Coordination of procedural equipment and supplies for the surgical set-up in the perioperative environment: A scoping review

Abstract

Background: Defective, incorrect or missing procedural devices from the surgical set-up contribute to delay, interruption, cancellation and patient harm in the perioperative environment.

Objective: This scoping review aims to identify evidence to guide approaches to surgical set-up used by perioperative health service personnel, organisations or teams. In addition, the review aims to describe factors that hinder or support the surgical set-up, identify gaps in the literature and determine any issues impacting the quality of available evidence.

Methods: Empirical research and grey literature were retrieved from seven electronic databases. Titles and abstracts were screened before full text screening. A mixed method appraisal tool (MMAT) and quality improvement minimum quality criteria set (QI-MQCS) were used for critical appraisal. After data extraction from included studies, key concepts were synthesised, thematically analysed and reported.

Results: Forty-nine full texts were included. Evidence generated by nurses responsible for the surgical set-up is limited. The majority of studies were quality improvement studies to reduce inefficiencies through optimisation or mathematical modelling with outcomes measured in cost and time saved. There is limited evidence exploring how optimisation or mathematical
modelling impacts the work of perioperative staff.

Conclusion: Technology will continue to influence work systems and processes of the surgical set-up. Implementing surgical set-up quality indicators within policy may aid waste and cost reduction of organisations. The impact of human factors upon the surgical set-up is relatively unaddressed. Nurse-led research on the surgical set-up would be valuable as nurses are key professionals contributing to delivery of, management of and policy about surgical set up.