School Prepares Future Nurses for the OR Environment, Emphasizes Aseptic Technique

The Frances Payne Bolton School of Nursing (FPB) at Case Western Reserve University (CWRU) will introduce mandatory perioperative nursing content to its undergraduate curriculum this fall and will become one of the first schools to do so. The newly designed courses in acute and critical care will bolster nursing students' skills in locations like the operating room (OR) and improve their understanding of infection control and sterile techniques.

"The perioperative environment is an area where quality and safety issues are both stark and critical," says Marilyn Lotas, PhD, RN, associate dean and director of FPB's undergraduate program. "Since FPB integrated a quality and safety component into its entire curriculum a few years ago, the perioperative content is a new opportunity for us to provide another excellent exemplar for our students' learning."

"Our program marks an important opportunity for hospitals which have had limited success in recruitment," says Rebecca M. Patton, MSN, RN, FAAN, who is FPB's Atkinson Scholar in Perioperative Nursing and the former president of the American Nurses Association. "Since most nursing students seek to reproduce their clinical experiences when they establish their careers, we saw it as vital to familiarize them with the OR setting early on."

Students will be required to spend seven weeks in the OR during their junior year. Patton anticipates that a number of them will then choose to work in the OR for their 10-week Senior Capstone project, an intensive community-based health care experience.

The new perioperative courses had their origins nearly a decade ago, when FPB alumna Lucy Jo Atkinson donated close to $2 million to the school to support the integration of perioperative content into the nursing curriculum. An assessment of Cleveland-area hospitals demonstrated that there was a growing unmet need in OR nurses as well as rising concern of hospital-acquired infections, which can occur from the lack of good sterile techniques.

"With this new content, FPB has increased its focus on strengthening the knowledge base in critical subjects such as aseptic techniques necessary for every nurse," says Patton.

Linda Burnes Bolton, DrPH, RN, FAAN, a CWRU trustee, vice president of nursing and chief nursing officer at Cedars-Sinai Medical Center, and co-chair of the Institute of Medicine's The Future of Nursing, agrees: "Healthcare organizations continue to experience significant nursing staff shortages in the perioperative arena. FPB's program to prepare nurses to provide care in OR, acute care, surgical, and procedural centers meets a community need and is a great public asset."

Two of the school's biggest nursing partners have also expressed their enthusiastic interest and support, and work is underway to have students placed in up to seven clinical OR sites around Cleveland.

"Years ago, perioperative experience and didactic was removed from undergraduate education, but FPB's program is bringing it back," says Catherine S. Koppelman, RN, MSN, NEA-BC, chief nursing officer of University Hospitals Case Medical Center. "Nurses need to understand the basics about the perioperative patient experience and nursing responsibilities as they care for all patients. Exposure and learning at the undergraduate level will benefit patients as well as generate interest for this specialty as a career upon graduation."

"The operating room is a primary component in any health system, and nurses are an imperative part of that environment," adds Sarah Sinclair, RN, BSN, MBA, FACHE, executive chief nursing officer of the Cleveland Clinic Health System. "This undergraduate coursework is a necessity that fills a void that has remained for many years in nursing education. We are very pleased to have CWRU nursing students training in our Cleveland Clinic operating rooms alongside our talented OR team members."

Patton says that FPB's educational program is extremely valuable, providing essential and meaningful experiences for students to learn how to keep their patients safe while providing quality care. "The OR is the best place to learn teamwork, communication, and coordination of care," she explains. "There is no better environment to learn patient advocacy."

"I see this new content as an exciting and powerful new element in our already excellent undergraduate curriculum," says FPB's new dean, Mary E. Kerr, PhD, FAAN. "It's wonderful to see it launch at the start of my deanship. With this fall's incoming freshman BSN class being the largest in the past fourteen years, FPB will provide a tremendous boost to the Cleveland and overall nursing community and once again demonstrate why we are at the forefront of nursing education."