Date of Graduation

Summer 8-14-2026

Document Access

Restricted Project/Capstone - USF access only

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Program

MSN project

First Advisor

Cynthia Huff

Abstract

Problem: Variability in pre-incision preparation workflows for minimally invasive robotic surgery cases in a high-volume operating room at a medical center in northern California resulted in inconsistent setup times, contributing to OR inefficiency and increased staff workload.

Context: The microsystem is an OR at a medical center in northern California. Primary participants are circulating nurses and scrub technicians assigned to robotic minimally invasive surgery cases. The project was led by a Clinical Nurse Leader student under the supervision of an OR nurse manager serving as practicum preceptor and project champion.

Interventions: The RITE project implemented three interconnected interventions: (1) a consensus-based standardized setup checklist co-created with OR nursing staff; (2) a structured pre-case huddle protocol; and (3) a targeted audit and correction of preference cards for robotic MIS cases.

Measures: The primary outcome measure was setup time in minutes from Room Set-Up Start to Room Ready status. Process measures included checklist adherence and staff education completion. Balancing measures included case delay rates and staff-reported workflow burden.

Results: The interventions produced a measurable downward trend in weekly average setup time and setup time variability. Checklist adherence exceeded 80% within four weeks. Preference card corrections produced the most immediate impact. No increase in case delays or staff-reported burden was identified.

Conclusions: Nurse-led workflow standardization is a feasible and effective strategy for reducing setup time variability in complex robotic surgery cases. Frontline OR nurses and scrub technicians, supported by structured QI methodology, can produce measurable improvements in perioperative operational efficiency.

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