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INMO Operating Department Nurses Today Celebrate The 6Th European Day Of Perioperative Nursing, Together With Colleagues Across Europe. 15/02/11


PRESS RELEASE, Tuesday, February 15th, 2011

Members of the Irish Nurses and Midwives Organisation’s Operating Department Nurses Section are today celebrating, together with perioperative nurses across Europe, the 6th European Day of Perioperative Nursing. The theme for the day is “Effective Team Communication improves Patient Safety” and is designed to draw attention to the critical role that perioperative nurses play in ensuring positive patient outcomes in surgery. It is also a time to reflect on the role of the perioperative nurse and the contribution they make in the health care arena and to society at large. 

One of the key issues in the perioperative setting is the effectiveness of the communication across the multidisciplinary fields that are involved in the care of a patient in surgery. An initiative by the WHO, ’Safe Surgery Saves Lives’, has seen the introduction of a surgical safety checklist. It has been estimated that by adhering to this checklist, surgery complications were reduced by more than one-third and deaths reduced by almost half, in test hospitals compared to control hospitals. At least half a million deaths per year worldwide would be preventable if the WHO Surgical Safety Checklist was effectively implemented. Perioperative nurses are key players in the Operating Room Teams communicating via these safety checklists. They ensure all identified aspects are checked and verbalised as accurate and correct by each relevant team member.

This is a specific area where effective team communication is the key to success and perioperative nurses play a pivotal role in this safety initiative as demonstrated in the recent publication “The Irish Operating Department Nurses experience of implementation of the Surgical Safety Checklist and Timeout Safety Check” (Nov, 2010 ). This is now an essential activity within the perioperative setting that creates whole team focus on the individual human being who presents for surgical care.

However this crucial nursing specialisation is facing a labour shortage exacerbated by the lack of uniform training programmes and diplomas recognised at EU level by fellow Member States. This creates a barrier to mobility within the EU, contributes to keeping salaries low and hinders recognition of such a key nursing specialisation. The situation in Ireland is that the moratorium is making it impossible to recruit perioperative nurses. Our foreign nurse colleagues are continuing to leave for the USA, London, the Middle East and Australia where conditions are better.  Once they leave, hospitals cannot replace them. Due to the on-going cutbacks we are ending up with situations of suppressed Clinical Nurse Manager and Staff Nurse posts, with fewer nurses available in theatre to perform this role.  As a result theatres will close and patients will suffer.

The European Operating Room Nurses Association (EORNA) which consists of 25 member associations, representing 50,000 healthcare professionals, has called for the urgent implementation, at EU level, of a minimum basic level of perioperative nursing education. Depending on their country of origin, nurses will specialise in perioperative nursing for 1-2 post-graduate years following their registered general nurse training.  In Ireland this course is at level 9 on the FETAC grade.  The course develops the skills of the perioperative nurse, with up to 800 hours of lectures and 10 months of clinical placements in areas at which they want to become competent in e.g. orthopaedic surgery. 
This qualification gives the nurse the knowledge base to challenge situations or practices that puts patient safety at risk in the operating room.

Some countries have introduced Operating Department Assistants (ODA’s) or Operating Department Practitioners (ODP’s).  However, the experience of a general nurse’s training should not be underestimated. He /she on qualification, is a multi-skilled practitioner who has a broad training beyond the critical perioperative setting. While perioperative nurses work in the operating department, they have experience of pre and post operative care, and critically understand the implication of nursing interventions performed both in theatre and in the wider context of the patient’s hospital journey. Nurse training is inclusive of primary care, acute hospital care, and care continued in the community for patients discharged from the acute setting. It is questionable whether there is any value to be gained in introducing another grade of health care worker who is not qualified to work outside of the perioperative environment. 

According to Sandra Morton, National Chairperson, INMO ODN Section:

“Perioperative nurses, also called OR nurses or ODN (Operating Department Nurses), work closely with the patient and healthcare professionals to help plan, implement, assess and evaluate the surgical treatment. Their role is crucial in ensuring positive outcomes in surgery, knowing when more medical expertise is required, while managing the patient with their expert knowledge base. The INMO ODN Section believes that individuals who are not registered to practice nursing but perform in the role of anaesthetic /scrub / circulating/recovery nurse, would be performing without a professional licence, a practice that cannot be allowed in the interests of patient safety. For many patients, undergoing surgical intervention is a very vulnerable and psychologically challenging experience for them and the trained nurse is best placed to provide the expert care for this patient.

We are calling on the government to lift the recruitment moratorium, stop the exodus of nurses from Ireland, and fill all the vacant posts in hospital Operating Departments across the country with fully trained perioperative nurses to ensure best practice and best outcome for the patient.”

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