Donna Doyle

Perioperative nurses use evidence‐based practice to achieve optimal outcomes when caring for patients. Translating evidence‐based guidelines into practice, however, can be difficult, especially when barriers to compliance are present. Compliance barriers may arise from organizational culture, knowledge deficits, absence of policy, shortcuts, competing priorities, time constraints, physician pushback, or system‐level barriers. When evidence‐based practices are not followed, patient safety events and suboptimal outcomes may occur. This article addresses how legislative advocacy and policy provide solutions when barriers prevent full compliance or efforts fail. Even with organizational policy solutions, barriers to implementation may still exist. Perioperative nurses should therefore advocate in policy arenas to promote change that results in optimal quality and safety outcomes for themselves, their team, and their patients. Compliance, barriers, and advocacy are explored to navigate the intersections of policy, quality, and safety.

The professional literature predicts worldwide perioperative nursing shortages. Compounding this is the absence of perioperative curricula in most nursing programs, which reduces new graduate interest in and awareness of employment opportunities in the OR environment. Educators at a university and a large hospital system formed an innovative partnership to create a pilot undergraduate nursing course to better prepare nurses for the surgical setting. The course was offered in a condensed‐semester format and included online activities, simulation experiences, classroom discussions, and clinical experiences in a small group setting. Two of the four nursing students in the course were hired directly into the perioperative setting after graduation, decreasing hospital costs related to recruitment and orientation. The success of the course led to its integration into the undergraduate curriculum, thus providing a valuable elective option for junior and senior nursing students, as well as achieving a new model for perioperative nursing education.

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