Perceived Crises and Preparedness Gaps in Operating Room Nursing: A Qualitative Study of Training Priorities With Nurses and Educators

BACKGROUND: The operating room (OR) is a complex, high-stress environment in which crisis situations place considerable demands on staff and compromise patient care. Despite the availability of crisis management training, existing research has predominantly relied on objective measures of effectiveness rather than examining nurses' perceived preparedness to manage crises. AIM: This study aims to explore nurses' perceptions of crisis management in the OR, specifically what they perceive as a crisis situation, and which crises they consider important but feel insufficiently prepared to manage. Examining these dimensions allows for the identification of crisis situations representing priority areas for OR nurses' training. METHODS: This exploratory qualitative study used focus group interviews with certified nurse anaesthetists, perioperative nurses, and nurse educators from anaesthesia and perioperative nursing programmes. Seven focus groups were analysed using qualitative content analysis, using an inductive approach with limited quantification. RESULTS: Five categories of crisis situations were identified: (1) interpersonal dynamics; (2) staffing and equipment constraints; (3) errors or incidents during the care process; (4) unexpected external events; and (5) deterioration in the patient's condition. Participants reported feeling least prepared to manage interpersonal conflicts, emotional demands, and unexpected external events. CONCLUSION: This study identifies two critical training gaps. First, while nurses receive substantial training in procedural and technical crisis management, they perceive a significant lack of nontechnical skills training, particularly regarding interpersonal dynamics. Second, training related to low-frequency, high-impact crises appears insufficient.