The purpose of this concept analysis is to present the term mindfulness and a definition that can be operationalized in the context of perioperative nursing, bringing awareness and empowerment to registered nurses in this specialty area of nursing.
Background
Mindfulness is associated with meditation and yoga and has been touted as helping to reduce stress and other ailments. Those in healthcare organizations that implement mindfulness training noticed increased retention, reduced turnover and increased patient satisfaction (Magtiby & Chesak, 2017). The term has also been used in the context of high reliability organizations and organizations that have achieved impressive safety records despite difficult environments. The mindfulness principles, within this context, directly impact reliability and decrease errors (Grissinger, 2017).
The perioperative arena is one of the most complex work environments in health care. Operative procedures are high-risk activities that require vigilance, concentration and situational awareness. Many distractions and sources of stress must be managed to maintain patient, and healthcare worker safety (AORN, 2014, p. 1). Errors due to stress, distraction and lack of awareness, can have devastating outcomes for a patient such as: surgical site infections; medication errors; mismatched surgical specimens; wrong-site surgeries; pressure injuries and equipment malfunctions (Myers, 2017).
As this one word has different meanings depending upon the context with which it is used in diverse areas of healthcare, it was believed that a concept analysis would provide clarity when used in the context of perioperative nursing.
Method
The methodology of Chinn and Kramer was used for this concept analysis. In their approach, Chinn and Kramer allow a variety of sources of evidence to assist with defining the criteria, including: visual images, music, poetry, popular literature, professional research, and anecdotal opinions. The gathered criteria are then used to explore and analyze cases in which the conceptual meaning is used. An exemplar case is first discussed to present initial understanding of the concept. Understanding is then tested with contrary, borderline and related cases. The concept’s meaning is then explored to reveal various experiences and values. This clarifies how meanings associated with the concept are influenced by context (Chinn & Kramer, 2015).
For this concept analysis of mindfulness, popular and professional literature were explored, as well as anecdotal opinion. Definitions of mindfulness were extracted from these sources and then synthesized into an operational definition appropriate for use in perioperative nursing. With this operational definition in mind, the author’s personal photographs were surveyed and used to build an exemplar case of mindfulness. Test cases were also constructed from the photographs.
Although Chinn and Kramer do not specify the inclusion of antecedents, attributes and consequences within their methodology, it was thought that identifying these would assist with clarifying a definition of mindfulness that can be used in perioperative nursing. A concept map was developed to understand the relationships among these terms and the photograph descriptors. Finally, a definition was formed and considered through varying contexts and values.
Conclusion
The conceptual meaning evolved throughout study resulting in an operational definition of the term mindfulness provided for use in the specialty area of perioperative nursing. Mindfulness to the perioperative nurse means: Being aware of what is happening around you at any given moment and empowered to react appropriately in a safe manner.
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