Department of Nursing & Midwifery, Faculty of Education & Health Science, University of Limerick, Limerick, Ireland.
School of Nursing and Midwifery, University Collect Cork, Cork, Ireland.
J Clin Nurs. 2018 Jan;27(1-2):247-256. doi: 10.1111/jocn.13881. Epub 2017 Oct 27.
To explore and explain how nurses minimise risk in the perioperative setting.
Perioperative nurses care for patients who are having surgery or other invasive explorative procedures. Perioperative care is increasingly focused on how to improve patient safety. Safety and risk management is a global priority for health services in reducing risk. Many studies have explored safety within the healthcare settings. However, little is known about how nurses minimise risk in the perioperative setting.
Classic grounded theory.
Ethical approval was granted for all aspects of the study. Thirty-seven nurses working in 11 different perioperative settings in Ireland were interviewed and 33 hr of nonparticipant observation was undertaken. Concurrent data collection and analysis was undertaken using theoretical sampling. Constant comparative method, coding and memoing and were used to analyse the data.
Participants' main concern was how to minimise risk. Participants resolved this through engaging in anticipatory vigilance (core category). This strategy consisted of orchestrating, routinising and momentary adapting.
Understanding the strategies of anticipatory vigilance extends and provides an in-depth explanation of how nurses' behaviour ensures that risk is minimised in a complex high-risk perioperative setting. This is the first theory situated in the perioperative area for nurses.
This theory provides a guide and understanding for nurses working in the perioperative setting on how to minimise risk. It makes perioperative nursing visible enabling positive patient outcomes. This research suggests the need for training and education in maintaining safety and minimising risk in the perioperative setting.
探索并解释护士如何在围手术期环境中降低风险。
围手术期护士负责照顾接受手术或其他有创性探查手术的患者。围手术期护理越来越关注如何提高患者安全性。安全和风险管理是全球卫生服务机构的重点，旨在降低风险。许多研究都探讨了医疗保健环境中的安全性。然而，对于护士如何在围手术期环境中降低风险知之甚少。
经典扎根理论。
对研究的所有方面都获得了伦理批准。在爱尔兰的 11 个不同围手术期环境中，对 37 名护士进行了访谈，并进行了 33 小时的非参与性观察。使用理论抽样进行了同期数据收集和分析。使用常数比较方法、编码和备忘录对数据进行分析。
参与者最关心的是如何降低风险。参与者通过采取预期性警惕（核心类别）来解决这个问题。这一策略包括协调、例行化和即时适应。
理解预期性警惕策略扩展并深入解释了护士的行为如何确保在复杂的高风险围手术期环境中降低风险。这是第一个位于围手术期领域的护士理论。
该理论为在围手术期环境中工作的护士提供了降低风险的指南和理解。它使围手术期护理变得可见，从而实现积极的患者结果。这项研究表明，需要在围手术期环境中进行培训和教育，以维持安全性并降低风险。
