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recommendations made for practice and future research. Fatigue Fatigue is a rapidly growing staffing concern that surrounds perioperative nursing7 . The perioperative environment is fatiguing for a multitude of reasons, including physical, emotional and cognitive demands; prolonged standing; limited breaks; rostering practices; on-call shifts; wearing of heavy lead aprons and manual handling7 . High levels of fatigue may also lead to practitioners developing compassion fatigue13. Compassion fatigue is a concern as it can cause nurses to avoid interactions with patients, and provide services that are of low quality13 . e-18 Journal of Perioperative Nursing Volume 34 Number 1 Autumn 2021 acorn.org.au Current research demonstrates that 17 hours without sleep degrades nurses’ performance to similar levels as having a blood alcohol concentration of 0.05 per cent14. This data reveals the implications of fatigue and the additional risk to patient safety caused by fatigued nurses14 . Qualitative research conducted over a one-month period showed that 14 per cent (n=393) of nurses worked shifts over 16 hours14 . During this period 199 errors and 213 near-misses were reported (total=412 incidents) which were attributed to fatigued nurses14 . The age of this research is seen as a limitation; however, it is still relevant and used as seminal research in contemporary studies. Research undertaken by Sonoda, Onozuka and Hagihara assessed the implications of stress and fatigue in the perioperative nursing arena5 . The results reported that 40 per cent of participating perioperative nurses (n=279) felt stress throughout the work day due to the complexity of work and poor rostering13 . These high levels of nursing staff stress attributed to increasing levels of fatigue5 . The implications of this study show that stressful and complex work environments lead to significant fatigue among staff 5 . A Table 1: Summary of article appraisal scores Article Score QualSyst Scores Platt M, Coventry T, Monterosso, L. Perioperative nurses’ perceptions of cross-training: a qualitative descriptive study. Journal of Perioperative Nursing 2019;32(1):19-25. Available from: www.journal.acorn.org.au/jpn/vol32/iss1/4/ 0.8 Gutierres L, Santos J, Peiter C, Megegon F, Sebold L, Erdmann A. Good practices for patient safety in the operating room: nurses’ recommendations. Rev Bras Enferm 2018;71(6):2775-2782. doi: http://dx.doi.org/10.1590/0034-7167-2018-0449 0.9 Sonoda Y, Onozuka D, Hagihara A. Factors related to teamwork performance and stress of operating room nurses. J Nurs Manag 2018;26:66-73. doi: 10.1111/jonm.12522 0.8 Saver C. Staffing ratio trends – a survey of perioperative nurse managers. AORN Journal 2005;81(5):1041-1044. Available from https://doi.org/10.1016/S0001-2092(06)60470-5 0.85 Foran P. Effects of Guided Undergraduate Perioperative Education on Recruiting Novice RN’s and Retaining Expericed RN’s. AORN Journal 2015;102(3):254-61. 0.9 MMAT Scores Beitz J. The perioperative succession crisis: /1?pqorigsite=gscholar&cbl=30765 16 Newhouse R, Johantgen M, Pronvost P, Johnson E. Perioperative nurses and patient outcomes - mortality, complications, and length of stay. AORN Journal 2005;81(3):508-528. doi: 10.1016/s0001- 2092(06)60438-9. 17 Vortman R, Gergren M, Baur K, Floyd V. Nurse retention in the operating room after perioperative core curriculum completion. ORNAC Journal 2019;37(3):13-27. _ Curriculum_Completion 16 Foran P. The value of guided operating theatre experience for undergraduate nurses. Journal of Perioperative Nursing in Australia 2016;29(1):10-8. 25 SQACEPR* Foran P. Undergraduate surgical nursing preparation and guided operating room experience: A quantitative analysis. Nurse Education in Practice. 2016;16(1):217-24. 0.85 *Standard Quality Assessment Criteria for Evaluating Primary Research – Quantitative scores Journal of Perioperative Nursing Volume 34 Number 1 Autumn 2021 acorn.org.au e-19 limitation of this research is that it included only one Japanese hospital with the majority of participants (96 per cent) in the study being female. Fatigue endangers patient safety – perioperative nurses as fatigued staff are significantly more
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