Exploring Normalization of Deviance among Perioperative Registered Nurses in the Operating Room

Area of Science:

• Healthcare safety
• Organizational behavior
• Nursing practice

Background:

• Normalization of deviance erodes safety culture in healthcare.
• High-risk environments like operating rooms (ORs) are particularly vulnerable.
• Deviance from standards can become normalized practice.

Purpose of the Study:

• Explore normalization of deviance in the OR.
• Identify reasons contributing to this phenomenon.
• Determine factors that protect against it.

Main Methods:

• Focused ethnographic study.
• Interviews with 10 perioperative nurses.
• Qualitative data analysis.

Main Results:

• Normalization of deviance is present in the OR.
• Reasons include productivity pressures, complacency, social pressures, and negative acculturation.
• Nurse engagement and supportive management protect against deviance.

Conclusions:

• Normalization of deviance poses a risk to OR safety.
• Addressing productivity pressures and fostering positive acculturation are key.
• Promoting nurse engagement and supportive leadership can enhance safety culture.