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nurse educators before they develop educational activities. This study shows that the motivation for learning was different between the baccalaureate- and master’s-prepared nurses. Nurse educators should design educational programs to meet the needs of the targeted audience.

The study implies that baccalaureate-prepared perioperative nurses may be more motivated by educational activities related to new surgical techniques, equipment, and instrumentation. Master’s-prepared perioperative nurses may be more motivated by activities dealing with networking, presentations, and publishing. Perioperative nurse educators should identify specific factors that will facilitate learning. These include (1) time required for the activity, (2) self- study programs, (3) easy access to educational materials and information, and (4) adequate resource people. Most perioperative nurses have limited time to devote to professional learning activities. Educators can be supportive by establishing an area in the operating room for educational materials. Materials that can be taken home may promote SDL activity participation. Well-planned, appropriate perioperative educa- tional strategies can motivate perioperative nurses to engage in self-directed learning activities.

JANE H. JOHNSON, RN, MSN, CNOR NURSING RESEARCH COMMITTEE

NURSING PRACTICE

Ritual and risk R Carter Nursing Times Vol86 (March 28-April 3, 1990) 63-64

This study on the current practice of wearing overshoes (ie, shoe covers) was based on a recommendation by the Leicestershire (England) Health Authority that overshoes no longer be worn as an infection control measure. The recommen- dation was based on the theory that hands were contaminated when donning or removing shoe covers and that contamination is a hazard to patients.

The researchers observed current practice and traffic patterns and tested subjects’ hands for contamination. Two trials were conducted; one had 10 subjects and the other had eight subjects. Finger impressions were obtained on blood agar plates and examined for aerobic spore-bearing bacillus (ASB). Floors were cultured in the “clean” and “dirty” corridors during the two separate trials, 14 days apart. The soles of six subjects’ shoes were cultured before donning covers, and the shoe covers were cultured before they were removed. The researchers also observed handwashing practices following shoe cover removal. This aspect of the study was repeated two weeks after the initial trial.

Results of the study show only 48% of staff complied with current policy of wearing shoe covers. Microbiological testing of hands revealed ASBs on every subjects’ hands after donning or removing shoe covers in the first trial and an increase in total number of colonies in the second trial.

Investigation of the soles of shoe covers revealed a higher bacterial count than on shoes in the first trial and a lower count in the second. The investigators attribute this discrepancy to the possibility that shoe covers were worn for a shorter time in the second trial. The “clean” corridor floor actually showed higher colony counts than the “dirty” floor in both trials.

Staff members indicated that they wore shoe covers for infection control, but 79% reported it was not common practice to wash their hands after contact with their shoes. Few operating theatres provide handwashing facilities at entrance and exit points. Other studies have shown that 70% alcohol is a valuable hand disinfectant when proper handwashing facilities are unavailable.

The authors conclude that the study clearly reveals a contrast between what practitioners thought they were doing and actual practice. Therefore, if shoe covers play no role in control of infection their use is ritual and should be discontinued.

Perioperative nursing impiications. Wear- ing shoe covers as an infection control measure is a “sacred cow” that should be put out to pasture once and for all. The AORN recommended

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practices on surgical attire states that the use of shoe covers has not been proven to reduce the incidence of postoperative wound infection. This study provides additional support that wearing shoe covers actually may be detrimental to patients undergoing surgical intervention. Perioperative nurses must incorporate published research findings into their practice. This study can be replicated easily in individual practice settings if nurses must prove to themselves, physicians, or infection control practitioners that the ritual of wearing show covers provides a risk to the surgical patient.

AILEEN R. KILLEN, RN, MS, CNOR CHAIRMAN

NURSING RESEARCH COMMITTEE

NURSE RETENTION

Relationship between organizational climate and job satisfaction of nursing personnel D A Gillies, M Franklin, D A Child Nursing Administration Quarterly Vol 14 (Summer 1990) 15-22

This pilot study was designed to obtain preliminary information about the relationship between organizational climate and job satisfaction of nursing personnel. This information is especially important in view of today’s nursing shortage and decreased nursing student enrollments.

The study used a descriptive survey design. The nonrandom sample included 34 nursing care givers from a teaching institution. The participants completed a 50-item, Likert-type organizational climate description questionnaire and a 48-item work satisfaction questionnaire. The findings were tested and indicate that the majority of satisfied individuals described organizational climates as providing high levels of responsibility, warmth, support, and identity. The findings suggest that organizational climate affects job satisfaction. They also suggest that nurse managers might decrease nurse turnover by promoting staff autonomy, increasing social interaction among staff, support- ing subordinates, and developing unit “spirit.”

A majority of dissatisfied individuals (79%)

disagreed with the statement that there were warm relations between administration and nurses. This suggests that interventions by upper-level and first- line managers could improve the work climate. A majority of study participants also perceived little support for taking risks.

Perioperative nursing implications. It is important for perioperative nurse managers to retain staff nurses, especially with the present nursing shortage.

This study should be replicated with a larger sample in a perioperative setting. The findings of the present study suggest that the nurse manager promote autonomy, risk taking, social interaction, support of staff, team spirit, and administration interaction to create an organizational climate that improves job satisfaction.

BARBARA DIOMEDE, RN, MSN, CNOR NURSING RESEARCH COMMITTEE

ETHICS

Participation and perception of nurse members in the hospital ethics committee L F Oddi, V R Cassidy Western Journal of Nursing Research Vol 12 (June 1990) 307-317

Recent technological advances, biomedical research, the aging population, and many other issues present a variety of ethical concerns for health care professionals. Nurses are involved integrally in patient care and play the important role of patient advocate. Consequently, they should discuss ethical concerns and should be involved in ethical decision making.

The purposes of this study were to explore the degree to which nurses are included in ethical decision making as members of hospital ethics committees, to describe nurses’ perceptions of the role of such committees, and to assess nurses’ preparation for functioning in the role of an ethics committee member.

There were two phases in this descriptive study. During the first phase, all acute-care hospitals in a midwestern state were surveyed to determine how many had ethics committees and to obtain

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