EORNA2024_Abstract Book

1 #EORNA2024 www.eorna-congress.eu ABSTRACT BOOK 11th EORNA CONGRESS LIGHTS OF HOPE 16 - 18 May 2024 | Valencia, Spain

11th EORNA Congress Valencia, Spain | 16 - 18 May 2024 2 Content Priority Sessions 3 Symposia 5 Parallel Sessions 11 Round Table Sessions 24 Clinical Case Studies 29 ePosters Guided View 31 ePosters 43 We are very grateful for the valuable and hard work of all our reviewers in ensuring that abstracts are compliant with EORNA guidelines and themes. A special thank you to all of you: Maria Loureiro Cathrine Heen Dimitrios Poulis Filiz Ogce Manuel Jose Gião Valente Marin Repustic Toni Haapa

Valencia, Spain | 16 - 18 May 2024 11th EORNA Congress Priority Sessions 3 Priority Sessions 152 Skills Management for New Nurses in the OR: When MYORCO Becomes An Essential Tool! Christine Willems1 1Haute Ecole Léonard de Vinci, Perioperative care, Bruxelles, Belgium Background: In Europe, the education of nurses in perioperative care is diverse and, in some countries, not mandatory to work in the OR. Objectives: I will present MYORCO tool as a possibility to facilitate the integration of new nurses in the staff. Methods: MYORCO is a European Erasmus Partnership project. The aim of our project was to create a website with online tools for the skills management of new OR nurses and students. It was created, tested and experimented in 5 European countries: Sweden, Finland, Czech Republic, Greece, France and Belgium. It was developed in English and translated in French, Swedish, Finish, Czech and Greek languages. Results: MYORCO was developed around the basic practices in the OR for the new OR nurses and students. It offers a wide range of training videos. These short videos show the correct and safe ergonomics of instrumentation and explain the use of some basic equipment the OR nurses regularly use during surgical procedures. A second part is the instruments library with around 150 pictures of instruments presented with their context of use. The results are visual and educational tools that can be used easily in the field of training and evaluation. This tool is very useful for OR head nurses to plan and manage the competencies of their team, and for new nurses to self-assess their progress in acquiring the required competencies. Conclusion: I will present a power point on the MYORCO tool with print screens. It will give a visual idea of the benefit of using these tools to facilitate the self-learning of the students and the new nurses in the OR. 258 Is the WHO Surgical Safety Check List effective? A Meta-analysis. Fabio Ferraiuolo1, Angelo Dante1, Vittorio Masotta1, Alessia Marcotullio1, Luca Bertocchi1, Cristina Petrucci1, Loreto Lancia1 1University of L’Aquila, Department of Health, Life, and Environmental Sciences, L’Aquila, Italy Background: Every year, millions of individuals die within 30 days following surgical procedures and nearly one-fifth of individuals undergoing surgical procedures experience complications. The WHO Safety Surgery Checklist (SSCL) appears to have the potential to enhance surgical safety and quality across all surgical settings. However, there is still limited understanding of the overall impact of implementing the SSCL on clinical and organizational outcomes. Objectives: To value the impact of SSCL on clinical and organization outcomes. Methods: An extensive systematic review and meta-analyses were conducted following the relevant criteria outlined in the ‘Cochrane Handbook for Systematic Reviews of Interventions’. In order to ensure a high level of reliability of study results, the literature search, study inclusion, and data extraction processes were independently conducted by two researchers, and any evaluation conflicts were resolved by a third researcher. Results: A total of 2,776 records were retrieved, and after removing duplicates, 1,571 were assessed for eligibility. Sixty-five manuscripts met the criteria for inclusion, and ultimately, 35 studies were included in the review. Of these, 16 studies were suitable for meta-analysis. The meta-analytic synthesis was feasible for ‘mortality within 30 days’ as well as sixteen other surgical complications. Findings highlighted the protective role of SSCL in reducing mortality rates, instances of deep vein thrombosis, surgical site infections, and unplanned returns to the operating room. Nevertheless, while these results are promising, further confirmation is required for positive outcomes on other outcomes. An exploration of the reasons for heterogeneity among the included studies was also conducted and presented. Conclusion: This systematic review has confirmed the importance of the SSCL in ensuring patients’ safety and informs healthcare managers about the rationale for implementing organizational review aimed at improving SSCL implementation.

11th EORNA Congress Valencia, Spain | 16 - 18 May 2024 Priority Sessions 4 255 Determination of Individual Innovation Characteristics of Operating Room Nurses Nurgül Arpag1 2, Sevgi Gür3, Hamdiye Banu Katran4 1Istanbul Atlas University Faculty of Health Sciences, Faculty of Nursing, Turkey, 2Istanbul Atlas University Faculty of Health Sciences, Department of Nursing, Turkey, 3Selçuk University Faculty of Nursing, Department of Surgical Nursing, Turkey, 4Marmara University Faculty of Health Sciences, Department of Surgical Nursing, Turkey Background: Operating rooms appear as service areas where innovative approaches are most needed with the effect of rapidly developing technology. The nurses, who work in operating rooms where many biomedical devices and sensitive instruments are used and are constantly changing with the developments in technology, need to lead in terms of individual innovative features and adapt quickly to change. Objectives: The study was conducted to determine the individual innovativeness of the operating room nurses and the individual factors affecting them. Methods: A descriptive and cross-sectional study was conducted between 15 November and 31 December 2021 with the participation of 153 operating room nurses in the province of Istanbul. “Individual Innovation scale (IIS)” and “Descriptive Information Form” were used as data collection tools. The snowball sampling technique, one of the nonprobability sampling methods was used. Results: The operating room nurses’ total IIS score was 68.7±7.7, while their opinion leadership, resistance to change, and risk-taking subscale scores were 28.4±3.4, 23.2±5.5, 17.1±1.8 respectively. It was determined that gender, marital status, education level, years of experience in the operating room, surgical department, and institution characteristics affected individual innovativeness characteristics. Conclusion: It has been determined that the individual innovativeness of the operating room nurses is mostly in the inquiring category, women are more open to change than men, men and those with more than ten years of experience are perceived as more opinion leaders, and married people are perceived as both more open to change and opinion leaders. It was found that as the level of education and years of experience increased, the innovativeness level was positively affected, while the risk-taking feature decreased. Conducting the research with including different geography and cultures; it can obtain important information about identifying and supporting the innovative characteristics of operating room nurses.

5 Valencia, Spain | 16 - 18 May 2024 11th EORNA Congress Symposia Symposium 1: Education 148 Perioperative nurses’ development of professional competence from interprofessional simulationbased learning to meet acute clinical practice situations. Hege Kristin Aslaksen Kaldheim1, Judy Munday1 2, Johan Creutzfeldt3, Mariann Fossum1 1University of Agder - Grimstad Campus, Department of Health and Nursing Science, Grimstad, Norway, 2QUT Kelvin Grove Campus, School of Nursing/Centre for Health Transformation, Kelvin Grove, Australia, 3Karolinska Institutet Clintec, Department of Clinical Science, Intervention and Technology, Stockholm, Sweden Background: Perioperative nurses require professional education (1) to ensure high-quality perioperative care and patient safety in acute situations. Interprofessional simulation-based learning exposes perioperative nursing students to acute situations in a safe environment without the risk of harming the patient and can prepare them for clinical practice (2). There is a need for studies about perioperative students’ professional development (3) and how interprofessional simulation-based learning influences future practice (4). Objectives: This study explored recently graduated perioperative nurses’ experiences of interprofessional simulationbased learning during their education and their development of professional competence to meet acute situations after graduation. Methods: We utilised a qualitative and explorative design. Between March 2019 and November 2020, sixteen semistructured individual interviews were conducted with perioperative nurses three to five months after they graduated from five different educational institutions in Norway. Data analysis applied a phenomenological hermeneutical method (5). Results: Perioperative nurses reported they experienced the development of competency in handling acute situations (e.g., prioritising, working in stressful situations) and contingency planning. They also expanded their interprofessional communication and collaboration competence as they experienced the value of clear communication, repetitive messages, and conciseness. Being in an interprofessional context created an awareness of their dependence on each other and an understanding of team dynamics. This enabled them to meet acute situations with insight and preparedness as recently graduated. Self-confidence developed through increased competence and mastery resulted in a belief that they would handle (future) acute situations. Professional identity was developed in conjunction with a rise in self-confidence as they became more aware of their professional role and the sense of belonging to their future profession. Conclusion: Participating in interprofessional simulation-based learning during education developed essential competencies for dealing with acute situations, supported incipient professional identity and strengthened their courage to speak up in interprofessional teams as recent graduates. 178 Undergraduate Student Nurses learning Experiences in the Perioperative setting Claire Mc Namara1, Brid O Brien1, Pauline O Reilly1 1University of Limerick, Nursing and Midwifery, Castletroy, Ireland Background: The perioperative setting presents a unique environment that involves varied demands i.e., clinical care undertaken by multidisciplinary teams, use of sophisticated technologies, skills in maintaining safety and minimising risk for the surgical patient. Currently, in Ireland, undergraduate student nurses spend clinical placement time in the perioperative department. Here students get an opportunity to be involved in the preoperative, intraoperative, and immediate postoperative care of the surgical patient. To date, little research has been undertaken to establish students’ learning experiences in this area. Objectives: To explore the evidence on the experiences of undergraduate student nurses within the perioperative learning environment. Methods: Using an integrative systematic review approach studies published between 2012 and 2022 were identified via a comprehensive search of eight databases. The databases included CINAHL, Medline (OVID), Medline (PubMed), Medline (EBSCO), EMBASE, PsycINFO, ISI Web of Science and SCOPUS. This review utilised the Preferred Reporting for Systematic Reviews and Meta-Analysis (PRISMA) to report results. Following the screening process 17 articles were identified that met the inclusion criteria. Papers were appraised using the Critical Appraisal Skills Programme (CASP). Narrative synthesis was utilised to synthesise the results.

6 11th EORNA Congress Valencia, Spain | 16 - 18 May 2024 Symposia Results: Three categories were identified: ‘Learning opportunities’ which included theoretical knowledge, psychomotor skills and values and attitudes. ‘Appreciation for perioperative role and intent to return’, and ‘Factors influencing student learning’ included factors promoting and prohibiting acquisition of knowledge, skills, and values. Conclusion: Numerous opportunities for student learning occurs within the perioperative setting. Students perceived senior nurses as role models to aspire to in this pressurised and varied setting. The complexities and uniqueness of the perioperative setting poses opportunities and challenges for student learning. Students who are not accustomed to this environment require more support to help achieve increased learning opportunities. Symposium 2: Healthy Workplaces & Leadership 190 Ergonomic risk factors and musculoskeletal system problems in healthcare professionals working in central sterilization unit Doğan Beysİr1, Esra Eren2 1Kütahya, central sterilization unit, Turkey, 2Istanbul Medipol University South Campus, Turkey Background: Healthcare professionals face environmental, psychological, chemical, biological, ergonomic, and physical risks arising from their work environment. Central sterilization units, which are usually located on the lower floors of hospitals, are special working areas that host many risks in this context. The lack of appropriate ergonomic structure of the central sterilization unit significantly affects the health of health professionals. Objectives: This descriptive study was conducted to determine the ergonomic risk factors and musculoskeletal problems of healthcare professionals working in central sterilization units. Methods: The population and sample of the study consisted of 87 healthcare professionals working in the central sterilization unit of seven hospitals of a private healthcare group in Istanbul. The data were collected using the sociodemographic characteristics form, Ergonomic Risk Factors and Musculoskeletal Disorders Scale (ERFMDS) and Cornell Musculoskeletal Disorders Questionnaire (CMDQ) between February and September 2020. The data were evaluated with SPSS. The significance level was determined as p<0.05 in all analyzes. Results: According to the findings, the health professionals were between the ages of 18-25 years (34.5%), male (51.7%), undergraduate graduates (52.9%), nurses (74.7%), and their experience in the central sterilization unit was 1-5 years (65.5%). The mean ERFMDS total score was 119.39 and the mean CMDQ score was 77.62. Significant differences were found between ERFMDS physical environment, performance efficiency sub-dimensions and some sociodemographic characteristics, and the sub-dimensions showed a significant positive relationship with each other. Significant differences were determined between CMDQ mean scores according to age, gender, body mass index, educational status, occupation and professional experience. Conclusion: It is recommended to create a safe and comfortable working environment for healthcare professionals in the Central Sterilization Unit, to take necessary precautions by determining ergonomic risk factors, and to give importance to the ergonomic design of the areas so that healthcare professionals do not experience musculoskeletal disorders. 301 Surgical Smoke Hazards in the Operating Theater. A survey on perioperative nurses perceptions in Northern Greece Hospitals Iordanis Stefanidis1, Anastasia Ntavrani2, Ioannis Koutelekos3, Konstantinos Karakostas4 1General Hospital of Thessaloniki “Ippokrateio”, Operating Theater, Thessaloniki, Greece, 2AHEPA Hospital, Θεσσαλονίκη, Greece, 3University of West Attica, Egaleo, Greece, 4Thriasio General Hospital of Elefsina, Magoula, Greece Background: Surgical smoke is produced when energy generating devices such as diathermy, lasers and ultrasonic surgical systems are used for cutting and coagulation of tissue during surgical procedures. Surgical smoke plume is considered a serious threat to the health of operating room personnel and patient safety may be compromised if plume is not properly captured and removed. Surgical smoke contains carbon, aerosolized blood and blood borne pathogens,

7 Valencia, Spain | 16 - 18 May 2024 11th EORNA Congress Symposia bacteria and a range of volatile organic compounds and gases. Viruses, including HIV, HPV and Hepatitis B are known to be present in plume and can be transmitted. Objectives: The aim of this study was to determine the perceptions, attitude and preventive practice among perioperative nurses toward surgical smoke hazards. Methods: A quantitative survey was conducted at hospitals of Thessaloniki in July 2023. A Questionnaire consisting of Likert Scale Multiple Choice Questions was used to collect data regarding Surgical Smoke. The statistical package SPSS version 27 was implemented for the statistical processing. Frequency tables and bar plots of percentages, oneway analysis of variance (ANOVA) test and independent samples for equality of means test (t-test) were the statistical techniques used. The sample size of this research included 201 perioperative nurses. Results: From the responses in 5 hospitals, it is concluded that there is 9% - 50% equipment of surgical smoke evacuation in operating theatres. Between 29% and 46% of perioperative nurses do not know about the existence of equipment of surgical smoke evacuation. Only 11% of operating room nurses are aware of a local policy for surgical smoke management being in place within their organization. Conclusion: Lack of effective management strategies, shortage of evacuation equipment and perioperative nurses unawareness of the existence of surgical smoke evacuation devices are some of the findings that cause barriers to the implementation and use of plume evacuation devices Symposium 3: Perioperative / Clinical practice 140 Presence in the cold room Johanne Søborg Hartmann1 1Rigshospitalet, 3043, København, Denmark Background: The first imprint with the perioperative nurse is important for the way patients feel in the operating room. The perioperative field is a highly technical and complex environment, where focus is on specialization and productivity. In this special room the patient might feel anxious and alien. The perioperative nurse has a special role keeping the patients’ needs in mind while mastering the complexities of the operating room. Objectives: The purpose of this study was to investigate perioperative nurses’ experiences with presence in the patient encounter. Methods: To explore this, an explorative qualitative investigation comprising individual interviews with 10 perioperative nurses were applied. The philosophy of Merleau-Ponty was used as a theoretical starting point and a hermeneutic methodology as a qualitative frame. Results: Seven themes’ findings illuminated how presence has value, especially when patients experiences anxiety, or during complex and acute procedures. Presence requires nurses to be open towards perception, and to be able to balance between intimacy and distance in order to respect the patients’ different ways of managing feelings of loss of control. The themes were: ‘Offering touch as a sense of care’, ‘Opening a conversation’, ‘Daring to be in the moment’, ‘Feeling a time pressure’, ‘Focusing on technical skills’, ‘Being part of a team’ and ‘Creating habits’. Conclusion: The experience of presence is challenged by a task-centered care, which focusses on efficiency, productivity, specialization and technology. Improving practice requires change towards a more patient-centred care, both within the team in the operating room, and on a larger scale in how the healthcare system is organized.

8 11th EORNA Congress Valencia, Spain | 16 - 18 May 2024 Symposia 225 Set-up of surgical instruments during emergency Cesarean section. Advantages and disadvantages of using a standardized set-up of the Mayo stand from the surgical nurse’s perspective. Linn Terese Ourom1, Bodil Ane Helland2, Brynhildur Gudmundsdottir2 1University of Agder, Department of Health and Nursing Science, kristiansand, 2University of Agder, Department of Health and Nursing Science, Norway Background: Surgical nurses have responsibility for the instruments during surgery. Losing control of the instruments can have negative consequences for the patient and the surgical team. Some hospitals use a standardized set-up of the Mayo stand for surgeries, including Cesarean Section. Purpose: To examine the surgical nurses’ experiences and attitudes regarding using a standardized set-up of the Mayo stand during emergency Cesarean section. Research question: What are the advantages and disadvantages of using a standardized set-up of the Mayo stand during emergency Cesarean section? Methods: We collected data through qualitative, semi-structured, in-depth interviews with 12 surgical nurses. Data was analyzed using Malterud’s systematic text condensation. Results: The analysis revealed 4 result categories and 12 subcategories. The most important thing for the participants was to keep control of the instruments. Standardized set-up proved most useful for the inexperienced surgical nurses, in acute situations, in cooperation with gynecologists and during concurrency conflicts. Some disadvantages emerged, such as that the implementation can be challenging, especially for the experienced and a standard does not suit all ergonomic needs and situations. Some disagreed whether individual adaptations to the set-up were an advantage or a disadvantage. They emphasized that a standardized set-up must never replace a counting control. Conclusion: Ideally, a standardized set-up can ensure the quality of optimal collaboration and make surgical nurses feel safe, regardless of experience. However, using a standard is not necessarily the best in all situations and can be challenging, especially during implementation. 318 The Effect of Virtual Reality Glasses Used During Colonoscopy on Vital Signs, Pain and Anxiety Level: A Study Protocol for Randomized Controlled Trial Esra KILINÇ AKMAN1, Ayfer Özbaş2 1Halic University Faculty of Health Sciences, Nursing, Istanbul, Turkey, 2Demiroğlu Bilim University Florence Nightingale Hospital School of Nursing, Istanbul, Turkey Background: Colonoscopy is a screening method used for screening, diagnosis, treatment and monitoring of colorectal and anal canal pathologies. Because it is an invasive and painful procedure, it causes psychological and physiological changes in the patient such as tension, irritability, increased blood pressure and pulse. Nurses are responsible for pain management by using pharmacological and non-pharmacological methods before, during and after the intervention in people who are exposed to painful procedures. Although distraction is one of the non-pharmacological methods, virtual reality glasses are a frequently used device in this context. Objectives: To determine the effect of virtual reality glasses used during colonoscopy on vital signs, pain and anxiety levels. Methods: The study was planned with 60 patients (experiment group:30, control group:30) in a pretest-posttest, randomized controlled experimental design. The study was carried out in the endoscopy unit of a hospital in Istanbul between September 2020 and September 2021. Data were collected with Descriptive Information Form, State-Trait Anxiety Scale, Visual Comparison Scale-Pain, Vital Signs Follow-up Form, and Satisfaction Form. Conclusion: As a result, it was found that there was a statistically significant difference between the experimental group and the control group after the procedure in terms of heart rate, anxiety and pain scores during the procedure in terms of vital signs of the virtual reality glasses used during the colonoscopy procedure. The use of virtual reality glasses is an effective non-pharmacological method to distract attention during painful and invasive procedures.

9 Valencia, Spain | 16 - 18 May 2024 11th EORNA Congress Symposia Symposium 4: Patient safety 328 The Retained Surgical Items Risk Assessment Scale: Development and Psychometric Characteristics Hamide Nur Erkan1, Özlem Soyer Er2 3 1Afyonkarahisar State Hospital, Infection Control, Afyonkarahisar, Turkey, 2Afyonkarahisar Health Sciences University, Surgical Nursing Department, Afyonkarahisar, Turkey, 3Afyonkarahisar Health Sciences University, Surgical Nursing Department, Afyonkarahisar Background: The retained surgical items is a serious patient safety problem, especially for patients undergoing surgery. Objectives: The aim of this study was to develop the Retained Surgical Items Risk Assessment Scale and examined its psychometric properties. Methods: Methodological design.The research was carried out with 270 patients who underwent surgery in a university hospital. The data of the study were collected with the Sociodemographic and Clinical Characteristics Form, Operating Room Count Control Form and the Retained Surgical Items Risk Assessment Scale developed. In the analysis of the data, Content Validity Index (CVI), Cronbach α, item-total score correlation, Kuder-Richardson, Cohen Kappa, exploratory and confirmatory factor analysis, and Recevier Operating Characteristic (ROC) curve analysis were performed. Results: The CVI of the scale was found to be 0.92. Cohen Kappa value was found to be 0.993. The variance explained in the exploratory factor analysis of the scale is 50.03%. After confirmatory factor analysis, two factors were obtained for the final version of 15 items. Factors has been determined as “Count and Surgery” and “Equipment”. Among the subdimensions of the scale, Cronbach’s α values were between 0.742 and 0.760, and 0.722 for the whole scale. When the ROC analysis results were examined, the cut-off point was ≥ 8 points, the specificity was 93.13%, and the sensitivity was 87.50%. The area under the ROC curve (AUC) was calculated as 0.938. Conclusions: The scale was presented as a valid and reliable measurement tool developed to assess the risk of retained surgical items in operating rooms. 208 Hospital self-evaluation to detect room for improvement in perioperative patient safety, a European multicenter study Anita Heideveld-Chevalking1, Ana Rodriguez2, Paula Perez Caballero3, María José Felip Llácer3, Yvette Emond1, Hiske Calsbeek1, Kaja Polluste4, Adam Žaludek5, Paulo Sousa6, Daniel Arnal7, Marieke Voshaar8, Claudia Valli2, Henriette SmitNanninga9, Hans Boer, de9, Marion Kolk, van der10, Jan Hofland10, Sjoukje Vet, de-Kersten10, Nuno Diogo11, Maria José Maia11, Ana Azevedo12, Ayshe Seyfulayeva11, Sara Rodrigues12, Elsa Guimarães12, Laura Bruno13, Mónica Millan Scheiding13, Rodrígo Molina14, Laura Vidaurreta14, Liis Jaanimäe15, Maret Laheveer15, Olav Tammik16, Kristina Lillemets15, Helena Mcmenamin17, Lucie Kubátová17, Michal Ondica17, Jan Frühauf17, Blanka Hošková18, Martina Landová18, Carola Orrego2 1Radboud University Medical Center, Nijmegen, Netherlands, 2Fundación Avedis Donabedian, Barcelona, Spain, 3La Fe University and Hospital, València, Spain, 4University of Tartu, Tartu, Estonia, 53rd Faculty of Medicine, Czech Republic, 6University of Lisbon, Lisboa, Portugal, 7Hospital Universitario Fundación Alcorcón, Alcorcón, Spain, 8NIVEL Netherlands Institute for Health Services Research, Utrecht, Netherlands, 9SAFEST hospital group: Martini Hospital, Groningen, Netherlands, 10SAFEST hospital group: Radboud University Medical Center, Nijmegen, Netherlands, 11SAFEST hospital group: Centro Hospitalar Universitário Lisboa Central, Lisbon, Spain, 12SAFEST hospital group: Centro Hospitalar Universitário de São João, Porto, Portugal, 13SAFEST hospital group: Hospital Universitari i Politècnic La Fe, Valencia, Spain, 14SAFEST hospital group: Hospital Universitario Fundación Alcorcón, Madrid, Spain, 15SAFEST hospital group: Tartu University Hospital, Tartu, Estonia, 16SAFEST hospital group: North Estonia Medical Centre, Tallinn, Estonia, 17SAFEST hospital group: University Hospital Prague, Prague, Czech Republic, 18SAFEST hospital group: Hořovice Hospital, Hořovice, Czech Republic Background: In Europe, 8%-12% of patients admitted to hospitals experience adverse events; perioperative care is one of the most reported fields. Adverse events lead to patient complications and increased costs, highlighting the need for continuous improvement. Objectives: This study is part of international research ‘Improving quality and patient SAFEty through STandardisation and harmonisation of perioperative care in Europe (SAFEST)’, funded by the European Union’s Horizon Europe research

10 11th EORNA Congress Valencia, Spain | 16 - 18 May 2024 Symposia and innovation programme grant agreement No 101057825. The objectives are to: • Carry out a self-evaluation and compare compliance with the SAFEST Perioperative Patient Safety Standardized Practices across ten hospitals in five countries: Spain, The Netherlands, Portugal, Estonia and Czech-Republic. • Gain insight and raise awareness for patient safety in the entire perioperative care. Methods: First, multi-professional implementation teams were established in each participating hospital. These teams conduct a guided self-evaluation through team review, document review, patient interviews, medical-record review and observation. A total of 154 measurable elements (extracted from 101 recommendations resulting from an extensive Delphi-procedure) are assessed covering a wide range of perioperative safety aspects, e.g. preoperative evaluation and complication prevention. Patient research partners and representatives were actively involved, e.g. in formulating the recommendations and (preparing) the patient interviews. The self-evaluation tool includes an online scoring system, using a 3-point scale ranging from poorly, partially, to fully implemented (0,5,10 points respectively). Finally, the scores between the participating hospitals are compared. Results: The results from the self-evaluation will be presented, covering the variation between hospitals and improvement areas. Experiences with the feasibility of the tool will also be shared. Conclusion: The SAFEST self-evaluation tool provides a broad structured insight into the extent of implementation of the defined safety standards for surgical care. Results are widely supported from a multi-professional point of view, including patient representatives, which can be used for benchmarking, learning and knowledge-sharing. 116 Real-time monitoring of fluorescent bioparticles - an alternative to traditional CFU measurements regarding air quality in operating theatres Lise-Lott Larsson1 1, Johan Nordenadler1, Mattsson Janet1, Gunilla Björling1, Harald Brismar1 1Stockholm, Karolinska Institutet, Stockholm, Sweden Background: Microbiological cleanliness of the air is crucial for infection-sensitive procedures as there is a risk of airborne bacteria-carrying particles contaminating surgical wounds or surgical instruments. The standard method for controlling air cleanliness during surgeries is the measurement of bacterial presence per volume unit of air - Colony Forming Units (CFU/m3). The analysis gives answers no earlier than 5 days after sampling. A new method is real time measurement of fluorescent bioparticles per unit volume of air (FBP/dm3), which could constitute a surrogate measure for the presence of bacteria in the air. Objectives: To validate the measuring instrument Bio Aerosol Monitoring System (BAMS), by comparing simultaneous measurements of FBP/dm3 with CFU/m3. Methods: 15 arthroplasty surgeries were performed in two modern operating theatres with mixed ventilation (approx. 49 air changes per hour). A traditional air sampler (Sartorius MD8 Air Sampler) and a BAMS were placed next to each other about 3 meters from the operating table. Six parallel 10 - minute measurements were performed per surgery. Only particles larger than 3 µm were analysed. The measurement pairs were plotted with FBP/dm3 on the x-axis and CFU/m3 on the y-axis. Simple linear regression was performed and r2 was calculated as a measure of the ratio of FBP/dm3 to CFU/m3. Results: The mean value of FBP/dm3 and CFU/m3 during individual 10-minute measurements showed moderate correlation (r2=0.36, ci 0.04-0.67). The mean value of FBP/dm3 per operation and mean of CFU/m3 per operation showed strong correlation (r2=0.72, ci 0.52-0.92). Conclusion: Analysis of fluorescent bioparticles during surgery is an opportunity to estimate air quality in the operating theatres in real time. The method gives a good estimate of what simultaneous CFU measurement had shown, but has the advantage of being faster, simpler and cheaper to perform. Controlling air cleanliness during infection-sensitive surgeries increases patient safety.

Valencia, Spain | 16 - 18 May 2024 11th EORNA Congress Parallel Sessions 11 Parallel Session 1: Evaluation of clinical practices in the context of perioperative nursing 198 Could trauma and orthopaedic surgeons in the East of England region use their SCPs better? An assessment of the utilization of this resource DARYL ANTHONY DY TAN1 1Norfolk and Norwich University Hospitals NHS Foundation Trust, Trauma and Orthopaedic Department, Norwich, United Kingdom Background: Surgical Care Practitioners (SCPs), a now established role within the UK extended surgical team, are considered fundamental to addressing the post pandemic waiting list crisis in the National Health Service (NHS). Anecdotal evidence suggests that there are considerable variations in the utilization of the role. This study describes SCPs in trauma and orthopaedics (T&O) in the East of England. Objectives: To investigate the job plans and clinical utilization of SCPs working in Trauma and Orthopaedics in the region. Methods: A quantitative descriptive cross-sectional survey was undertaken. Respondents were recruited through nonprobability purposive sampling. Online self-completion questionnaires were administered, through gatekeepers, over a four-week period. Descriptive statistics was used to analyse the data. Ethical approval was granted by the Faculty Research Ethics Panel of Anglia Ruskin University. Results: A response rate of 87% was achieved. The survey assessed the job plans of T&O SCPs based on the different aspects of the surgical pathway. It revealed considerable variation in practice with some practitioners working in a more advanced capacity while others remain limited in their scope. Of the SCPs involved in supporting outpatient clinics, a majority perform clinical examination (82.4%), patient history taking (70.6%), and request investigations (70.6%). Whereas the more advanced roles of independently formulating diagnoses then instigating treatment and performing minor therapeutic procedures in clinic were limited to a smaller number, 58.8% and 47.1% respectively. Similarly, in theatres, SCPs are primarily utilized as first assistants providing interventional surgical assistance, however, an elite group (10%) undertake minor operations without direct consultant supervision. Conclusion: This research demonstrates the variation in SCP practice. A significant number of practitioners appear to be underutilized. It is hoped that the dissemination of these findings will encourage much greater use of this valuable resource in NHS trusts thus capitalizing on the full benefits of the role. 220 Enhancing Learning Opportunities within the Operating Room with the use of the Scrub Practitioner’s List of Intraoperative Non-Technical Skills Emily Puddicombe1 1Krembil Nursing Awards, Toronto Western Hospital, University Health Network, Operating Room, Toronto, Canada Background: The operating room (OR) is a fast-paced environment that many healthcare workers feel privileged to work in. However, this environment can become overwhelming to novice nurses who have not had the opportunity to immerse themselves in the OR prior to beginning to work in one. As a result of attempting to keep up with the OR pace while absorbing various new skills, novice nurses sometimes find it difficult to determine what skills to focus on. In fact, it is not uncommon for novice nurses to devote more attention to technical skills, such as instrument passing, and forget about the equally important non-technical skills, such as communication. Objectives: After identifying this learning gap, we decided to trial the use of a tool developed by nurses, surgeons, anesthesiologists, and psychologists called the Scrub Practitioners List of Non-Technical Skills (SPLINTS), to help novice nurses identify how to improve non-technical skills within the OR. We trialed this tool on preceptees and their preceptors to assess whether it would be useful for preceptees to improve their learning and subsequent practice. We combined this with trialing debrief time outside of the OR between preceptors and preceptees. We provided preceptees and their preceptors with entry and exit surveys to assess the efficacy of the SPLINTS tool and debrief time. Main Findings: Our results demonstrated that preceptees and preceptors found this tool and debrief time useful in improving their non-technical skills within the OR. Furthermore, preceptors found this tool and debrief time enhanced

11th EORNA Congress Valencia, Spain | 16 - 18 May 2024 Parallel Sessions 12 their ability to provide meaningful feedback within the OR. Conclusion: The use of the SPLINTS tool within the OR should be considered as a valuable tool while training novice nurses to improve their non-technical skills and overall learning. Additionally, this tool would be a valuable teaching resource for preceptors to use within the OR. 237 Evaluation of the effect of wearable educational materials on anxiety, adjustment and self-efficacy levels on individuals with stoma care Hacer Akbayrak1 1, Yasemin Uslu2 1Acıbadem Health Group Altunizade Hospital, Nursing Department, Turkey, 2Istanbul University, Nursing Faculty Surgical Nursing Department, istanbul, Turkey Background: Patients need to acquire the necessary knowledge and skills to ensure their stoma adaptation and selfefficacy. This learning process is based on the nurse’s practical experience and teaching methods. Objectives: The study was conducted to determine the effect of wearable educational materials in stoma care training in patients with colostomy/ileostomy on patients’ anxiety at the time of stoma care, postoperative stoma adjustment and self-efficacy level. Methods: The study was conducted in a randomized controlled design. The study was conducted in two hospitals in Istanbul between 2021 and 2023. A total of 78 patients were included in the study, 33 in the experimental group (wearable educational materials) and 37 in the control group (routine training model). Data were collected with the ‘Stoma SelfEfficacy Scale’, ‘Ostomy Adjustment Inventory’ and ‘State Anxiety Inventory’. Patients’ self-efficacy and adjustment levels were assessed at discharge and at the third and sixth weeks after discharge. Results: The mean age of the patients was 53.51±16.03 years, 50% were male, 64.3% were diagnosed with colorectal cancer, and 82.9% had a temporary stoma. The group trained with the wearable educational materials had statistically lower state anxiety levels (p<0.001) during the first postoperative stoma care, statistically higher stoma adjustment (p<0.001 at the time of discharge; p<0.001 at the third week; p<0.001 at the sixth week) and higher self-efficacy levels (p<0.001 at the time of discharge; p<0.001 at the third week; p<0.001 at the sixth week). Conclusion: It was determined that stoma education given with the wearable educational materials increased patients’ stoma adjustment and self-efficacy level and decreased the level of anxiety during the first stoma care. It is thought that the use of interactive education methods that support the participation of patients in stoma care will increase the quality of care and improve patient outcomes. Parallel Session 2: Patient Safety 175 Evaluation of the effect of compassion fatigue on medical error tendency in intensive care nurses Meltem Altay1, Yasemin Uslu2 1Acıbadem Bakırköy Hospital, Nursing services directorate, İstanbul, Turkey, 2Istanbul University, Nursing Faculty, İstanbul, Turkey Background: Compassion fatigue adversely impacts both the physical and mental psychological of nurses. In addition, compassion fatigue leads to negative patient experiences, poor concentration, decreased efficiency, reduced quality of care, disruptions in patient care, and increased work errors, and therefore is negatively associated with patient safety. Objectives: This study was conducted to evaluate the relationship between compassion fatigue and tendency to medical errors in critical care nurses. Methods: This descriptive study was conducted in the intensive care units of 16 hospitals (N=420) belonging to a private health group in Turkey between December 2021 and March 2022. Data were collected using the Compassion FatigueShort Scale and the Tendency to Medical Error in Nursing Scale. Ethics committee permission was obtained for the research.

Valencia, Spain | 16 - 18 May 2024 11th EORNA Congress Parallel Sessions 13 Results: In research, 74.8% (n=314) of the nurses were female and the mean age was 26.15±5.47 years. It was determined that 30% (n=126) of the nurses had 3-5 years of nursing experience, 28% (n=118) had worked in ICUs for 1-3 years, and 73.3% (n=308) worked in general intensive critical units. The nurses’ mean score on the Compassion Fatigue-Short Scale was 56.20±26.77 and their mean score on the Tendency to Medical Error in Nursing Scale was 4.82±0.28. There was a statistically significant negative correlation between total scale scores (r=-0.252). Conclusion: The results suggest that the nurses in this study had moderate compassion fatigue and low tendency to medical errors. A weak relationship was observed between higher compassion fatigue and greater tendency to medical errors. Determining the factors that cause nurses to make medical errors is crucial to enable the necessary precautions to be taken. We recommend conducting multidimensional studies to evaluate the effects of compassion fatigue on patient safety and nursing outcomes. 163 Electronic counting of used swabs in the operating room Zoran Preveden1 1, Blaž Tintor1 1NOVO MESTO HOSPITAL, TRAUMA, NOVO MESTO, Slovenia Electronic Counting of Used Swabs in the Operating Room – Trial Use of the „SC Smart Cart“ Device in General Hospital Novo Mesto Zoran Preveden*, Lovro Bobic, Blaž Tintor, Klemen Bedencic Department of Orthopaedic Trauma, Novo Mesto General Hospital, Novo mesto, Slovenia Email address: zpreveden@gmail.com (Z. Preveden) *Corresponding author Background: Leftover surgical materials in the body after surgery, including the surgical swab as the most commonly forgotten item, remain a considerable problem despite advances in surgical techniques. Alongside manual counting, in recent years electronic counting has also been introduced. Objectives: Objective of study was to evaluate advantages and disadvantages of electronic swab counting as opposed to traditional swab counting. Methods: Electronic counting was experimentally introduced in cooperation with the company Smart-OR d.o.o. from Trbovlje, Slovenia. A „SC Smart cart“, a special device for electronic counting, was used in 90 major procedures in various surgical specialities while traditional counting was simultaneously performed. We recorded the surgical team’s workflow, the net time needed to count swabs, and errors with and without the device. Results: No errors were made with either electronic or traditional counting method, time analysis showed faster work with the device with team members reporting reduced workloads. Counting with the device offered greater transparency in the operating room. The trial did not record any negative consequences of electronic counting Conclusion: Electronic counting using the SC smart cart proved to be a safe and efficient alternative to the traditional manual counting of items with several other advantages – lower team workload, a faster workflow, greater patient safety, and more efficient organisation of the operating room. 226 Medication safety in the sterile field: one label away Burcu Özkan1, Esra Eren2, Hanife Özdemir3 1Demiroglu Bilim University, Graduate School of Health Sciences, İstanbul, 2Istanbul Medipol University, nursing, 3Ataşehir Memorial Hastanesi Background: Every area where medication is present and every procedure with medication-related problems are included in the scope of medication safety. Medication errors occurring in the intraoperative process are recognized as a serious potential threat to patient safety. Objectives: In this study, it is aimed to determine the practices and opinions of nurses regarding the labeling of medications within the scope of medication safety in the sterile field.

11th EORNA Congress Valencia, Spain | 16 - 18 May 2024 Parallel Sessions 14 Methods: The research is a phenomenological, qualitative research. The study was conducted with 9 nurses who working in the operating room. The data were collected using in-depth, face-to-face interview technique with a semi-structured interview form and a personal information form. The data obtained were analyzed using document and content analysis and thematic analysis. Results: As a result of the participants sharing their experiences, the findings consisted of 5 themes. Nurses defined medication labeling in the sterile field as distinguishing medications and identifying who opened/prepared them. Nurses identified antiseptic and irrigation solutions, local anesthetics, antibiotics, steroids, anticoagulants and antifibrinolytics as the drugs/solutions that should be labeled in the sterile field. For this process, practices such as dipping the syringe plunger in antiseptic solution, writing on the syringe with a sterile marker pen, using different sized syringes and needle tips, and localizing the medications in different areas on the table were identified. To use medication labeling in the sterile field as an effective method, it was said that there should be a certain standard and control mechanism in institutions. Conclusion: With the themes obtained, important information regarding the labeling of drugs in the sterile field was provided and it was recommended that nurses providing care in this field should receive the necessary training within the scope of this process and that current practices should be used in hospitals. 286 Local unidirectional airflow above the surgical instruments reduce bacterial contamination of the instrument area during orthopedic implant surgery in an operating room with conventional ventilation Josefin Seth Caous1 2, Karin Svensson Malchau1 3, Max Petzold4, Ylva Fridell3, Henrik Malchau3 5, Linda Åhlström3 6, Peter Grant1, Annette Erichsen3 6 1University of Gothenburg, Department of Orthopedics, Gothenburg, 2RISE Research Institutes of Sweden, Materials and Production, 3Sahlgrenska University Hospital, 4University of Gothenburg, Public Health and Community Medicine, 5Harvard Medical School, Boston, 6University of Gothenburg, Health & Care Sciences Background: Surgical site infection (SSI) is a dreaded complication after implant surgery, often leading to resource demanding treatment and implant replacement. Airborne bacterial contamination of the wound, either directly, or indirectly through air-contaminated instruments or implants, has been described as an important risk factor for SSI in orthopedic implant surgery. Objectives: The aim of this study was to evaluate if instrument and assistant tables equipped with local unidirectional airflow reduce bacterial contamination of the instrument area to ultra clean levels, during orthopedic implant surgery in an operating room (OR) with conventional displacement ventilation. Methods: Local airflow units of instrument and assistant tables were either active or inactive. Colony forming units were sampled intraoperatively from the air above the instruments and from instrument dummies. Three air filtration samples and two-three surface samples from instrument dummies were taken during each surgery. Air filters and surface imprints were incubated on agar for total aerobic bacterial count. The mean air and instrument contamination during each surgery was calculated and used to analyze the difference in contamination depending on use of local airflow or not. All procedures were performed in the same OR. Results: 188 air and 124 instrument samples were collected during 48 orthopedic implant procedures. Analysis showed that local unidirectional airflow above the surgical instruments significantly reduced the bacterial count in the air above the assistant table (p<0.001) and instrument table (p=0.002), as well as on the instrument dummies from the assistant table (p=0.001). Conclusion: Instrumentation tables equipped with local unidirectional airflow protect the surgical instruments from bacterial contamination during orthopedic implant surgery and may therefore reduce the risk of indirect wound contamination.

Valencia, Spain | 16 - 18 May 2024 11th EORNA Congress Parallel Sessions 15 Parallel Session 3: Education 280 Education of operating room nurses- a systematic literature review Marin Repustic1, Ivanka Budiselic Vidaic2, Irena Vukcevic1, Elvira Medved1 1General Hospital “Dr. Ivo Pedisic”, General surgery- operating rooms, Sisak, Croatia, 2University Hospital Center Rijeka, Clinic for cardiac surgery, Rijeka, Croatia Background: Operating room nurses have worked in a very complex environment. Activities in daily work in the operating rooms requires very high level of theoretical knowledges and practiced skills. The knowledges and skills for work in the operating rooms are specific, and according to that operating room nurses have to have very high level of education. Objectives: Aim of this systematic literature review is determine which specific knowledge operating room nurses must have to work in operating rooms. As well, aim is to determine which techniques and learning methods are used in education process of operating room nurses. Methods: This systematic literature review has been done according to the rules of the PRISMA methodology. Two databases CINAHL and SCIENCEDIRECT were searched by four authors. Keywords used in searching of the literature were: operating room nurses, education and methods. Including criteria for selection of articles were: all keywords, articles not older than 5 years, English language and the strength of impact factor. Excluding criteria were: articles older than 5 years, not containing all keywords, articles without impact factor. Results: On CINAHL database had been found 24.869 articles, and on SCIENCEDIRECT database 16.284 articles. After application of including and excluding criteria, analysis was done on 43 articles. 30 articles from CINAHL database and 13 articles from SCIENCEDIRECT database. Resurchify application had been used for checking of impact factors. Conclusion: For the successful and efficient implementation of work processes in operating rooms it is very important to have knowledge about legal, ethical and professional principles of perioperative nursing care. Interpersonal relations, communication, organizational and managers skills is a base for implementation of good practice in operating rooms. It is important to mention knowledges about clinical and operative surgery, leadership, education process, learning methods and obligation of professional development. 202 Designing a flipped classroom model to prepare perioperative nurses to be workforce ready Patricia Nicholson1 1, Tarryn Armour2 2, Elyse Coffey2 2 1Deakin University, School of Nursing and Midwifery, Geelong, Australia, 2Deakin University, School of Nursing and Midwifery, Melbourne, Australia Background: Online technologies have challenged curriculum design to move from a traditional lecture-based learning model towards a curriculum delivery method that maximises student learning and increases student engagement. These changes prompted the development of student-centred learning, seeking to actively engage students in higher-order thinking. The flipped classroom is an innovative teaching approach that reverses the traditional order of content delivery. Students engage with instructional material independently outside of the class, through pre-recorded videos or readings, and then use class time for active learning activities, such as discussions, group work, and problem-solving exercises. Objective: The objectives of this project were to explore the level of student engagement with course materials, both online and during face-to-face seminars, and to develop active and authentic learning that mirrored real-life contexts, preparing them for the world around them. Methods: Guided by constructivism, the need for developing and delivering a curriculum that facilitated active learning was deliberated, with the flipped classroom model adopted to facilitate deeper learning and improved student engagement. Four core units nested in the Master of Nursing program were enhanced, based on the blended learning principles and guided by learning and teaching goals in creating an engaging learning experience for all students. Results: The blended learning approach led to contextualising the course to the needs of the healthcare industry, ensuring the sustainability of the course, while intellectually challenging and engaging students. This presentation will include an overview of the learning modalities designed to guide students in constructing their own learning in preparation for in-class active learning, checking their understanding of the learning material and keeping them engaged with course material. Conclusion: The flipped classroom model promotes active learning, collaboration, and student-centered instruction. It maximises the effective use of class time, facilitates deeper understanding of concepts, and supports the development of critical thinking skills.