10th EORNA Congress Stavanger, Norway | 12 - 15 May 2022 Round Table Sessions 26 RT03 Re-traumatization of torture survivors under somatic healthcare generally and specifically under surgical care A.C. S. P. Schippert1, E.K. Grov1, A.K. Bjørnnes1 1OsloMet, Oslo, Norway To achieve a successful and meaningful clinical interaction with torture survivors during surgical care and to prevent re-traumatization, it is important to build trust, to maintain confidentiality, and to show empathy. An important factor preventing re-traumatization in departments as operating theatre is to increase awareness about re-traumatization of torture survivors among health professionals as well as identification of triggers. Health care professionals at surgical departments must be familiar with potential challenges giving torture survivors quality healthcare and to adapt standard treatments with increased focus on safety and protection of patients who have been victims of torture. A systematization of literature summarizing the patients’ experiences may be a start to improve awareness around the topic and to implement necessary improvement of surgical routines to prevent re-traumatization. Method: In this systematic review we included qualitative studies including refugees, asylum seekers and war survivors who have experienced torture and have received treatment in somatic departments. We included studies that used qualitative methods for data collection (participant observations, in-depth Interviews, focus groups, and case reports) and qualitative methods for data analysis (thematic analysis, grounded theory and framework analysis). We also included studies using mixed methods if the findings were of a qualitative nature and were fully explained. Phenomenon of interest: We assessed experiences of survivors of torture receiving somatic health care in different contexts like hospitals, operating theatres, health care centres, emergency departments, intensive care departments and polyclinics. We focused on experiences of re-traumatization. Conclusion: This systematic review included eight studies summarizing healthcare experiences from 290 participants. The findings show that torture survivors experienced challenges receiving somatic healthcare. The results suggest that retraumatization can occur under treatment in somatic departments. Keywords: Refugees, asylum seekers, torture survivors, somatic, surgical care, re-traumatization RT04 Patient safety during joint replacement surgery: experiences of operating room nurses A. Nyberg1,2, B. Olofsson1,3, V. Otten3, M. Haney4, A.-M. Fagerdahl5 1Umeå University, Faculty of Medicine, Department of Nursing, Umeå, Sweden, 2Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Umeå, Sweden, 3Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopedics, Umeå, Sweden, 4Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anesthesiology, Umeå, Sweden, 5Karolinska Institutet, Department of Clinical Research and Education, Södersjukhuset, Stockholm, Sweden Background: Avoidable complications for surgical patients still occur despite efforts to improve patient safety processes in operating rooms. Analysis of experiences of operating room nurses can contribute to better understanding of perioperative processes and flow, and why avoidable complications still occur. Objectives: To explore aspects of patient safety practice during joint replacement surgery through assessment of operating room nurse experiences. Method: A qualitative design using semi-structured interviews with 21 operating room nurses currently involved in joint replacement surgery at three different hospitals in Sweden: one university hospital, one public general hospital, and one private orthopaedic hospital. Inductive qualitative content analysis was used. Results: The operating room nurses described experiences with patient safety hazards on an organisational, team, and individual level. Uncertainties concerning a reliable plan for the procedure and functional reporting, as well as documentation practices, were identified as important. Teamwork and collaboration were described as crucial at the team level, including being respected as valuable, having shared goals, and common expectations. On the individual level, professional knowledge, skills and experience were needed to make corrective steps. Conclusion: The conditions to support patient safety, or limit complication risk, during joint replacement surgery continue to be at times inconsistent, and require steady performance attention. Operating room nurses make adjustments to help solve problems as they arise, where there are obvious risks for patient complications. The organisational patient safety management process still seems to allow deviation from established practice standards at times, and relies on individualbased corrective measures at the ‘bedside’ at times for good results.
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