The effect of nursing quality on orthopaedic surgery with fixed care teams in the operating room

Purpose: The work value of operating room (OR) nurses is directly reflected in the nursing quality are identified. However, there is not enough evidence to evaluate the work value for those. This study aims to evaluate the impact of fixed care teams for nursing quality in the OR. Methods: This study was conducted from July 2015 - June 2018 in Zhanjiang, China. The nursing quality indicators used in the operating room were those defined by Li-Hua Huang in China, which included 23 nursing-sensitive quality indicators. Data were collected through a survey of the registry systems of the operating room, nosocomial infection departments, quality control departments and electronic medical records. The primary end point was the rate of surgical site infections during in-hospital visits, and other nursing-sensitive quality indicators were also assessed with historically controlled data. Results: This study included 8392 surgical patients who were observed over three years. The period with fixed care teams in the operating room demonstrated a reduction in turnover time (OR 3.405, 95% 2.760-4.210, P<0.0001), a reduction in surgical site infections (OR 0.559, 95% 0.333-0.927, P=0.0231), and a significant improvement in team satisfaction (OR 0.067, 95% 0.0385-0.096, P=0.0017). We did not find significant differences between the period with and without fixed care teams in terms of other indicators. Conclusion: The use of fixed care teams in the operating room reduced turnover time and surgical site infections in orthopaedic surgery and improved team satisfaction. Whether fixed care teams are effective needs further research in other professional operating room settings. Clinical relevance: These findings contribute to leadership development for Operating Room Nursing and Operating Room Leaders, and improved patient outcomes, while aiming at improved surgery service delivery and guiding of hospital policies and reforms.