Nurse-led randomised controlled trials in the perioperative setting: A scoping review

Abstract

Purpose: Nurses provide care at each phase of the complex perioperative pathway and are well placed to identify areas of care requiring investigation in randomised controlled trials. Yet, currently, the scope of nurse-led randomised controlled trials conducted within the perioperative setting are unknown. This scoping review aims to identify areas of perioperative care in which nurse-led randomised controlled trials have been conducted, to identify issues impacting upon the quality of these trials and identify gaps for future investigation. Methods: This scoping review was conducted in reference to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Searches were conducted in PubMed, Embase, Cumulative Index for Nursing and Allied Health Literature and the Cochrane Central Register of Controlled Trials, with a date range of 2014–2019. Sources of unpublished literature included Open Grey, ProQuest Dissertation and Theses, Clinical Trials.gov and the Australian and New Zealand Clinical Trials Registry. After title and abstract checking, full-text retrieval and data extraction, studies were appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Randomised Controlled Trials. Data were synthesised according to the main objectives. Key information was tabulated. Results: From the 86 included studies, key areas where nurses have led randomised controlled trials include patient or caregiver anxiety, post- operative pain relief, surgical site infection prevention, patient and caregiver knowledge, perioperative hypothermia prevention and post-operative nausea and vomiting in addition to other diverse outcomes. Issues impacting upon quality (including poorly reported randomisation) and gaps for future investigation (including a focus on vulnerable populations) are evident. Conclusion: Nurse-led randomised controlled trials in the perioperative setting have focused on key areas of perioperative care. Yet, opportunities exist for nurses to lead experimental research in other perioperative priority areas and within different populations that have been neglected, such as in the population of older adults undergoing surgery.