Perioperative Nursing Shortages: An Integrative Review of Their Impact, Causal Factors, and Mitigation Strategies

Abstract

Aim. This study aims to explore contributing factors, impacts, and strategies to address perioperative nursing shortages. Background. Health facilities worldwide are experiencing nursing shortages, especially in specialty fields such as perioperative nursing. Evaluation. This integrative review is reported according to the PRISMA guidelines. The title, abstract, and full article screening, as well as the quality appraisal process, were performed by two independent reviewers, with a third for disagreement. This review focused on empirical and theoretical research published from 2013 to 2023 using databases including CINAHL, Embase, Emcare (via OVID), Medline (via EBSCOhost), Scopus, Web of Science, ProQuest Dissertations and Theses Global, Overton, and GreyNet. Key Issues. This study thoroughly reviewed 84 articles. The perioperative domain confronts significant staffing challenges due to increased demand, lack of experienced nurses, insufficient new entrants, high turnover, and an aging workforce. Notably significant are the deficiencies in recruiting new nurses and the elevated turnover levels, potentially amendable issues. The shortages negatively impact the remaining nurses, patient care quality, and hospital revenue. Strategies to address perioperative nursing workforce challenges include promoting the specialty to undergraduate nursing students, bolstering recruitment efforts, and retaining experienced perioperative nurses. However, none of the studies examined in this review adopted a comprehensive approach. Furthermore, the effectiveness of these strategies relative to one another remains uncertain due to a lack of reliable measurements. Conclusion. Perioperative nursing faces considerable challenges, including an aging workforce, limited new recruits, and high turnover rates. Present strategies primarily prioritise workforce preparation over supporting current staff. Mitigating the perioperative nursing shortages requires comprehensive approaches integrating preparation, recruitment, retention, and retirement plans. In addition, these strategies must be adapted to the diverse regulatory environments of different countries, recognising the absence of a one-size-fits-all solution to perioperative nursing shortages globally. Implication for Nursing Management. Perioperative nursing managers are vital in reducing shortages.