Core Competency, Interprofessional Collaboration, Job Satisfaction, Patient Safety, Surgical Outcome
Conditions
Keywords
Simulation Training, Procedure Manual, Operating Room Nurses, Cambodia, Quasi-Experimental Study, Nursing Education, Interprofessional Collaboration, Surgical Outcomes, Job Satisfaction
Brief summary
This study aims to evaluate the effectiveness of a procedure manual-based simulation training program in improving the core competencies of operating room nurses in a Cambodian national hospital. Operating room nurses play a critical role in maintaining patient safety, assisting the surgical team, and ensuring efficient surgical workflow. This study will use a single-group quasi-experimental pre-post design. Baseline data will be collected before the intervention to assess operating room nurses' core competencies, interprofessional collaboration, job satisfaction, and surgical procedure duration. Participants will receive structured educational sessions and simulation-based training based on standardized surgical procedure manuals. After the training phase, nurses will implement the procedure manuals during real surgical procedures for six weeks. End-line data will be collected to evaluate improvements in competency levels, teamwork, job satisfaction, and surgical efficiency.
Detailed description
* Background and Rationale Nurses in Cambodia face significant challenges in achieving the government's goal of Universal Health Coverage, specifically regarding the quality of care and competency levels. This study addresses the need for standardized procedure manuals in the operating room (OR) to minimize practice variation, reduce adverse outcomes, and enhance the core competencies of OR nurses at the Cambodia-China Friendship Preah Kossamak Hospital (CCFKH). * Study Design This is a quasi-experimental study utilizing a one-group pre- and post-test design. There is no control group or randomization involved. The study aims to recruit approximately 49 registered nurses currently working in the intraoperative phase at CCFKH. * Intervention Protocol The intervention is divided into three distinct phases: 1. Preparation: Standardized surgical procedure manuals and training videos were developed for two specific procedures: Total Hip Replacement (THR) in orthopedics and Retrograde Intrarenal Surgery (RIRS) in urology. 2. Training Phase (2 weeks): Participants are divided into six small groups of approximately eight members. Each group attends two sessions biweekly. Each session consists of a 1-hour lecture and 2 hours of simulation practice. An E-manual is provided for continuous self-study. 3. Implementation Phase (6 weeks): Following training, participants implement the standardized protocols during real surgical procedures. During this time, the research team provides follow-up support and consultation to address clinical concerns. * Data Collection and Outcomes Data will be collected at baseline (pre-intervention) and after the intervention period (end-line) with primary outcome and secondary outcomes: 1. Primary Outcome: Core competency is measured using a 20-item researcher-developed questionnaire based on a 5-point Likert scale (total score range: 20-100). 2. Secondary Outcomes: These include Interprofessional Collaboration (Relational Coordination Survey), Job Satisfaction (Short Index of Job Satisfaction), and Surgical Outcome (measured as procedure duration/surgical time). * Analysis Statistical evaluation will include descriptive statistics and paired t-tests to analyze changes between baseline and end-line data.
Interventions
BEHAVIORALProcedure Manual-Based Simulation Training
The intervention consists of a simulation training program of procedure manuals focused on two surgical procedures: Total Hip Replacement (THR) and Retrograde Intrarenal Surgery (RIRS). Training Phase (2 weeks): Participants attend two sessions (one per procedure). Each session includes a 1-hour lecture and 2 hours of hands-on simulation practice. Self-Study: Participants are provided with a digital E-manual for continuous review. Implementation Phase (6 weeks): Participants apply the standardized procedure manuals in real surgical settings with follow-up support from the research team.
Sponsors
Hiroshima University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Masking description
This is an open-label, single-group educational intervention. Blinding is not feasible or applicable because the participants (Operating Room nurses) and the research team are actively engaged in the lecture-based learning, simulation practice, and manual implementation. Additionally, there is no control group involved in this quasi-experimental design, precluding the need for masking.
Intervention model description
This is a quasi-experimental, single-group study utilizing a pre- and post-test design. All enrolled participants undergo the same sequence of events: baseline data collection, followed by a two-week standardized training intervention (lectures and simulations). After the training, participants enter a six-week clinical implementation phase to apply the procedure manual in real surgical settings. Finally, end-line data is collected to evaluate changes in core competencies and secondary outcomes.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Registered nurses who are appointed to work in the intraoperative phase of Cambodia-China Friendship Preah Kossamak Hospital. * Registered nurses at Cambodia-China Friendship Preah Kossamak Hospital who are willing to participate in the study.
Exclusion criteria
* Registered Nurses Cambodia-China Friendship Preah Kossamak Hospital who are unable to participate in intervention requirements. * Registered Nurses Cambodia-China Friendship Preah Kossamak Hospital who are scheduled to participate in hospital mission assignments.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Core Competencies of Operating Room (OR) Nurses | Baseline (Day 0) and End-line (8 weeks), immediately following the 2-week training and 6-week implementation phase. | Measured using a 20-item researcher-developed intraoperative core competency scale. It uses a five-point Likert scale (1: never to 5: always). The total score ranges from 20 to 100, where a higher score indicates a higher level of nursing competency in the operating room. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Interprofessional Collaboration | Baseline (Day 0) and End-line (8 weeks), immediately following the 2-week training and 6-week implementation phase. | Measured by the Relational Coordination Survey (RCS). This 7-item tool uses a five-point Likert scale. The total score ranges from 7 to 35, where a higher score represents better collaboration between surgeons, anesthetists, and nurses. |
| Job Satisfaction | Baseline (Day 0) and End-line (8 weeks), immediately following the 2-week training and 6-week implementation phase. | Measured by the Short Index of Job Satisfaction (SIJS). This 5-item tool uses a five-point Likert scale. The total score ranges from 5 to 25, where a higher score indicates greater job satisfaction among OR nurses. |
| Surgical Outcome | Comparison of the 1 month prior to intervention (baseline) versus 1 month after the total intervention period. | Mean duration of the total time from "skin incision" to "skin closure" for the targeted procedures (Total Hip Replacement and Retrograde Intrarenal Surgery). |
Countries
Cambodia
Contacts
STUDY_DIRECTORMichiko Moriyama, RN, MSN, Ph.D, FAAN
Hiroshima University
Outcome results
None listed