Content area
Background
The operating room (OR) presents a highly demanding environment due to its complexity in clinical work. This study examines the sub-specialty management model of operating rooms from various evaluative perspectives. We intend to assess the influence of this model on overall operating room quality using a scientific methodology, thereby establishing a foundation for future optimization of operating room management.
Materials and methods
In September 2024, a convenience sampling method was employed across 22 provinces, five autonomous regions, and four municipalities directly administered by the central government. A total of 731 hospital surveys were disseminated. The questionnaire encompassed five dimensions: specialty care, nursing care quality, academic research, patient satisfaction, and nursing growth Through reliability analysis, validity analysis, correlation analysis, and regression analysis, we investigated the relationships among these variables and their influence on satisfaction with the OR subspecialty management model.
Result
Descriptive statistical analysis indicated that “specialty care” attained the highest overall evaluation, with a mean score of 4.51 ± 0.420. Examination of Dimensional Variations among Hospitals of Distinct Grades.Significant differences exist in speciality nursing (t = 2.890, p < 0.001) and nurse growth (t = 1.997, p < 0.05) between tertiary and secondary medical institutions, with tertiary institutions exhibiting superior performance in speciality nursing mean (4.528 ± 0.404) and nurse growth mean (4.120 ± 0.415). Correlation analysis revealed a significant positive correlation (p < 0.001) among speciality nursing, nursing quality, scientific research and academia, nurse-patient satisfaction, and nurse growth.
Conclusion
The sub-specialty management model for operating rooms has markedly enhanced the professionalism and safety of surgical procedures, emerging as a pivotal trend in contemporary operating room management. The creation of a specialized management evaluation model for operating rooms offers a robust scientific foundation for enhancing operating room management. The enhancement of operating room management efficiency can be significantly achieved by fortifying specialty nursing, advancing nurse career development, and elevating scientific research and service quality through multidimensional collaborative improvements, thereby promoting the quality and advancement of subspecialty management in operating rooms.
Introduction
Clinical practice in the operating room (OR) is universally acknowledged as exceptionally demanding due to its intrinsic complexity [1, 2]. In recent years, the ongoing advancement of medical technologies and the evolution of operating room management concepts have led to an increasing specialization and refinement in the field of perioperative nursing, both domestically and internationally. Surgical sub specialization entails the structuring of surgical teams into concentrated groups according to distinct surgical categories and the attributes of each specialty. Such as sub specialty groups in surgery, orthopedics, thoracic surgery, etc.Forming subspecialty teams in operating room nursing promotes focused training and oversight in specific surgical domains, thereby improving the technical skill and overall capability of nursing personnel. Improve the level of surgical cooperation, the quality of surgical emergency diagnosis and treatment, and promote the growth and development of nursing staff.Subspecialty management facilitates the further division and specialization of perioperative nursing, enhancing both academic research and clinical practice in this domain [3, 4]. Therefore, the adoption of subspecialized management models in the operating room has become a dominant trend, markedly enhancing surgical quality and patient safety [5, 6].
Specialized nursing is essential for maintaining patient safety in operating room management [7]. The quality of nursing is a fundamental component for healthcare organizations aiming to provide superior services, directly affecting patient safety and satisfaction. The ongoing enhancement of nursing quality management is crucial for improving patient satisfaction with perioperative care, alleviating negative emotions in patients, and reducing the incidence of adverse events [8]. Meanwhile, the satisfaction of patients and healthcare workers has emerged as a pivotal concern in the modern healthcare environment [9]. Nursing research equips practitioners with innovative knowledge and methodologies, promoting professional development and serving as a crucial catalyst for high-quality patient care and enhanced clinical outcomes [10]. The professional advancement of nurses is directly correlated with enhanced nursing quality and the provision of superior patient care. Consequently, the advancement of nursing research and the promotion of nurse growth have emerged as common goals among healthcare professionals [11, 12]. Conflicts and contradictions persist in the daily operations and management of the operating room [13]. Hospital administrators must tackle these challenges from various angles, including optimizing workflows, refining management systems, and enhancing nurse training, to collaboratively cultivate an environment that elevates satisfaction within the operating room setting [14].
The existing research lacks multidimensional evaluation of sub specialty management models in operating rooms, as well as the relationship between variables in each dimension and their impact on management model evaluation. This study aims to thoroughly and impartially evaluate the impact of speciality nursing, nursing quality, research and academia, patient and nurse satisfaction, and nurse professional development on the subspecialized management model of operating rooms. The study seeks to furnish empirical evidence to improve the efficiency and efficacy of operating room management,providing essential insights and direction for perioperative nursing management.
Materials and methods
Sampling
A convenience sampling survey will be conducted in September 2024 across hospitals in 22 provinces, 5 autonomous regions, and 4 municipalities directly governed by the central government in China. The criteria for participant inclusion were as follows: (1) possession of a valid nursing license; (2) experience in operating room nursing exceeding three years; and (3) voluntary involvement in the survey. The exclusion criteria included: (1) nursing interns or trainee nurses; and (2) employees on sick leave exceeding three months. According to Ken Dahl’s estimation method, n=k ×(5∼10)/1 − r (n = Adjusted sample size, k = Number of independent variables/factors, 5∼10 = Multiplier range proposed by Kendall, r = Sample attrition rate (20% or 0.20 in this study)), the sample size was calculated to be 5 to 10 times the quantity of dependent variables. This study encompassed 41 variables and considered a projected sample attrition rate of 20% [15], resulting in an estimated necessary sample size of 256 to 513 cases. Participation was wholly voluntary, and informed consent was secured from all participants. The confidentiality of participants’ personal information was rigorously upheld.
Methods
A panel of experts from the Operating Room Nursing Committee of the Chinese Nursing Association performed a comprehensive literature review and subsequently created the “National Survey Questionnaire on the Current Status of Operating Room Subspecialties.” After two rounds of group discussions, 11 experts revised the questionnaire, culminating in a final version with two sections. The initial section gathered general demographic information, encompassing gender, age, educational attainment, professional designation, and job role. The second section comprised a subspecialty-specific questionnaire for operating room nurses, containing 31 items distributed across five dimensions: specialty care (5 items), nursing care quality (7 items), academic research (7 items), patient satisfaction (4 items), and nurse growth (8 items).
A five-point Likert scale was utilized, with response options spanning from “very dissatisfied” to “very satisfied,” aligned with scores from 1 to 5. The questionnaire’s overall reliability was evidenced by a Cronbach’s alpha coefficient of 0.954. The Cronbach’s alpha values for each dimension, specialty care, nursing care quality, scientific research and academic involvement, nurse-patient satisfaction, and nurse growth,varied from 0.742 to 0.905, signifying high internal consistency. The Kaiser-Meyer-Olkin (KMO) test yielded a value of 0.971, and the validity indices for each dimension varied from 0.777 to 0.916, thereby affirming the construct validity of the questionnaire [16]. The comprehensive analysis findings are displayed in Tables 1 and 2.
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Data collection
This research employed a cross-sectional design and employed electronic questionnaires disseminated through the Operating Room Nursing Committee of the Chinese Nursing Society. Due to the intricacy of the research and the necessity to improve the precision and dependability of the results, the sample size was increased beyond initial estimates during data collection. A cumulative total of 955 questionnaires was gathered. Subsequent to data cleansing, responses completed in under 3 minutes, those with missing data, or those failing to adhere to the subspecialty model were eliminated. A total of 731 valid questionnaires were preserved, resulting in a response rate of 76.54%.
Statistical analysis
Data were analyzed using SPSS version 21.0. Continuous variables exhibiting a normal distribution are expressed as mean ± standard deviation (x ± s), whereas categorical variables are summarized using frequencies and percentages. The statistical methods employed comprised univariate t-tests, multivariate regression analysis, and Pearson correlation analysis. A two-tailed P-value below 0.05 or 0.01 was deemed statistically significant [17].
Result
Demographic characteristics of the study participants
Of the respondents, 87.4% were female, and 85.5% possessed a bachelor’s degree or higher. Concerning professional designations, 42.6% of participants possessed senior-level titles, whereas 41.3% held mid-level titles. The percentages of head nurses and operating room nurses were 51.7% and 46.4%, respectively. Additionally, 84.4% of the participants were associated with tertiary care institutions, and 68.2% indicated an annual surgical volume between 5,000 and 80,000 procedures, as outlined in Table 3.
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Description statistics for each dimension
The mean score for speciality nursing (4.51 ± 0.420) and the minimum score of 3.00 are the highest among all items, signifying that participants possess a favorable overall assessment of specialized nursing. The minimal standard deviation signifies a limited extent of variability and uniform assessment. The mean growth rate of nurses was the lowest at 4.11 ± 0.431. The minimum value of 1.86 in scientific research and academia signifies the lowest evaluation, suggesting that certain participants provided exceedingly low assessments. Furthermore, its standard deviation of 0.587 is the highest among all items, indicating substantial variability in participants’ evaluations, as shown in Table 4.
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Differences across hospital levels
Examination of Variations in Dimensions Across Hospitals of Distinct Grades.
Significant differences exist in specialty nursing (t = 2.890, p < 0.001) and nurse growth (t = 1.997, p < 0.05) between tertiary and secondary medical institutions, with tertiary institutions exhibiting superior performance in specialty nursing mean (4.528 ± 0.404) and nurse growth mean (4.120 ± 0.415), as shown in Table 5.
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Correlation analysis between various dimensions
A substantial positive correlation exists among specialty care, nursing care quality, academic research, patient satisfaction, and nurse growth. The correlation coefficient between nursing care quality dimensions and the overall average score is r = 0.925, p < 0.001. The enhancement of nursing care quality significantly contributes to the overall assessment. Specialty nursing and nursing care quality (r = 0.765, p < 0.001), academic research (r = 0.672, p < 0.001), among others, exhibited robust correlations. A strong positive correlation exists between patient satisfaction and nursing care quality (r = 0.790, p < 0.001), as well as between academic research performance (r = 0.788, p < 0.001), indicating a significant relationship between patient satisfaction and the quality of hospital nursing and academic standards. The growth dimension of nurses exhibits a significant positive correlation with nursing care quality (r = 0.787, p < 0.001), indicating a reciprocal enhancement between nurses’ personal development and the overall elevation of hospital nursing quality, as illustrated in Table 6.
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Factors influencing satisfaction with subspecialty management model
The overall satisfaction score was identified as the dependent variable, while five independent variables, specialty care, nursing care quality, academic research, patient satisfaction, and nurse growth, were examined through linear regression analysis. The p-values for each independent variable were below 0.001, signifying a substantial positive correlation with overall satisfaction and justifying their incorporation into the regression model. The standardized regression coefficient (β) for academic research was the highest, indicating that this factor has the most significant impact on the evaluation within the OR subspecialty management model.
The regression analysis produced F(5, 725) = 4,261,757.281, p <.001, indicating a statistically significant linear correlation between the independent variables (specialty care, nursing care quality, academic research, patient satisfaction, and nurse growth) and the dependent variable (overall satisfaction score). The adjusted R² was 1.000, signifying that the model accounts for almost all variance in the dependent variable. The Durbin-Watson (D–W) statistic was 2.610, approximating the optimal value of 2, indicating an absence of significant autocorrelation among the residuals, as illustrated in Table 7.
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Discussion
Verification of the core role of specialized nursing
The research data reveal that the Cronbach’s Alpha coefficient for speciality nursing is 0.782, indicating substantial reliability of the scale. The mean score (4.51 ± 0.42) and the minimum value of 3 are the highest among the assessed dimensions, indicating a significant acknowledgment from participants of the importance of specialized nursing. By delineating professional domains, nursing personnel can focus on particular surgical procedures, amass specialized expertise, and improve the accuracy of their services. Current literature indicates that specialized nursing teams, through continuous training and practice, enhance individual professional growth and markedly elevate the overall quality of nursing care [18]. This study recognizes specialized nursing as fundamental to the subspecialty management model in the operating room, highlighting the necessity for ongoing improvement of professional training programs.
Clarify the key position of nursing quality
Quality of care is foundational for medical institutions to deliver effective services, playing a crucial role in ensuring patient safety and improving patient satisfaction. Nursing quality reflects the behaviors and practices of nurses. By standardizing nursing procedures, ensuring effective communication, and consistently improving nursing operations, higher-quality nursing services can be provided to patients.Table 4 shows,The mean score for nursing quality was 4.46 ± 0.473, exceeding the overall average, with a correlation coefficient of 0.925 (P < 0.001) with the overall satisfaction score, signifying a significant influence on the efficacy of subspecialty management in operating rooms. Prior research indicates that enhancing nursing quality markedly improves the overall satisfaction of medical personnel in operating rooms [19]. Consequently, initiatives to enhance subspecialty management must focus on the ongoing advancement of nursing care quality. This can be accomplished by enhancing staff training, optimizing nursing workflows, and elevating clinical nursing competencies. A comprehensive nursing quality assessment system must be instituted to facilitate ongoing monitoring and evaluation. Prompt identification and resolution of quality-related issues are crucial for the continuous optimization and enhancement of the subspecialty management model in the operating room.
Exploration of the differential impact of scientific research and academia
The nursing research in operating room subspecialties represents a process of accumulating and innovating knowledge. It involves the adoption, utilization, communication, and transfer of knowledge. Through engagement in scientific research activities, nursing staff can acquire the latest professional knowledge, stay informed about recent advancements in the nursing field, and subsequently improve their professional expertise. Table 4 shows, The data indicate polarization in the academic and scientific research dimension, with a minimum score of 1.86 and a standard deviation of 0.587(maximum), the highest among all dimensions. This indicates that certain participants offered markedly low assessments, demonstrating considerable disparity in responses. Such disparities are likely due to inconsistent levels of research funding, research environments, and personnel capabilities among various medical institutions. Regression analysis revealed that scientific research and academia possessed the highest standardized regression coefficient (β = 0.267), signifying that this dimension is a pivotal factor affecting the overall assessment of subspecialty management models in operating rooms. Insufficient research investment and disparities in academic settings lead to varied research outputs [20]. It is advisable to allocate increased support to secondary hospitals, thereby bridging the disparity with tertiary hospitals through strategic resource distribution and talent cultivation initiatives, ultimately improving the overall efficiency of the management model.
Research on differences in medical institution grades
The average scores for speciality nursing (4.528 ± 0.404) and nurse growth (4.120 ± 0.415) were significantly elevated in tertiary hospitals relative to secondary hospitals (p < 0.05). This disparity is directly associated with the enhanced availability of professional teams, sophisticated equipment, and extensive training systems in tertiary hospitals, while secondary hospitals encounter comparatively restricted resources. To effectively promote the subspecialty management model, it is essential to enhance standardized training initiatives and allocate resources to secondary hospitals, with the objective of fostering equitable development and diminishing disparities in service quality across institutional tiers.
Analysis of sub specialty management mode in operating room
This study analyzed the significant positive correlation between variables such as specialized nursing, nursing quality, scientific research, patient satisfaction, and nurse growth and the overall evaluation of the operating room sub specialty management model through reliability analysis, validity analysis, and correlation analysis.Institutions can enhance the management of operating room subspecialties by concentrating on the advancement of specialized nursing and nursing quality, elevating academic and research standards, improving nurse-patient satisfaction, and promoting professional development for nurses [13]. It offers a scientific framework for nursing administrators, emphasizing the need for multifaceted strategies to attain coordinated optimization across all dimensions. These initiatives will facilitate the superior development of operating room services and provide improved care experiences for patients.
Conclusion
This study analyzed the influencing factors of sub specialty management mode in Chinese operating rooms through cross-sectional research. A comprehensive evaluation framework for sub specialty management of operating rooms has been developed, covering core dimensions such as specialty nursing, nursing quality, and scientific research and academia. The experience of improving surgical safety and reducing infection rates through sub specialty models in the field of Chinese operating rooms provides strategic references for international response to the growth of medical demand.
Limitation
The study possesses limitations: the sample size may not adequately reflect the diverse spectrum of healthcare institutions nationwide, data collection relied on self-reported questionnaires, and the assessment of the management model lacked dynamic longitudinal validation. Subsequent research ought to augment the sample size to encompass a wider array of primary-level institutions, prolong the observation duration, and further improve the generalizability and profundity of the findings.
Implication
Inspiration for practice: The study emphasizes the importance of specialized nursing, nursing quality, scientific research and academia, patient satisfaction, and nurse development in meeting the satisfaction of specialized management models in operating rooms. Medical institutions should pay attention to these aspects and improve the overall level of operating room management through measures such as strengthening professional training, optimizing nursing processes, enhancing research capabilities, focusing on patient experience, and promoting nurse career development. Differentiated management strategies should be developed to address the differences between hospitals of different levels, especially by strengthening professional training and resource investment in secondary and lower level hospitals, in order to promote balanced development of medical services.
Consent
Participants were provided with comprehensive information regarding the nature and rationale of the study, as well as the requirements of participation, enabling them to provide voluntary informed consent.
Limitations
The limitations of this study include: only investigating the current situation in China, without corresponding data on the international situation.
The limitations of this study include: not searching for articles in languages other than English and Persian, so our search strategies may have under-represented studies in other languages, such as Spanish and Portuguese.
Data availability
No datasets were generated or analysed during the current study.
Abbreviations
B:
Regression Coefficient
SE:
Standard Error
β:
Standardized Regression Coefficient
VIF:
Variance Inflation Factor
R2 :
Coefficient of Determination
Adjusted R2 :
Adjusted Coefficient of Determination
F:
F-Statistic
D–W:
Durbin-Watson Statistic
Research
Open access
Published:28 July 2025
Correlation analysis of satisfaction with subspecialty management model in operating rooms: a cross-sectional survey in ChinaW. Wang1,
J. Shen1,
Y. Ma2,
Y. Chen1,
R. Gong1,
Q. Qian 1 &
…
Y. Sun 3
Show authors BMC Nursing volume 24, Article number: 978 (2025) Cite this article7 Accesses
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