Setting the standard : the role of the Australian College of Operating Room Nurses

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NO FULL TEXT AVAILABLE. This thesis contains 3rd party copyright material. ----- The usefulness of professional organisations, including professional perioperative nursing associations, is generally accepted. The focus of the Australian College of Operating Room Nurses (ACORN) is on improving and determining a uniform standard of care within perioperative settings. This thesis presents the results of an evaluation of ACORN undertaken to identify the organisation's role and effectiveness. Broadly speaking, evaluation is about the discovery of the nature and merit or worth of something. The approach chosen to examine ACORN was Parlett and Hamilton's illuminative model from the interpretive paradigm. The value of this flexible evaluation strategy is that it permits further examination of issues that may emerge during the course of an investigation. Data were collected from three broad subject groups. These groups were (1) all perioperative nurses who had attended one of a series of ACORN competency workshops offered in 2000 and 2001; (2) a national sample of perioperative managers; and (3) a small group of current or former ACORN board members. The first two groups were surveyed via questionnaire, and the board members were interviewed. Selected documents were analysed. ACORN demonstrated some of the characteristics of a successful organisation but not all of them. Its most significant and effective achievement was (and remains) the publication of the ACORN Standards, guidelines and policy statements. Organisational weaknesses included little evidence of research activity and limited political activism. Also uncovered during the study were the limitations of one standard, the ACORN counting standard. This is notwithstanding the fact that completing a surgical count during every surgical intervention is the 'gold standard' globally, to help prevent the inadvertent retention of surgical items. In response to these findings and following an analysis of the literature, a framework was developed that permitted a systematic examination and categorisation of the risks associated with this adverse event. Taking a 'systems approach' to managing each of the identified risks is proposed and ways to achieve this are detailed. Other recommendations focus on enhancing those attributes that are associated with successful organisations that ACORN lacks, to increase its efficacy. Additionally, improving the robustness of the ACORN standards, and enhancing their distribution and use is suggested. In conclusion, ACORN's role was determined to be representative as the professional body for perioperative nurses and the production of practice standards were identified as its most significant achievement. Perioperative nurses' beliefs that the standards have a positive effect on nursing practice and patient outcomes attested to this.
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