SURGICAL NURSING CARE IN THE OPERATING ROOM: AN INTEGRATIVE REVIEW

an integrative review with search and selection of primary studies conducted in April and May 2022 in four major data sources in the health field, namely: LILACS, SciELO, BDENF and PubMed, from 2018 to 2022. The sample consisted of 13 studies, 8 selected from a universe of 293 articles and 5 obtained through the manual search.

Results:

three categories were generated: Associating surgical care with care, people and material resources management for patient safety; Surgical care and ethical sensitivity in the search for patients' well-being; and Operating room nurses' manifestation and omission experiences and surgical care.

Conclusions:

surgical Nursing care in the operating room is varied and is manifested through meeting the administrative demands, ethical sensitivity, body temperature maintenance, preservation of individuality and meeting all the needs in the intraoperative period when patients are more vulnerable, including being duly informed as a way to provide safe surgical care. On the other hand, nurses acknowledge the need to change their world view and direct surgical care towards a more human, social and cultural perspective.

DESCRIPTORS:
Nursing; Operating Room Nursing; Nursing Care; Nursing Role; Nurses

Database	Search strategy	Studies found	Limits/Filters
SCIELO	Enfermagem de Centro Cirúrgico OR Papel do Profissional de Enfermagem AND Cuidado de enfermería OR Cuidados de Enfermagem	84	16
BDENF	(enfermería de quirófano) AND (cuidado de enfermería)	56	18
LILACS	(Enfermagem de Centro Cirúrgico) AND (Cuidados de Enfermagem)	70	14
PUBMED/MEDLINE	"Operating Room Nursing"[Mesh] AND "Nursing Care"[Mesh]	83	9

Studies	Author(s), locus and year	Study objective	Methodology	Main result
1	Gutierres LS et al1212. Gutierres LS, Santos JLG, Peiter CC, Menegon FHA, Sebold LF, Erdmann AL. Good practices for patient safety in the operating room: nurses' recommendations. Rev Bras Enferm [Internet]. 2018 [cited 2023 Mar 28];71(Suppl 6):2775-82. Available from: https://doi.org/10.1590/0034-7167-2018-0449 https://doi.org/10.1590/0034-7167-2018-0... Brazil/2018	To describe the Nursing recommendations for good patient safety practices in the operating room.	Quantitative, descriptive and exploratory research	Highlights: Establishing the patient safety culture and the Safe Surgery Checklist, which nurse can use as care management strategies for patient safety in the surgical center.
2	Dutra CKR, Salles BG, Guirardello EB1313. Dutra CKR, Salles BG, Guirardello EB. Situações e razões para a omissão do cuidado de enfermagem em unidades de clínica médica e cirúrgica. Rev Esc Enferm USP [Internet]. 2019 [cited 2023 Mar 28];53:e03470. Available from: https://doi.org/10.1590/S1980-220X2017050203470 https://doi.org/10.1590/S1980-220X201705... Brazil/2019	To evaluate the frequency and reasons for missed Nursing care and to verify if the reasons for the omission differ across the professional categories.	Quantitative and cross-sectional study	The main reasons attributed for care omissions were inadequate professional staffing, urgency situations with patients during the work shift, and unavailability of medications, materials or equipment when required.
3	Oliveira Souza, É, Gonçalves, N, Alvarez AG1414. Souza ÉO, Gonçalves N, Alvarez AG. Cuidados de enfermagem no período intraoperatório para manutenção da temperatura corporal. Rev SOBECC [Internet]. 2019 [cited 2023 Mar 28];24(1):31-6. Available from: https://revista.sobecc.org.br/sobecc/article/view/469 https://revista.sobecc.org.br/sobecc/art... Brazil/2019	To describe Nursing care to maintain body temperature during the intraoperative period.	Descriptive and cross-sectional study	The main Nursing care measures applied in all patients during the intraoperative period were infusion of a heated intravenous solution and use of a cotton surgical field.
4	Sandelin A, Kalman S, Gustafsson BÅ66. Sandelin A, Kalman S, Gustafsson BÅ. Prerequisites for safe intraoperative nursing care and teamwork-Operating theatre nurses' perspectives: A qualitative interview study. J Clin Nurs [Internet]. 2019 [cited 2023 Mar 28];28(13-14):2635-43.Available from: https://doi.org/10.1111/jocn.14850 https://doi.org/10.1111/jocn.14850... Sweden/2019	To describe the experience of operating room nurses about the previous conditions for safe intraoperative Nursing care and teamwork.	Qualitative and descriptive	Operating room nurses struggle to obtain proper information about the care to be provided to the patients, the surgical intervention and the equipment to be well-prepared for intraoperative Nursing care.
5	Barboza BC, Sousa CALSC, Morais LAS1515. Barboza BC, Sousa CALSC, Morais LAS. Percepção da equipe multidisciplinar acerca da assistência humanizada no centro cirúrgico. Rev SOBECC [Internet]. 2020 [cited 2023 Mar 28];25(4):212-8. Available from: https://revista.sobecc.org.br/sobecc/article/view/611 https://revista.sobecc.org.br/sobecc/art... Brazil/2020	To understand the perceptions of the multidisciplinary team professionals about care humanization in the operating room.	A qualitative approach, with descriptive purposes.	They considered that humanized care was perceived as seeking the patients' well-being, maintaining an empathic relationship towards others with a comprehensive care approach.
6	Mert Boğa S, Aydin Sayilan A, Kersu Ö, Baydemİr C1616. Mert Boğa S, Aydin Sayilan A, Kersu Ö, Baydemİr C. Perception of care quality and ethical sensitivity in surgical nurses. Nurs Ethics [Internet]. 2020 [cited 2023 Mar 28];27(3):673-85. Available from: https://doi.org/10.1177/0969733020901830 https://doi.org/10.1177/0969733020901830... Turkey/2020	To determine the relationship between operating room care behaviors and their ethical sensitivity.	Quantitative, cross-sectional and descriptive-correlational	The nurses' perception levels about care quality were high and their ethical sensitivity levels were moderate. The nurses' ethical sensitivity improved along with their care quality perception and, as their time working in the clinic increased, their ethical sensitivity in the Benefit provision, Holistic approach and Guidance subscales was also increased.
7	Erikson J, Lindgren BM, Lindahl E55. Eriksson J, Lindgren BM, Lindahl E. Newly trained operating room nurses' experiences of nursing care in the operating room. Scand J Caring Sci [Internet]. 2020 [cited 2023 Mar 28];34(4):1074-82.Available from: https://doi.org/10.1111/scs.12817 https://doi.org/10.1111/scs.12817... Sweden/2020	To explore the Nursing care experiences of recently-trained surgical nurses in an operating room.	Qualitative research	Operating room nurses experienced threats to safe Nursing when they lacked time for the patients, as well as for their own recovery, in addition to lacking feedback to improve the assistance provided. They watched for the patients' safety when establishing one-on-one contact, protecting the patients' well-being and working in teams for the patients' best interest.
8	Martins KN et al77. Martins KN, Bueno AA, Mazoni SR, Machado VB, Evangelista RA, Bolina AF. Processo de gestão em centro cirúrgico na perspectiva do enfermeiro. Acta Paul Enferm [Internet]. 2021 [cited 2023 Mar 28];34:eAPE00753.Available from: https://doi.org/10.37689/acta-ape/2021AO00753 https://doi.org/10.37689/acta-ape/2021AO... Brazil/2021	To describe the management process performed by nurses in the operating room.	A descriptive and exploratory study, with a qualitative approach	The similarity analysis shows the Nursing team role in the surgical center and its direct relationship with patient care, whereas nurses' role is characterized by predominantly managerial actions related to work organization. Three categories were listed: people management, material resources management and care management.
9	Matzenbacher LPS et al1717. Matzenbacher LPS, Espírito Santo DMN, Paczek RS, Tanaka AKS da R, Galvan C. Nursing care in ophthalmologic surgeries: experience report. Res Soc Dev [Internet]. 2021 [cited 2023 Mar 28];10(11):e271101119629. Available from: https://doi.org/10.33448/rsd-v10i11.19629 https://doi.org/10.33448/rsd-v10i11.1962... Brazil/2021	To describe the experience underwent by nurses in an outpatient surgical center during the care phases for patients subjected to eye surgeries.	Descriptive study, of the experience report type	The checklist promote the culture safety for eye surgery patients in a solid way in the care process, with participation of all the team members: nurses, surgeon and anesthesiologist.
10	Santo DMNE et al1818. Santo DMNE, Matzenbacher LPS, Paczek RS, Galvan C, Tanaka AKSR. Cuidados de enfermagem ao paciente submetido à litotripsia extracorpórea em centro cirúrgico ambulatorial. REAS [Internet]. 2021 [cited 2023 Mar 28];13(7):e8282. Available from: https://doi.org/10.25248/reas.e8282.2021 https://doi.org/10.25248/reas.e8282.2021... Brazil/2021	To describe the care provided by the Nursing team to patients subjected to extracorporeal lithotripsy.	Experience report	Nursing care includes all of the patients' needs, respecting their individualities and paying attention to possible complications, providing good quality care during the patients' time in the operating room, from preparation to the anesthetic recovery room.
11	Gemelli R et al1919. Gemelli R, Aguiar DCM, Moser GAS, Maier SRO, Sudré GA, Carrijo MVN. Roles of nurses in the operating room: perceptions of themselves in the intraoperative setting. RSD [Internet]. 2021 [cited 2023 Mar 28];10(11):e105101119331. Available from: https://doi.org/10.33448/rsd-v10i11.19331 https://doi.org/10.33448/rsd-v10i11.1933... Brazil/2021	To understand operating room nurses' perception about the care provided to the patients during the transoperative period in a hospital from western Santa Catarina.	Qualitative study, delimited by ethnographic study assumptions	It highlights the work overload to which the Nursing team is exposed as the main factor restricting nurses' work with the patients in care provision.
12	Bastami M, Imani B, Koosha M2020. Bastami M, Imani B, Koosha M. Operating room nurses' experience about patient cares for laparotomy surgeries: A phenomenological study. J Family Med Prim Care [Internet]. 2022 [cited 2023 Mar 28];11(4):1282-7. Available from: https://doi.org/10.4103/jfmpc.jfmpc_1085_21 https://doi.org/10.4103/jfmpc.jfmpc_1085... Iran/2022	To explain the experiences underwent by operating room nurses about the care provided to patients subjected to laparotomy surgeries.	Qualitative and phenomenological study	The main topics included a positive view about patient care, preservation of the patients' physical safety, and considering the patients' vulnerability in the operating room.
13	Batista Sá Moraes R et al2121. Batista Sá Moraes R, de Amorim Lino AI, Pereira de Oliveira F, Mendonça E, Ramos de Andrade Antunes Gomes J, Carvalho Boaventura A, et al. A vivência da humanização por profissionais de enfermagem em centro cirúrgico. Health Res J [Internet]. 2022 [cited 2023 Mar 28];3(14):294-306. Available from: https://doi.org/10.51723/hrj.v3i14.375 https://doi.org/10.51723/hrj.v3i14.375... Brazil/2022	To analyze how the Nursing team working in the Surgical Center of a public hospital experiences humanization in the work environment.	Quantitative, descriptive, cross-sectional and exploratory study	A total of 39 (67.2%) of the professionals considered that their work environment is humanized, welcoming the user (49 [84.5%]), and 44 (75-9%) stated that the users are understood. In the communicative aspect, 31 (53.4%) considered that there may have been dialog with the users, 31 (53.4%) indicate that no information is conveyed during the perioperative period and that they have difficulties providing humanized care; however, 43 (74.1%) consider that the team is willing to improve humanized care and the entire sample shows predisposition to implement these changes.

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] CORRESPONDING AUTHOR
Davydson Gouveia Santos davydsongouveia@gmail.com