristics of resilience that can be learned include positive coping skills, engaging the support of others, optimism, humour, and cognitive restructuring (Mealer et al, 2014). Irrespective of the method or approach there appears to be a demand for the design and implementation of stress management that promote resilience for employees. This may reduce burnout and attrition. It can be achieved by offering counselling and other occupational health measures that promote the physical and mental wellbeing of staff. However, the provision of an opportunity for careers to discuss the psychological and emotional aspects of their work may encourage the development of resilience (Gray, 2012).

11 Stavanger, Norway | 12 - 15 May 2022 10th EORNA Congress Symposia Resilience is a vital skill that nurses require which will enable them to reflect on their experiences and develop stress coping tactics (McAllister, 2013). This is further reiterated by McGee (2006) who suggests that the promotion of personal growth is paramount for nurses. Recognising the value of developing resilience may increase retention within the profession. Schulte (2013) state that healthcare organisations needed to develop resilience in their leaders in order to inspire the people working within them. Resilience breeds resilience. The author advises that recognising the benefit of resilience may help reduce nurse’s stress and illness associated with stress. Resilience may reduce attrition and improve retention of much needed nurses. It is important to consider it is an innate quality that can be nurtured. The author who is an experienced perioperative nurse and is currently undertaking a doctorate in Stress has designed strategies to develop resilience. These are based on her experience, observation and extensive reading. The strategy known as the (OSPCS) strategy include: • Optimism cultivation • Shift the focus/Flip the thought • Process difficult feelings • Connect • Self-awareness

10th EORNA Congress Stavanger, Norway | 12 - 15 May 2022 Parallel Sessions 12 Parallel session: Scientific research - Shaping the nurse identity OP01 Nurse-led randomised controlled trials in the perioperative setting: a scoping review J. Munday1,2,3, N. Higgins1, S. Mathew1, L. Dalgleish1, A. Batterbury1,3, L. Burgess1, J. Campbell1, L. Delaney1, B. Griffin1, J. Hughes1, J. Ingleman1, S. Keogh1,3, F. Coyer1,3 1Centre for Healthcare Transformation / Queensland University of Technology, Kelvin Grove, Australia, 2University of Agder, Department of Health and Nursing Science, Kristiansand, Norway, 3Royal Brisbane and Women’s Hospital, Herston, Australia Objectives: The aim of this review was to identify domains of perioperative care in which nurse-led randomised controlled trials have been conducted, and issues impacting upon quality of research undertaken in this setting. Within the multidisciplinary perioperative setting, it is appropriate that nurses are at the frontline of driving care improvements and identifying research priorities. Methods: This scoping review was conducted in reference to Joanna Briggs Institute (JBI) scoping review methodology (Peters, Godfrey et al. 2015), by a collaborative group of acute care researchers and clinicians. A comprehensive search strategy found both published and unpublished nurse-led randomised controlled trials in the perioperative setting from 2014-2019. Full text screening, critical appraisal using the Joanna Briggs Institute Critical Appraisal tool for Randomised Controlled Trials (Joanna Briggs Institute., 2017) and data extraction were undertaken by independent paired reviewers. Studies were organised into subgroups according to the objectives. Results: From the 86 included studies, key areas where nurses have led randomised controlled trials include: patient or caregiver anxiety; postoperative pain relief; surgical site infection prevention: patient and caregiver knowledge; perioperative hypothermia prevention; postoperative nausea and vomiting, in addition to other diverse outcomes. Issues impacting upon quality (including poorly reported randomisation), and gaps for future investigation (including a focus on vulnerable populations), are evident. Conclusions: Nurse-led randomised controlled trials in the perioperative setting have focused on key areas of perioperative care. Yet, opportunities exist for nurses to lead experimental research in other perioperative priority areas, and within different populations that have been neglected, such as in the population of older adults undergoing surgery. References: Peters, M.D., Godfrey, C.M., Khalil, H., McInerney, P., Parker, D., Soares, C.B. (2015) Guidance for conducting systematic scoping reviews. International Journal of Evidence-Based Healthcare. 13(3):141-146. Joanna Briggs Institute. Checklist for Randomised Controlled Trials. https://joannabriggs.org/sites/default/files/2019-05/ JBI_RCTs_Appraisal_tool2017_0.pdf OP02 Unveiling tacit knowledge: non-technical skills in operating room nursing I. Sirevåg1 1University of Stavanger, Faculty of Health Sciences, Department of Caring and Ethics, Stavanger, Norway Objectives: Previous studies of the non-technical skills (NTS) of operating room (OR) nurses have primarily explored the skills of scrub nurses. The low volume of previous research including the circulating nurse warrants an exploration of the NTS used by scrub and circulating nurses. Thus, the aim of the study was to identify the NTS essential for OR nursing in the intraoperative timeframe. Methods: A three-round modified e-Delphi technique was used. Norwegian registered OR nurses (n=106) with a minimum of two-year experience (mean=17.1) were selected for the expert panel. Response rates in the three consecutive online surveys were 100%, 90.6%, and 84.4% respectively. Descriptive analysis was performed on the quantitative data while deductive thematic analysis based on crew resource management (CRM) theory was performed on the qualitative data. Consensus was determined by stability between rounds. Preliminary results: Consensus was obtained on which CRM categories are essential to OR nursing, and several novel NTS was identified in the qualitative data. The following list presents CRM categories with representative NTS: Situation awareness (SA): Uses all senses to gain SA; Has awareness towards wrong information; Are continually ‘One step ahead’. Leadership: Uses authority to promote patient safety; Shows competence in management; Considers consequences when planning activities.

Stavanger, Norway | 12 - 15 May 2022 10th EORNA Congress Parallel Sessions 13 Decision-making: Safeguarding availability and function of surgical equipment; Considers the patient, surgeon, and available equipment when making decisions; Considers urgency and available resources when selecting and implementing options. Communication: Uses appropriate communication techniques; Identifies and reduces barriers to communication. Teamwork: Contributes to shared SA; Contributes to efficiency. Conclusions: This study shows that the NTS of OR nurses are more extensive than previously identified. Identification of a diversity of novel NTS contributes to the verbalisation of skills which formerly were considered tacit. This verbalisation may facilitate teaching of NTS, promoting accelerated development of NTS and further improve patient safety. OP03 Interprofessional simulation-based learning and its impact on developing perioperative nursing students’ professional identity H.K.A. Kaldheim1, M. Fossum1, J. Munday1,2,3, K.M.F. Johnsen1, Å. Slettebø1 1University of Agder, Department of Health and Nursing Science, Grimstad, Norway, 2Queensland University of Technology, Brisbane Queensland, Australia, 3Royal Brisbane and Women’s Hospital, Brisbane Queensland, Australia Objectives: The purpose of this study was to explore how interprofessional simulation-based learning contributes to shaping perioperative nursing students’ professional identity. Methods: We used a qualitative and explorative design for this study. Between May and October 2019, we conducted six focus-group interviews with thirty-four perioperative nursing students from five educational institutions in Norway. Data analysis used a phenomenological hermeneutical method (Lindseth & Norberg, 2004). Results: To include students from different professionals’ educations can create challenges when organising interprofessional simulation-based learning to develop a greater understanding of their role function as a member of the interprofessional team. When organising interprofessional-simulation based learning for perioperative nursing students, there is a need for facilitators with competence in perioperative nursing to provide students with required information, and to focus on the perioperative role during debriefing. This is important to support their need for information related to their role, tasks, environment, and equipment and to be able assisting the perioperative nursing students with constructive feedback and knowledge during debriefing. The content of the simulation case needs to be relevant to perioperative nursing student’s future professional roles or tasks and to ensure this, educators from different educational professions should collaborate in organising interprofessional simulation-based learning, scenarios, helping participants to fulfil their roles and functions. Through interaction with others, perioperative nursing students can discover what is peculiar to one’s own profession and practice and what sets them apart from other professions. By evaluating themselves in this social interaction context, perioperative nursing students begin shaping their professional identity. Conclusions: It seems that interprofessional simulation-based learning creates experiences that can shape perioperative nursing student’s professional identity. It is important to organise interprofessional simulation-based learning to enable the students within the different educational professions to feel included, accepted and provide them with affiliation in the interprofessional team. OP04 Effectiveness of nurse-led preoperative assessment for anaesthesia: a prospective cohort study C. Diez Garcia1, G.S. Ignasi2,2, B.R. Ignasi2 1Hospital de la Santa Creu i Sant Pau, Area Quirurgica, Barcelona, Spain, 2Hospital de la Santa Creu i Sant Pau, Department of Clinical Epidemiology and Public Health, Barcelona, Spain Aims and objectives: To evaluate, in low-complexity surgical patients, the effectiveness of preoperative assessment carried out by nurses with anaesthetic training compared to that carried out by anaesthesiologists in terms of cancellations and inadequate surgical preparation. Background: Preoperative assessment of surgical patients is vital to identify patient’s risk factors and provide education. In some hospitals, a nurse with anaesthesia training evaluates, under supervision, patients who are candidates for lowcomplexity surgery. Design: Non-superiority prospective cohort study. Methods: One hundred and eighty-three patients were recruited who had undergone low-complexity surgery between

10th EORNA Congress Stavanger, Norway | 12 - 15 May 2022 Parallel Sessions 14 May and September 2020. Sixty-nine patients were preoperatively assessed by a nurse and 114 by an anaesthesiologist. Data collection included a questionnaire to assess patient satisfaction and knowledge acquired from the preoperative assessment. Descriptive and inferential statistics were used for data analysis. Results: Incidents causing cancellation of surgery were the same in both cohorts (3.8%, 2.6%). The incidence of poor preparation attributable to the patient was also similar in both cohorts (17.0% vs 18.4%). Patients seen by nurses valued the satisfaction with the preoperative assessment more highly than patients seen by anaesthesiologists (median 91.67 vs 84.62). In terms of Knowledge obtained from the preoperative assessment, both professionals did not show statistically significant differences in knowledge levels. Conclusions: Preoperative patient assessment performed by a nurse with anaesthesia training in low-complexity surgical patients can be as effective as that performed by an anaesthesiologist, without having an impact on surgical cancellations or patient preparation. On the day of surgery, patients who had been assessed by a nurse were more satisfied with their care during the visit and acquired similar knowledge about preoperative preparation as patients assessed by anaesthesiologists. Relevance for clinical practice: Properly trained nursing staff can perform the preoperative assessment in low-complexity surgical patients to the same standard as anaesthesiologists. Parallel session: On the path to success - A way out burnout OP05 Professional burnout of nursing staff and working groups in surgical unit M.C. Parejo-Aguilera1, M.J. Uñón-García2, I.M. Cortés-Ortega1, M.Á. Fuentes Montes1, A. Bazo-Sánchez1, C. San Juan Cristóbal1 1Gerencia de Asistencia Sanitaria de Segovia, Quirófano, Segovia, Spain, 2Gerencia de Asistencia Sanitaria de Segovia, Dirección de Enfermería, Segovia, Spain Immersed in a project on professional burnout and working groups, the COVID-19 Pandemic forced us to segregate the staff. Once the team has regrouped, we studied the evolution of their level of professional burnout and quantified the participation in working groups. Methodology: Prospective longitudinal descriptive study. We used the Maslach Burnout Inventory (MBI) questionnaire in June 2019, 2020 and 2021. Epi_ Info. 7 data processing. Diagnosis according to the values of Gilmonte and Peiró. Results: Response rates above 75%, 76% and 97.7% n 33 33 44. The group averages obtained were for Emotional Fatigue (EQ) 26.93 26.21 27.66. Levels high high high. For Depersonalisation (DP) 6,73 7,39 8,77. Levels medium medium medium. For Personal Accomplishment (PR) 33,94 36,15 35,25. High medium medium level. The number of people affected by high level of professional burnout has been for CE 60.61%. 63.64% and 68.18% for PD 30.30% 45.45%, 46.45%. For PR 54.55%, 36.36% 50.00%. 38% of those who participated and 60% of those who did not participate in working groups present a high level of professional burnout in PR Personal Accomplishment. Conclusions: Although the 2021 figures position us at high medium medium level for CE, DP and PR, we interpret that the group diagnosis is HIGH LEVEL of professional burnout as the scores have increased and less than 3 tenths is the distance to the high level in DP, PR. The number of people with high level has increased more than 8% for CE and 16% for DP compared to 2019 data. 22% of the participants in working groups have a better level of PR and 12% have a better level in CE, which suggests that working groups could reverse the observed trend and encourages us to continue promoting them in our work environment.

Stavanger, Norway | 12 - 15 May 2022 10th EORNA Congress Parallel Sessions 15 OP06 Operating room nurses’ resilience: systematic review M. Yavuz van Giersbergen1, Ö. Soyer Er2 1Ege University, Nursing Faculty, İzmir, Turkey, 2Afyonkarahisar Sağlık Bilimleri Üniversitesi, Health Sciences Faculty, Afyonkarahisar, Turkey Objectives: Resilience is an adaptive quality in the presence of adversity, contributing to independent functioning and well-being. Operating room (OR) nurses need to be resilient in order to cope with extreme demands in their workplace. The aim of this review is to examine studies investigating the resilience of operating room nurses. Methods: This study was created by using the Preferred Reporting Items for Systematic Review and Meta-Analysis - Meta Analyzer-PRISMA checklist. Medline/PUBMED, Scopus, Cochrane Library and Google Scholar were searched from electronic databases and published before August 2020. The keywords “resilience, operating room, operating room nurse and nursing” were searched in the databases in combination. After reviewing the eligibility and exclusion criteria, four studies were included. Results: It was observed that studies on resilience in operating room nurses were conducted between 2007 and 2017, and at least 41 and at most 772 operating room nurses were included in the studies. It was determined that three of the studies were quantitative and one was a quasi-experimental study. In one study, a statistically significant relationship (<.001) was found between burnout and resilience (r = -. 59, p <.001). In another study, it was stated that there is a high level of relationship between resilience and hope and self-efficacy, and a moderate relationship between coping skills, achievement and control. In a quasi-experimental study, it was observed that the effectiveness of sensory stimulation therapy was determined as an intervention to strengthen the resilience of operating room nurses. Conclusions: There are few studies examining resilience in operating room nurses. Studies show that resilience level, factors related to resilience and intervention activities performed to increase resilience in operating room nurses were determined. OP07 Mindfulness minding the minders – Introducing mindfulness to the OR T. Donnelly1, S. Boland2 1Sligo University Hospital, Sligo, Ireland, 2Sligo University Hospital, General Theatre, Sligo, Ireland Work-based stress and anxiety is unfortunately a fact of our working lives, COVID-19 has exacerbated that stress and exposed areas of weakness within teams. In order to mitigate against this a group of dedicated people including theatre nurses introduced an initiative “Mindfulness at Work’ to give our staff the resources to manage stress and build resilience. Mindfulness is the practice of paying attention to the present moment, bringing awareness to the fore without judgement or interpretation. Mindfulness based practices include breathing exercises, guided mediations and stress reduction relaxation. The benefits of mindfulness include: • Decreased stress and psychological distress in adults and employees • Enhanced mental health and functioning • Increased emotion regulation and self-control • Decreased anxiety, depression, worry, and rumination • Reduced incidence of problem drinking and symptoms associated with problem drinking. Mindful champions have been trained across all disciplines throughout the hospital. Mindfulness skills can be used by staff in their working and personal lives, and will be particularly helpful in delivering patient centred care. The theatre department currently have a number of trained mindfulness champions to include the author. They have implemented mindfulness exercises at the beginning and end of each working day. These are proving to be very beneficial in helping reduce stress in the theatre department. “When you hand good people possibility, they do great things.” Champions are trained and mentored to introduce mindfulness exercises to each handover / team meeting. There is also a weekly mindful check in. “A true champion without a cause is entrapped energy. A great cause without a champion is but an elusive dream. But with a great cause with a true champion is the realization of a vision”

10th EORNA Congress Stavanger, Norway | 12 - 15 May 2022 Parallel Sessions 16 OP08 How giraffes, monkeys and Jackals can help you being a happier and more efficient OR manager F. Delsa1, D. Veckmans2 1ULB - Free University of Brussels, Hôpital Erasme, Brussels, Belgium, 2CHU Brugmann, Brussels, Belgium NVC, mindfulness or even meditation have become popular in recent years. Those concepts offer new management skills such as authenticity, acknowledgement of emotions and the ability to let go. However, is this a sustainable way or will it soon be swept away by another more innovative model? As OR nurses, we have high standards, such as scientific rigor, quality of care and permanent formation to only name a few. Nevertheless, in the mindfulness world, we found and experienced lots of tools and tips that we would like to share with you. It will then allow you to have a more relaxed everyday practice and you would in this way become more serene and efficient. Interactively, we develop the means of giving oneself quality time even on a hectic day. We will discuss two little sentences that can help you sort out the demands quickly and efficiently, known as monkey management. Specifically in the communication field, we come back on how to give and receive feedback, especially negative feedback, how to speak as a giraffe choosing words that can build a relationship instead of destroying it. We explore how to avoid traps and bites of the jackal. We will present a 5 steps technique, which is fast and efficient. This technique will lead you to make fair decisions. At last, we finish with by 3 magic sentences to use without moderation during a crisis. Our goal is to share tools and inspiring techniques which are proven to be working and will give to each OR manager the keys to achieve an even deeper well-being and personal blossom at work. “I treat as I am” Parallel session: Online and practical tools to enhance students´ learning OP09 Operating room nursing lecture during COVID-19 pandemic: two years’ experience M. Yavuz van Giersbergen1, A. Çankaya2, Z. Aykut1 1Ege University, Nursing Faculty, İzmir, Turkey, 2Firat University, Health Sciences Faculty, Elazig, Turkey Introduction: During COVID pandemic all education systems started online education. 2019- 2020 and 2020-2021 Spring term second year nursing students have a selective course operating room nursing course. When the pandemic started classes also continued online. Online classes have many applications and university systems. These applications are already using all students. Objectives: This study was aimed to determine the opinions of nursing students about the usage of YouTube in content of operating room nursing lectures and using WhatsApp application for communications. Methods: A descriptive study was conducted with 2019- 2020 semester 53, 2020-2021 term 75 second grade nursing students. Videos related to the topics found by the students were shared over the WhatsApp group and were presented in the lesson when their suitability was approved by the educator. The data were collected with an online survey. Questions asked on a 1-10 rating scale obtained students’ opinions. Data were analysed by number percentage, mean and standard deviation. Results: 2019- 2020 term the nursing students stated that the integration of YouTube videos were 7.4 points. The students were given 7, 4 point online classes done via cellular telephone with WhatsApp application. 2020-2021 term the effect of integrating course content with video on their understanding of the subject is 7.99±1.9; The level of satisfaction with the “Video” application in the course content was 7.81±1.80; The contribution of the videos to their education is 7.80±2.0; The effect of using “Video” in the lesson on learning levels 7.71±1.8; points were found. Conclusions: Active participation of students can be ensured with video presentations in order to support the course content in nursing education, enrich the learning environment, and provide targeted information.