Nurses' Perception of Introducing Single-Use Gastroscopes in an Operating Theatre

Nurses' Perception of Introducing Single-Use Gastroscopes in an Operating Theatre | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Nurses' Perception of Introducing Single-Use Gastroscopes in an Operating Theatre Lea Rosenkilde Vikkelsø, Gunnvør Trebbien, Bettina Blom Jensen, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8422977/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Introducing new medical technologies in clinical settings affects workflows and staff experiences. Nurses, as stakeholders, are often impacted by changes in equipment and processes. Understanding these effects is important in the context of global nurse shortages, where improving working conditions may be essential for retention. This study aimed to assess how transitioning from a reusable-only gastroscope setup to a hybrid setup implementing single-use gastroscopes impacts nurses’ perceived organizational conditions. Methods A cross-sectional survey was conducted among nurses working in gastrointestinal operating theatre at Copenhagen University Hospital Hvidovre, Denmark. Eligible participants had experience handling both reusable and single-use gastroscopes. The survey, based on the organizational impact framework by Roussel et al., included closed-ended questions across nine domains such as workflow, training, communication, safety, and logistics. Responses were scored on a 0–10 scale and converted to percentages. Paired t-tests were used to compare perceptions between reusable-only and hybrid setups, with significance set at p<0.05. Results Of the 30 nurses invited, 27 (90%) initiated the survey, and 25 completed it and were included in the final analysis. Across all assessed domains, the single-use gastroscope/hybrid setup was rated more favorably compared to the reusable-only endoscope/setup. Work processes (77% vs. 43%, p<0.0001), Cooperation and Communication (80% vs. 53%, p<0.0001), Vigilance and Monitoring (90% vs. 45%, p<0.0001), Logistics (85% vs. 37%, p<0.0001), Training Requirements (60% vs. 45%, p=0.0037), Working Conditions and Safety (73% vs. 37%), and Patient Flow (52% vs. 47%, p = 0.0437). Conclusions Nurses perceived the introduction of single-use gastroscopes as a supplement to the reusable gastroscopes as offering substantial organizational advantages. These findings underscore the importance of evaluating medical devices beyond clinical performance, incorporating organizational and workforce perspectives to support sustainable healthcare delivery. Hybrid implementation models may contribute to improved working conditions and nurse satisfaction, which are critical in addressing workforce challenges. Figures Figure 1 Background Integration of new technologies in clinical settings often leads to changes in the existing workflow and clinical settings. In gastrointestinal (GI) surgical units, the choice between reusable and single-use endoscopes extends beyond clinical efficacy and cost considerations; it also affects staff workload and has broader organizational implications. Nurses, as key stakeholders in the healthcare sector, are particularly affected by such changes. In OECD countries, 17% of nurses are expected to retire by 2030, and in some countries, nurses approaching retirement outnumber that of early career nurses ( 1 ). In Denmark, a national report shows that many nurses have left the healthcare sector due to working conditions and pay. However, two in five would consider returning if workplace conditions improved, highlighting the importance of understanding how organizational changes are affecting nurses ( 2 ). A recent study found that nurses in the surgical department spend a median time of 37 minutes handling a reusable gastro- or colonoscope compared to less than 10 minutes expected of a single-use counterpart ( 3 ). Despite growing interest in the clinical and economic aspects of endoscopic equipment, limited research has explored the organizational and workforce implications particularly for nurses. At the GI surgical theatre at Hvidovre Hospital in Denmark, single-use gastroscopes (Ambu® aScope™ Gastro) were initially introduced on a trial basis alongside the existing reusable gastroscopes. Following a period of evaluation, positive feedback from clinical staff led to the decision to continue using single-use gastroscopes as a permanent complement to the reusable ones. The aim of this study was to investigate how this shift in endoscopic setup - from reusable-only gastroscopes to a hybrid setup including both reusable and single-use gastroscopes - affects the organizational impact on nurses working in GI surgical theatre. Methods Design: This single-center study employed a cross-sectional online survey design with closed-ended and rating scale questions. Participants and setting: The survey was distributed to all nurses working in the GI operating theatre at Copenhagen University Hospital Hvidovre, Denmark. Inclusion criteria required participants to confirm that they had been involved in the handling of both single-use and reusable endoscopes, as indicated by a positive response to the screening question: “Have you been involved in the preparation of both single-use and reusable endoscopes?” . Data collection + Measures: The survey was designed based on the organizational impact (OI) assessment framework by Roussel et al. ( 4 ), aiming to systematically capture how implementation of medical devices influences healthcare delivery beyond clinical and economic dimensions. To ensure content validity each question was mapped to the appropriate OI type identified in the framework. Nine of the 12 types of OI (Table 1 ) was found to be relevant for the aim of this study, which was; work processes or health care production; patient pathways; patient flows; training requirement and skills needed from health care professionals; cooperation and communication modes; vigilance and monitoring method; working conditions and safety; accessibility; and logistics. Depending on the nature of the question, it was phrased either according to the type of endoscope (reusable vs single-use) or clinical setup (only reusable gastroscopes available at the department vs. hybrid setup with both reusable and single-use gastroscopes available). The survey included questions designed to capture both perceived advantages and disadvantages of each endoscope type/setup. Where appropriate, identical questions were asked about both counterparts to minimize the risk of response bias due to differences in phrasing. To enhance face validity, the survey underwent two rounds of review by nurses from the department. Reviewers assessed the clarity and contextual relevance of each question, ensuring that the language used was unambiguous and appropriate for clinical practice. Feedback from both rounds was incorporated to refine phrasing and improve interpretability. All nurses in the department were introduced to the study during a team meeting, where the study’s purpose, methodology, and ethical considerations were presented. Participants were informed of their right to withdraw at any time without explanation or consequence and informed about data handling and usage. The survey was conducted using SurveyXact and began with a written introduction explaining the study’s purpose, the anonymity of responses, and participants’ rights. All questions were to be answered on a numeric scale from 0 to 10, with clear indications of what was meant by low, average, and high values (0, 5, and 10). For questions where participants lacked sufficient knowledge or experience, they had the option to select “Don’t know.” All responses were subsequently converted to percentages for comparison. A link to the survey was distributed to all the participants by a department nurse, and each nurse completed the survey independently. Data was collected from November 2024 to January 2025. Data analysis: Data was exported from SurveyXact to Excel and response frequencies were calculated as percentages for each question and then visualized using a spider plot to illustrate the distribution of perceived OIs across the selected types of OI, following the framework by Roussel et al. (2015). To assess whether there were statistically significant differences in perceptions or outcomes between the counterparts paired t-test was conducted. This approach was chosen to account for within-subject comparisons, as the same participants had experience with both types. A significance level of p < 0.05 was used to determine statistical significance. Table 1 The 12 types of organizational impact by the framework of Roussel et al. (2015) for assessment of medical devices List of the 12 types of organizational impact Type Description Included in study Work processes or health care production Changes in how care is delivered. X Patient pathways Alterations in the sequence of care steps. X Patient flows Effects on volume and timing of patient movement. X Type and level of involvement of the patient/carer Shifts in roles or responsibilities. Training requirement and skills needed from health care professionals New skills or education required. X Cooperation and communication modes Changes in team dynamics or networks. X Vigilance and monitoring method New safety or oversight mechanisms. X Working conditions and safety Impact on staff safety or workload. X Accessibility Effects on service availability or equity. X Budget allocation Redistribution of financial resources. Architectural and infrastructural design Need for physical or architectural changes. Logistics Implications for supply and distribution systems. X Results Out of 27 nurses responding to the survey, 25 (93%) completed it and were included in the final analysis. Two were excluded due to incompletion of the survey. Across all assessed OI parameters, the hybrid/single-use setup was rated more favorably (Table 2 ). The responses showed consistent differences in perceived OI between hybrid setup/single-use gastroscopes and reusable-only/reusable gastroscopes (Fig. 1 ). For the parameter Work processes and healthcare production , the average perceived benefit score was 77% for the hybrid/single-use setup compared to 43% for the reusable-only setup (p < 0,0001). Patient pathways were rated at 71% for the hybrid/single-use setup and 48% for reusable-only (p = 0.0016). The parameter Patient flows showed the smallest difference, with scores of 52% and 47%, respectively, (p = 0,0437). Training requirements and skills needed from healthcare professionals had an average perceived benefit score of 60% for hybrid/single-use compared to 45% for reusable-only (p = 0,0037 ) , while the parameter Cooperation and communication modes received scores of 80% and 53%, respectively, (p < 0,0001). Vigilance and monitoring methods were rated highest among all parameters, with 90% of the hybrid/single-use and 45% of the reusable-only setup, and Working conditions and safety followed a similar pattern, with scores of 73% and 37%, respectively. Accessibility was rated at 68% and 39%, respectively, and Logistics showed average perceived benefit score of 85% for hybrid/single-use and 37% for reusable-only. Table 2 * Percentage-based average perceived benefit, where 100% is ideal and 0% is completely unsatisfactory. (SU/HY: single-use gastroscopes or hybrid setting. RE: reusable gastroscopes or reusable-only setting.) Organizational Impact Parameter Criteria Average perceived benefit/satisfaction score* No. Description SU/HY RE 1 Work process or healthcare production (n = 299) 1.1.1 Scope wear 38% 1.1.2 Scope availability 63% 1.1.3 Impact of broken scope 46% 1.1.4 Work process and time consumption 84% 1.1.5 Handling work processes of two systems 55% 1.2.1 1.2.2 Operating room reset post-endoscopy 78% 43% 1.2.3 1.2.4 Cleaning room organization and maintenance 87% 31% 1.2.5 1.2.6 Storage area organization and maintenance 80% 36% 1.3.1 Implementation of single-use gastroscopes 73% 1.3.2 Single-use scope implementation 83% Average perceived benefit rating 77% 43% 2 Patient pathways (n = 50) 2.1.1 2.1.2 Transport of scope and equipment 48% 71% Average perceived benefit rating 71% 48% 3 Patient flows (n = 150) 3.1.1 3.1.2 Patient throughput 54% 40% 3.1.3 3.1.4 Impact of shift workload 51% 54% 3.2.1 3.2.2 Patient waiting time 51% 46% Average perceived benefit rating 52% 47% 4 Type and level of involvement of the patient/carer NA - - Average perceived benefit rating - - 5 Training requirements and skills needed from health care professionals (n = 75) 5.1.1 5.1.2 Scope handling training 60% 28% 5.1.3 Microbiological sampling training 62% Average perceived benefit rating 60% 45% 6 Cooperation and communication modes (n = 150) 6.1.1 6.1.2 Communication and coordination for scope readiness 79% 55% 6.1.3 6.1.4 Internal communication for scope readiness 77% 56% 6.1.5 6.1.6 Inter-nurse collaboration for scope readiness 83% 49% Average perceived benefit rating 80% 53% 7 Vigilance and monitoring method (n = 183) 7.1.1 7.1.2 Scope breakage handling 94% 62% 7.1.3 7.1.4 Scope repair process 89% 30% 7.1.5 7.1.6 Documentation load 92% 60% 7.1.7 7.1.8 Scope cleaning diligence 86% 26% Average perceived benefit rating 90% 45% 8 Working conditions and safety (n = 300) 8.1.1 8.1.2 Type of scope at disposal (in general) 64% 37% 8.1.3 8.1.4 Type of scope at disposal during shifts 83% 32% 8.1.5 8.1.6 Cleaning chemical exposure 83% 33% 8.1.7 8.1.8 Transport-related physical impact 75% 44% 8.1.9 Availability of SU scopes and stress level 66% 8.1.10 Availability of SU scopes and job satisfaction 76% 8.1.11 Implementation of single-use scopes and job attractiveness 68% 8.11.12 Implementation of single-use scopes and job satisfaction and retention 67% Average perceived benefit rating 73% 37% 9 Accessibility (n = 49) 9.1.1 9.1.2 Scope availability 68% 39% Average perceived benefit rating 68% 39% 10 Budget allocation NA - - Average perceived benefit rating - - 11 Architectural and infrastructural design NA - - Average perceived benefit rating - - 12 Logistics (n = 147) 12.1.1 Scope cleaning logistics 34% 12.1.2 12.1.3 Logistics to ensure scopes are ready 78% 37% 12.1.4 12.1.5 Logistics linked to scope repair and maintenance 92% 34% 12.1.6 Logistics of purchase/restock reprocessing supplies 44% Average perceived benefit rating 85% 37% Discussion This study demonstrates that nurses working in gastrointestinal surgical theatre perceive that single-use gastroscopes in a hybrid setup offer organizational advantages over a reusable-only setup. Statistically significant benefits were found suggesting that adoption of single-use gastroscopes as a supplement to the reusable gastroscopes positively influenced nursing workflow, reduced operational complexity, and improved staff satisfaction. Châteauvieux et al. ( 5 ) also applied the OI framework by Roussel et al. ( 4 ) to evaluate the OI of implementation of a single-use flexible bronchoscope. They found that the single-use process scored better than the reusable process in 9 out of 10 assessed OI parameters. Their study highlighted simplified logistics, reduced exposure to hazardous substances, and improved device availability associated with single-use technologies. These findings are also supported by Gudnadottir et al. ( 6 ), who found that single-use rhinolaryngoscopes were significant superior in four OI domains: logistics, cooperation and communication, vigilance and monitoring, and working conditions and safety. Understanding the OI of new medical devices—especially from the perspective of frontline staff—is increasingly recognized as essential in improving healthcare delivery and workforce sustainability ( 7 ). Given the ongoing nurse shortages and high attrition rates in many healthcare systems, including Denmark ( 8 ), improving working conditions through thoughtful device implementation is not only a matter of efficiency but also of workforce sustainability ( 9 , 10 ). A Danish report have shown that 79% of nurses would consider returning to the healthcare sector if workplace conditions improved and the workload was reasonable compared to working hours ( 11 ). International policy also highlights the value of involving nurses and other staff in planning processes, and the WHO Regional Office for Europe reported that engaging approximately 200 frontline professionals in hospital design led to more effective and contextually relevant outcomes ( 12 ), reinforcing the broader recommendation to integrate staff perspectives into organizational change to enhance satisfaction, retention, and operational sustainability ( 13 ). Our findings reinforce the value of including staff-perceived OI before implementing new medical technologies and suggest that a hybrid model in the gastrointestinal surgical unit, with both reusable and single-use gastroscopes available, may contribute to such improvements by reducing physical and cognitive workload, improving job satisfaction, and streamlining communication. Strengths and Limitations The findings of this study, should be seen in the light that it was conducted at a single center, which may limit generalizability. Though having responses from 90% of the nurses employed at the surgical unit at the time of data collection (27 out of 30), the sample size was modest, and data were based on self-reported perceptions, which are subject to bias. Additionally, while the survey was designed to minimize phrasing bias and underwent face validity testing, further validation in multi-center settings would strengthen the findings. The study also did not assess long-term outcomes such as staff turnover, absenteeism, or patient throughput, which could provide deeper insights into the organizational effects of device implementation. A key strength of this study is its focus on a hybrid setup - evaluating the OI of introducing single-use gastroscopes alongside reusable ones, rather than comparing a single-use-only setup to a reusable-only setup. This design more accurately reflects the current reality of clinical practice in surgical GI settings, where single-use endoscopes are typically introduced as a supplement rather than a replacement. By capturing the nuances of this hybrid implementation, this study provides relevant and applicable insights for healthcare settings considering similar transitions. Conclusion This study highlights the impact adoption of new medical devices has on nurses’ daily work and overall working environment. The nurses of this Danish surgical gastrointestinal unit experienced clear organizational advantages across all assessed OI parameters after implementation of single-use gastroscopes as a supplement to their existing reusable gastroscopes. This study emphasizes the importance of evaluating medical devices through a multidimensional lens that includes organizational and workforce impacts. By integrating frameworks like that of Roussel et al. ( 4 ) and drawing on real-world insights, healthcare institutions can make more informed, sustainable decisions that support both clinical excellence, staff workflow and work processes. Even when clinical performance is equivalent, organizational benefits such as reduced training needs, simplified workflows, and improved safety should be considered alongside cost in the selection and implementation of new medical devices. Declarations Author contributions Conceptualization and design, L.R.R, G.T, K.N, I.M.B and P.B.M; Data curation, L.R.R, G.T, B.B.J, K.N, and I.M.B; Investigation, L.R.R, and I.M.B; Methodology, , L.R.R, G.T, B.B.J, K.N, and I.M.B; Writing—original draft, L.R.R, K.N, and I.M.B; Writing—review and editing, L.R.R, G.T, B.B.J, K.N, I.M.B and P.B.M; All authors have read and agreed to the published version of the manuscript. Funding No external funding was received for the conduct of this study. Ambu A/S will cover the article processing charge upon acceptance of the manuscript for publication. Data availability The author confirms that all data generated or analyzed during this study are included in this manuscript. Supplementary materials An English translation of the original questionnaire is included in the supplementary materials. Ethical Approval and Consent to Participate This study only collected anonymous nurse perception data regarding workflow and organizational impact, without involving patient data, human participants, human tissue, protected health information, or clinical outcomes. Therefore, formal ethics approval was deemed unnecessary according to the IRB guidelines of Copenhagen University Hospital Hvidovre. The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. Before accessing the questionnaire, all participating nurses were informed verbally and received written information about the purpose of the study, the anonymity of their responses, their right to withdraw at any time, and that the data collected would be used for research and publication. Completion of the survey was considered as providing informed consent. Therefore, informed consent to participate was obtained from all participants. Consent for publication Consent for publication was not applicable since the manuscript did not contain any identifiable personal information. The participating nurses answering the questionnaire were informed that the data collected would be used for research and publication. Competing Interests K.N. is employed as a Global Health Economist at Ambu A/S. All other authors declare no competing interests. Availability of data and materials Data and materials are available from the corresponding author upon request. Acknowledgement None. References WHO. State of the World’s Nursing 2025 Investing in Education, Jobs, Leadership and Service Delivery. World Health Organization; 2025. DST DS. Sygeplejersker uden for sundhedsvæsenet [Internet]. 2023 [cited 2025 Jul 30]. Available from: https://www.regioner.dk/media/t4kn4idh/rappport-sygeplejersker-uden-for-sundhedsvaesenet.pdf Nielsen K, Miliam PB, Adamsen S, Russell RV. Time spent for handling gastroscopes and colonoscopes in the operating theatre: A prospective observational study. Endoscopy [Internet]. 2024 Apr [cited 2025 Jul 30];56(S 02):eP509. Available from: http://www.thieme-connect.com/products/ejournals/html/ 10.1055/s-0044-1783798 Roussel C, Carbonneil C, Audry A, Burtey S, Faré S, Langevin F, et al. Impact organisationnel : définition et méthodes d’évaluation pour les dispositifs médicaux. Volume 71. Therapie. Elsevier Masson SAS; 2016. pp. 69–82. Châteauvieux C, Farah L, Guérot E, Wermert D, Pineau J, Prognon P, et al. Single-use flexible bronchoscopes compared with reusable bronchoscopes: Positive organizational impact but a costly solution. J Eval Clin Pract. 2018;24(3):528–35. Gudnadottir G, Hafsten L, Dahl Travis H, Nielsen K, Hellgren J. Comparison of utility and organizational impact of reusable and single-use rhinolaryngoscopes in a tertiary otorhinolaryngology department. Front Surg [Internet]. 2024;11. Available from: https://www.frontiersin.org/articles/ 10.3389/fsurg.2024.1380571/full American Organization for Nursing Leadership. Literature review: Frontline leader involvement in implementing new technology [Internet], Chicago IL. 2023 [cited 2025 Sep 22]. Available from: https://www.aonl.org/system/files/media/file/2024/01/LiteratureReviewFrontlineLeaderInvolvementInImplementingNewTechnology.pd OECD. State of Health in the EU; Denmark, Country Health Profile. Pris; 2023. Radis E, Fera Bill S, Sarah O’Hanlon, Lauren E, Natasha. Malhotra Richa. Technology and health care workforce: Restoring purpose in health care work through technology and workforce innovation. 2024 [cited 2025 Sep 5]; Available from: https://www.deloitte.com/us/en/insights/industry/health-care/technology-making-health-care-work-more-meaningful.html Jedwab RM, Manias E, Redley B, Dobroff N, Hutchinson AM. Impacts of technology implementation on nurses’ work motivation, engagement, satisfaction and well-being: A realist review. Vol. 32, Journal of Clinical Nursing. John Wiley and Sons Inc; 2023. pp. 6037–60. Danske, Regioner. Dansk Sygeplejeråd, Danmarks Statistik. Sygeplejersker uden for sundhedsvæsenet. 2023. World Health Organization CRO for E. Hospitals of the future: a technical brief on re-thinking the architecture of hospitals [Internet]. 2023. Available from: http://apps.who.int/bookorders World Health Organization CRO for E. Shaping the vision: strategic hospital transformation within WHO European Region health system. 2025. Additional Declarations Competing interest reported. The submission fee was paid by Ambu A/S Supplementary Files SurveyQuestionsinEnglish.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8422977","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":594861118,"identity":"8256cc9b-f967-4280-95c4-1d7a1b9ba1c5","order_by":0,"name":"Lea Rosenkilde Vikkelsø","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABBElEQVRIiWNgGAWjYBACPjBpkGDAwA5iVAAxMwQZ4NLCBtfCDGKcIVoLA1QLYxuEi18Le/MDZp6CNGN+ZvaHDz7Ouycn78587HEBg7UxTi08xwyYeQxyzCSbeYwNZ24rNjY8zJZuPIMh3QynFokEA8YZBhU2Bod52KR5tyUkbmzmMZPmYThsg1OL/PMPYC32h9mfSf+dk1BPWIsEjwHDB6DDDJgZzKQZGxIS5JkhWnA7jCen4MAHgzRjicNAv/QcSzDcwMyWJs1jkI7T+/zsxzc+SPiTbNjf3v7wwY+aBHn5/sPHpHkqrA0bcOkBggMoPAMwF2esYAPy+EwfBaNgFIyCEQkAEelGN/7vaAcAAAAASUVORK5CYII=","orcid":"","institution":"Copenhagen University Hospital","correspondingAuthor":true,"prefix":"","firstName":"Lea","middleName":"Rosenkilde","lastName":"Vikkelsø","suffix":""},{"id":594861119,"identity":"374147cc-9fce-4587-83ec-f1d74377e8d4","order_by":1,"name":"Gunnvør Trebbien","email":"","orcid":"","institution":"Copenhagen University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Gunnvør","middleName":"","lastName":"Trebbien","suffix":""},{"id":594861120,"identity":"2c363185-54c8-482b-9e12-4a0a2a3555d9","order_by":2,"name":"Bettina Blom Jensen","email":"","orcid":"","institution":"Copenhagen University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Bettina","middleName":"Blom","lastName":"Jensen","suffix":""},{"id":594861121,"identity":"34168dde-d2ff-443a-a919-6151e51d43f0","order_by":3,"name":"Kirsten Nielsen","email":"","orcid":"","institution":"Ambu A/S","correspondingAuthor":false,"prefix":"","firstName":"Kirsten","middleName":"","lastName":"Nielsen","suffix":""},{"id":594861122,"identity":"1f811ad2-6fd0-4525-8f50-be4e3b371043","order_by":4,"name":"Inge Merete Bramsholm","email":"","orcid":"","institution":"Copenhagen University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Inge","middleName":"Merete","lastName":"Bramsholm","suffix":""},{"id":594861123,"identity":"d908e091-e7dd-4c0c-b922-5d8ee2edaba7","order_by":5,"name":"Palle Bech Milliam","email":"","orcid":"","institution":"Copenhagen University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Palle","middleName":"Bech","lastName":"Milliam","suffix":""}],"badges":[],"createdAt":"2025-12-22 08:53:52","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8422977/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8422977/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":103383356,"identity":"8e1d0442-986b-4b24-be4b-6ab545917eb2","added_by":"auto","created_at":"2026-02-25 06:11:50","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":73045,"visible":true,"origin":"","legend":"\u003cp\u003ePercentage-based average perceived benefit. 100% represents the optimal/ideal and 0% is completely unsatisfactory. 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The submission fee was paid by Ambu A/S","formattedTitle":"Nurses' Perception of Introducing Single-Use Gastroscopes in an Operating Theatre","fulltext":[{"header":"Background","content":"\u003cp\u003eIntegration of new technologies in clinical settings often leads to changes in the existing workflow and clinical settings. In gastrointestinal (GI) surgical units, the choice between reusable and single-use endoscopes extends beyond clinical efficacy and cost considerations; it also affects staff workload and has broader organizational implications.\u003c/p\u003e \u003cp\u003eNurses, as key stakeholders in the healthcare sector, are particularly affected by such changes. In OECD countries, 17% of nurses are expected to retire by 2030, and in some countries, nurses approaching retirement outnumber that of early career nurses (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn Denmark, a national report shows that many nurses have left the healthcare sector due to working conditions and pay. However, two in five would consider returning if workplace conditions improved, highlighting the importance of understanding how organizational changes are affecting nurses (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). A recent study found that nurses in the surgical department spend a median time of 37 minutes handling a reusable gastro- or colonoscope compared to less than 10 minutes expected of a single-use counterpart (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Despite growing interest in the clinical and economic aspects of endoscopic equipment, limited research has explored the organizational and workforce implications particularly for nurses.\u003c/p\u003e \u003cp\u003eAt the GI surgical theatre at Hvidovre Hospital in Denmark, single-use gastroscopes (Ambu\u0026reg; aScope\u0026trade; Gastro) were initially introduced on a trial basis alongside the existing reusable gastroscopes. Following a period of evaluation, positive feedback from clinical staff led to the decision to continue using single-use gastroscopes as a permanent complement to the reusable ones. The aim of this study was to investigate how this shift in endoscopic setup - from reusable-only gastroscopes to a hybrid setup including both reusable and single-use gastroscopes - affects the organizational impact on nurses working in GI surgical theatre.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eDesign: This single-center study employed a cross-sectional online survey design with closed-ended and rating scale questions.\u003c/p\u003e \u003cp\u003e Participants and setting: The survey was distributed to all nurses working in the GI operating theatre at Copenhagen University Hospital Hvidovre, Denmark. Inclusion criteria required participants to confirm that they had been involved in the handling of both single-use and reusable endoscopes, as indicated by a positive response to the screening question: \u003cem\u003e\u0026ldquo;Have you been involved in the preparation of both single-use and reusable endoscopes?\u0026rdquo;\u003c/em\u003e.\u003c/p\u003e \u003cp\u003eData collection\u0026thinsp;+\u0026thinsp;Measures: The survey was designed based on the organizational impact (OI) assessment framework by Roussel et al. (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e), aiming to systematically capture how implementation of medical devices influences healthcare delivery beyond clinical and economic dimensions. To ensure content validity each question was mapped to the appropriate OI type identified in the framework. Nine of the 12 types of OI (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) was found to be relevant for the aim of this study, which was; work processes or health care production; patient pathways; patient flows; training requirement and skills needed from health care professionals; cooperation and communication modes; vigilance and monitoring method; working conditions and safety; accessibility; and logistics. Depending on the nature of the question, it was phrased either according to the type of endoscope (reusable vs single-use) or clinical setup (only reusable gastroscopes available at the department vs. hybrid setup with both reusable and single-use gastroscopes available). The survey included questions designed to capture both perceived advantages and disadvantages of each endoscope type/setup. Where appropriate, identical questions were asked about both counterparts to minimize the risk of response bias due to differences in phrasing.\u003c/p\u003e \u003cp\u003eTo enhance face validity, the survey underwent two rounds of review by nurses from the department. Reviewers assessed the clarity and contextual relevance of each question, ensuring that the language used was unambiguous and appropriate for clinical practice. Feedback from both rounds was incorporated to refine phrasing and improve interpretability.\u003c/p\u003e \u003cp\u003e All nurses in the department were introduced to the study during a team meeting, where the study\u0026rsquo;s purpose, methodology, and ethical considerations were presented. Participants were informed of their right to withdraw at any time without explanation or consequence and informed about data handling and usage. The survey was conducted using SurveyXact and began with a written introduction explaining the study\u0026rsquo;s purpose, the anonymity of responses, and participants\u0026rsquo; rights. All questions were to be answered on a numeric scale from 0 to 10, with clear indications of what was meant by low, average, and high values (0, 5, and 10). For questions where participants lacked sufficient knowledge or experience, they had the option to select \u0026ldquo;Don\u0026rsquo;t know.\u0026rdquo; All responses were subsequently converted to percentages for comparison. A link to the survey was distributed to all the participants by a department nurse, and each nurse completed the survey independently. Data was collected from November 2024 to January 2025.\u003c/p\u003e \u003cp\u003eData analysis: Data was exported from SurveyXact to Excel and response frequencies were calculated as percentages for each question and then visualized using a spider plot to illustrate the distribution of perceived OIs across the selected types of OI, following the framework by Roussel et al. (2015). To assess whether there were statistically significant differences in perceptions or outcomes between the counterparts paired t-test was conducted. This approach was chosen to account for within-subject comparisons, as the same participants had experience with both types. A significance level of p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was used to determine statistical significance.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe 12 types of organizational impact by the framework of Roussel et al. (2015) for assessment of medical devices\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eList of the 12 types of organizational impact\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDescription\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIncluded in study\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWork processes or health care production\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChanges in how care is delivered.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePatient pathways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlterations in the sequence of care steps.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePatient flows\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEffects on volume and timing of patient movement.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType and level of involvement of the patient/carer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eShifts in roles or responsibilities.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTraining requirement and skills needed from health care professionals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNew skills or education required.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCooperation and communication modes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChanges in team dynamics or networks.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVigilance and monitoring method\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNew safety or oversight mechanisms.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorking conditions and safety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eImpact on staff safety or workload.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAccessibility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEffects on service availability or equity.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBudget allocation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRedistribution of financial resources.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eArchitectural and infrastructural design\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNeed for physical or architectural changes.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLogistics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eImplications for supply and distribution systems.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eX\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eOut of 27 nurses responding to the survey, 25 (93%) completed it and were included in the final analysis. Two were excluded due to incompletion of the survey. Across all assessed OI parameters, the hybrid/single-use setup was rated more favorably (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The responses showed consistent differences in perceived OI between hybrid setup/single-use gastroscopes and reusable-only/reusable gastroscopes (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFor the parameter \u003cem\u003eWork processes and healthcare production\u003c/em\u003e, the average perceived benefit score was 77% for the hybrid/single-use setup compared to 43% for the reusable-only setup (p\u0026thinsp;\u0026lt;\u0026thinsp;0,0001). \u003cem\u003ePatient pathways\u003c/em\u003e were rated at 71% for the hybrid/single-use setup and 48% for reusable-only (p\u0026thinsp;=\u0026thinsp;0.0016). The parameter \u003cem\u003ePatient flows\u003c/em\u003e showed the smallest difference, with scores of 52% and 47%, respectively, (p\u0026thinsp;=\u0026thinsp;0,0437). \u003cem\u003eTraining requirements and skills needed from healthcare professionals\u003c/em\u003e had an average perceived benefit score of 60% for hybrid/single-use compared to 45% for reusable-only (p\u0026thinsp;=\u0026thinsp;0,0037\u003cem\u003e)\u003c/em\u003e, while the parameter \u003cem\u003eCooperation and communication modes\u003c/em\u003e received scores of 80% and 53%, respectively, (p\u0026thinsp;\u0026lt;\u0026thinsp;0,0001). \u003cem\u003eVigilance and monitoring methods\u003c/em\u003e were rated highest among all parameters, with 90% of the hybrid/single-use and 45% of the reusable-only setup, and \u003cem\u003eWorking conditions and safety\u003c/em\u003e followed a similar pattern, with scores of 73% and 37%, respectively. \u003cem\u003eAccessibility\u003c/em\u003e was rated at 68% and 39%, respectively, and \u003cem\u003eLogistics\u003c/em\u003e showed average perceived benefit score of 85% for hybrid/single-use and 37% for reusable-only.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e* Percentage-based average perceived benefit, where 100% is ideal and 0% is completely unsatisfactory. (SU/HY: single-use gastroscopes or hybrid setting. RE: reusable gastroscopes or reusable-only setting.)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eOrganizational Impact\u003c/p\u003e \u003cp\u003eParameter\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eCriteria\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eAverage perceived benefit/satisfaction score*\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDescription\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSU/HY\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRE\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"9\" rowspan=\"10\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"9\" rowspan=\"10\"\u003e \u003cp\u003eWork process or healthcare production (n\u0026thinsp;=\u0026thinsp;299)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eScope wear\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e38%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eScope availability\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e63%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.1.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eImpact of broken scope\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e46%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eWork process and time consumption\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e84%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHandling work processes of two systems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e55%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2.1\u003c/p\u003e \u003cp\u003e1.2.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOperating room reset post-endoscopy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e78%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e43%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2.3\u003c/p\u003e \u003cp\u003e1.2.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCleaning room organization and maintenance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e87%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e31%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2.5\u003c/p\u003e \u003cp\u003e1.2.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStorage area organization and maintenance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e80%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e36%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.3.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eImplementation of single-use gastroscopes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e73%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.3.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSingle-use scope implementation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e83%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eAverage perceived benefit rating\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e77%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e43%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient pathways (n\u0026thinsp;=\u0026thinsp;50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.1.1\u003c/p\u003e \u003cp\u003e2.1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTransport of scope and equipment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e48%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e71%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eAverage perceived benefit rating\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e71%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e48%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ePatient flows (n\u0026thinsp;=\u0026thinsp;150)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.1.1\u003c/p\u003e \u003cp\u003e3.1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePatient throughput\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e54%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.1.3\u003c/p\u003e \u003cp\u003e3.1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eImpact of shift workload\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e51%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e54%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.2.1\u003c/p\u003e \u003cp\u003e3.2.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePatient waiting time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e51%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e46%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eAverage perceived benefit rating\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e52%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e47%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eType and level of involvement of the patient/carer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eAverage perceived benefit rating\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTraining requirements and skills needed from health care professionals (n\u0026thinsp;=\u0026thinsp;75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.1.1\u003c/p\u003e \u003cp\u003e5.1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eScope handling training\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e60%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e28%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.1.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMicrobiological sampling training\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e62%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eAverage perceived benefit rating\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e60%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e45%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eCooperation and communication modes (n\u0026thinsp;=\u0026thinsp;150)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.1.1\u003c/p\u003e \u003cp\u003e6.1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCommunication and coordination for scope readiness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e79%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e55%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.1.3\u003c/p\u003e \u003cp\u003e6.1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eInternal communication for scope readiness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e77%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e56%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.1.5\u003c/p\u003e \u003cp\u003e6.1.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eInter-nurse collaboration for scope readiness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e83%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e49%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eAverage perceived benefit rating\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e80%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e53%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eVigilance and monitoring method (n\u0026thinsp;=\u0026thinsp;183)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.1.1\u003c/p\u003e \u003cp\u003e7.1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eScope breakage handling\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e94%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e62%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.1.3\u003c/p\u003e \u003cp\u003e7.1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eScope repair process\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e89%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e30%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.1.5\u003c/p\u003e \u003cp\u003e7.1.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDocumentation load\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e92%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e60%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.1.7\u003c/p\u003e \u003cp\u003e7.1.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eScope cleaning diligence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e86%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e26%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eAverage perceived benefit rating\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e90%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e45%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"7\" rowspan=\"8\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"7\" rowspan=\"8\"\u003e \u003cp\u003eWorking conditions and safety (n\u0026thinsp;=\u0026thinsp;300)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.1.1\u003c/p\u003e \u003cp\u003e8.1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eType of scope at disposal (in general)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e64%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e37%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.1.3\u003c/p\u003e \u003cp\u003e8.1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eType of scope at disposal during shifts\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e83%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e32%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.1.5\u003c/p\u003e \u003cp\u003e8.1.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCleaning chemical exposure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e83%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e33%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.1.7\u003c/p\u003e \u003cp\u003e8.1.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTransport-related physical impact\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e75%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e44%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.1.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAvailability of SU scopes and stress level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e66%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.1.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAvailability of SU scopes and job satisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e76%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.1.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eImplementation of single-use scopes and job attractiveness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e68%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.11.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eImplementation of single-use scopes and job satisfaction and retention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e67%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eAverage perceived benefit rating\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e73%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e37%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAccessibility (n\u0026thinsp;=\u0026thinsp;49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.1.1\u003c/p\u003e \u003cp\u003e9.1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eScope availability\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e68%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e39%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eAverage perceived benefit rating\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e68%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e39%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBudget allocation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eAverage perceived benefit rating\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eArchitectural and infrastructural design\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eAverage perceived benefit rating\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLogistics (n\u0026thinsp;=\u0026thinsp;147)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eScope cleaning logistics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e34%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.1.2\u003c/p\u003e \u003cp\u003e12.1.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLogistics to ensure scopes are ready\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e78%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e37%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.1.4\u003c/p\u003e \u003cp\u003e12.1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLogistics linked to scope repair and maintenance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e92%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e34%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.1.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLogistics of purchase/restock reprocessing supplies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e44%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eAverage perceived benefit rating\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e85%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e37%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study demonstrates that nurses working in gastrointestinal surgical theatre perceive that single-use gastroscopes in a hybrid setup offer organizational advantages over a reusable-only setup. Statistically significant benefits were found suggesting that adoption of single-use gastroscopes as a supplement to the reusable gastroscopes positively influenced nursing workflow, reduced operational complexity, and improved staff satisfaction.\u003c/p\u003e \u003cp\u003eCh\u0026acirc;teauvieux et al. (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) also applied the OI framework by Roussel et al. (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) to evaluate the OI of implementation of a single-use flexible bronchoscope. They found that the single-use process scored better than the reusable process in 9 out of 10 assessed OI parameters. Their study highlighted simplified logistics, reduced exposure to hazardous substances, and improved device availability associated with single-use technologies. These findings are also supported by Gudnadottir et al. (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e), who found that single-use rhinolaryngoscopes were significant superior in four OI domains: logistics, cooperation and communication, vigilance and monitoring, and working conditions and safety.\u003c/p\u003e \u003cp\u003eUnderstanding the OI of new medical devices\u0026mdash;especially from the perspective of frontline staff\u0026mdash;is increasingly recognized as essential in improving healthcare delivery and workforce sustainability (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Given the ongoing nurse shortages and high attrition rates in many healthcare systems, including Denmark (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e), improving working conditions through thoughtful device implementation is not only a matter of efficiency but also of workforce sustainability (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). A Danish report have shown that 79% of nurses would consider returning to the healthcare sector if workplace conditions improved and the workload was reasonable compared to working hours (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). International policy also highlights the value of involving nurses and other staff in planning processes, and the WHO Regional Office for Europe reported that engaging approximately 200 frontline professionals in hospital design led to more effective and contextually relevant outcomes (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e), reinforcing the broader recommendation to integrate staff perspectives into organizational change to enhance satisfaction, retention, and operational sustainability (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOur findings reinforce the value of including staff-perceived OI before implementing new medical technologies and suggest that a hybrid model in the gastrointestinal surgical unit, with both reusable and single-use gastroscopes available, may contribute to such improvements by reducing physical and cognitive workload, improving job satisfaction, and streamlining communication.\u003c/p\u003e \u003cp\u003eStrengths and Limitations The findings of this study, should be seen in the light that it was conducted at a single center, which may limit generalizability. Though having responses from 90% of the nurses employed at the surgical unit at the time of data collection (27 out of 30), the sample size was modest, and data were based on self-reported perceptions, which are subject to bias. Additionally, while the survey was designed to minimize phrasing bias and underwent face validity testing, further validation in multi-center settings would strengthen the findings. The study also did not assess long-term outcomes such as staff turnover, absenteeism, or patient throughput, which could provide deeper insights into the organizational effects of device implementation. A key strength of this study is its focus on a hybrid setup - evaluating the OI of introducing single-use gastroscopes alongside reusable ones, rather than comparing a single-use-only setup to a reusable-only setup. This design more accurately reflects the current reality of clinical practice in surgical GI settings, where single-use endoscopes are typically introduced as a supplement rather than a replacement. By capturing the nuances of this hybrid implementation, this study provides relevant and applicable insights for healthcare settings considering similar transitions.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study highlights the impact adoption of new medical devices has on nurses\u0026rsquo; daily work and overall working environment. The nurses of this Danish surgical gastrointestinal unit experienced clear organizational advantages across all assessed OI parameters after implementation of single-use gastroscopes as a supplement to their existing reusable gastroscopes.\u003c/p\u003e \u003cp\u003eThis study emphasizes the importance of evaluating medical devices through a multidimensional lens that includes organizational and workforce impacts. By integrating frameworks like that of Roussel et al. (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) and drawing on real-world insights, healthcare institutions can make more informed, sustainable decisions that support both clinical excellence, staff workflow and work processes. Even when clinical performance is equivalent, organizational benefits such as reduced training needs, simplified workflows, and improved safety should be considered alongside cost in the selection and implementation of new medical devices.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor contributions\u003c/h2\u003e\n\u003cp\u003eConceptualization and design, L.R.R, G.T, K.N, I.M.B and P.B.M; Data curation, L.R.R, G.T, B.B.J, K.N, and I.M.B; Investigation, L.R.R, and I.M.B; Methodology, , L.R.R, G.T, B.B.J, K.N, and I.M.B; Writing—original draft, L.R.R, K.N, and I.M.B; Writing—review and editing, L.R.R, G.T, B.B.J, K.N, I.M.B and P.B.M; All authors have read and agreed to the published version of the manuscript.\u003c/p\u003e\n\u003ch2 id=\"_Toc219984057\"\u003eFunding\u003c/h2\u003e\n\u003cp\u003eNo external funding was received for the conduct of this study. Ambu A/S will cover the article processing charge upon acceptance of the manuscript for publication.\u003c/p\u003e\n\u003ch2 id=\"_Toc219984058\"\u003eData availability\u003c/h2\u003e\n\u003cp\u003eThe author confirms that all data generated or analyzed during this study are included in this manuscript.\u003c/p\u003e\n\u003ch2 id=\"_Toc219984059\"\u003eSupplementary materials\u003c/h2\u003e\n\u003cp\u003eAn English translation of the original questionnaire is included in the supplementary materials.\u003c/p\u003e\n\u003ch2 id=\"_Toc219984061\"\u003eEthical Approval and Consent to Participate\u003c/h2\u003e\n\u003cp\u003eThis study only collected anonymous nurse perception data regarding workflow and organizational impact, without involving patient data, human participants, human tissue, protected health information, or clinical outcomes. Therefore, formal ethics approval was deemed unnecessary according to the IRB guidelines of Copenhagen University Hospital Hvidovre. The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003eBefore accessing the questionnaire, all participating nurses were informed verbally and received written information about the purpose of the study, the anonymity of their responses, their right to withdraw at any time, and that the data collected would be used for research and publication. Completion of the survey was considered as providing informed consent. Therefore, informed consent to participate was obtained from all participants.\u0026nbsp;\u003c/p\u003e\n\u003ch2 id=\"_Toc219984062\"\u003eConsent for publication\u003c/h2\u003e\n\u003cp\u003eConsent for publication was not applicable since the manuscript did not contain any identifiable personal information. The participating nurses answering the questionnaire were informed that the data collected would be used for research and publication.\u003c/p\u003e\n\u003ch2 id=\"_Toc219984063\"\u003eCompeting Interests\u003c/h2\u003e\n\u003cp\u003eK.N. is employed as a Global Health Economist at Ambu A/S. All other authors declare no competing interests.\u003c/p\u003e\n\u003ch2 id=\"_Toc219984065\"\u003eAvailability of data and materials\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eData and materials are available from the corresponding author upon request.\u003c/p\u003e\n\u003ch2 id=\"_Toc219984066\"\u003eAcknowledgement\u003c/h2\u003e\n\u003cp\u003eNone.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWHO. State of the World\u0026rsquo;s Nursing 2025 Investing in Education, Jobs, Leadership and Service Delivery. World Health Organization; 2025.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDST DS. Sygeplejersker uden for sundhedsv\u0026aelig;senet [Internet]. 2023 [cited 2025 Jul 30]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.regioner.dk/media/t4kn4idh/rappport-sygeplejersker-uden-for-sundhedsvaesenet.pdf\u003c/span\u003e\u003cspan address=\"https://www.regioner.dk/media/t4kn4idh/rappport-sygeplejersker-uden-for-sundhedsvaesenet.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNielsen K, Miliam PB, Adamsen S, Russell RV. Time spent for handling gastroscopes and colonoscopes in the operating theatre: A prospective observational study. Endoscopy [Internet]. 2024 Apr [cited 2025 Jul 30];56(S 02):eP509. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www.thieme-connect.com/products/ejournals/html/\u003c/span\u003e\u003cspan address=\"http://www.thieme-connect.com/products/ejournals/html/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1055/s-0044-1783798\u003c/span\u003e\u003cspan address=\"10.1055/s-0044-1783798\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRoussel C, Carbonneil C, Audry A, Burtey S, Far\u0026eacute; S, Langevin F, et al. Impact organisationnel : d\u0026eacute;finition et m\u0026eacute;thodes d\u0026rsquo;\u0026eacute;valuation pour les dispositifs m\u0026eacute;dicaux. Volume 71. Therapie. Elsevier Masson SAS; 2016. pp. 69\u0026ndash;82.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCh\u0026acirc;teauvieux C, Farah L, Gu\u0026eacute;rot E, Wermert D, Pineau J, Prognon P, et al. Single-use flexible bronchoscopes compared with reusable bronchoscopes: Positive organizational impact but a costly solution. J Eval Clin Pract. 2018;24(3):528\u0026ndash;35.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGudnadottir G, Hafsten L, Dahl Travis H, Nielsen K, Hellgren J. Comparison of utility and organizational impact of reusable and single-use rhinolaryngoscopes in a tertiary otorhinolaryngology department. Front Surg [Internet]. 2024;11. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.frontiersin.org/articles/\u003c/span\u003e\u003cspan address=\"https://www.frontiersin.org/articles/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/fsurg.2024.1380571/full\u003c/span\u003e\u003cspan address=\"10.3389/fsurg.2024.1380571/full\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAmerican Organization for Nursing Leadership. Literature review: Frontline leader involvement in implementing new technology [Internet], Chicago IL. 2023 [cited 2025 Sep 22]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.aonl.org/system/files/media/file/2024/01/LiteratureReviewFrontlineLeaderInvolvementInImplementingNewTechnology.pd\u003c/span\u003e\u003cspan address=\"https://www.aonl.org/system/files/media/file/2024/01/LiteratureReviewFrontlineLeaderInvolvementInImplementingNewTechnology.pd\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOECD. State of Health in the EU; Denmark, Country Health Profile. Pris; 2023.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRadis E, Fera Bill S, Sarah O\u0026rsquo;Hanlon, Lauren E, Natasha. Malhotra Richa. Technology and health care workforce: Restoring purpose in health care work through technology and workforce innovation. 2024 [cited 2025 Sep 5]; Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.deloitte.com/us/en/insights/industry/health-care/technology-making-health-care-work-more-meaningful.html\u003c/span\u003e\u003cspan address=\"https://www.deloitte.com/us/en/insights/industry/health-care/technology-making-health-care-work-more-meaningful.html\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJedwab RM, Manias E, Redley B, Dobroff N, Hutchinson AM. Impacts of technology implementation on nurses\u0026rsquo; work motivation, engagement, satisfaction and well-being: A realist review. Vol. 32, Journal of Clinical Nursing. John Wiley and Sons Inc; 2023. pp. 6037\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDanske, Regioner. Dansk Sygeplejer\u0026aring;d, Danmarks Statistik. Sygeplejersker uden for sundhedsv\u0026aelig;senet. 2023.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization CRO for E. Hospitals of the future: a technical brief on re-thinking the architecture of hospitals [Internet]. 2023. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://apps.who.int/bookorders\u003c/span\u003e\u003cspan address=\"http://apps.who.int/bookorders\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization CRO for E. Shaping the vision: strategic hospital transformation within WHO European Region health system. 2025.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-8422977/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8422977/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e Introducing new medical technologies in clinical settings affects workflows and staff experiences. Nurses, as stakeholders, are often impacted by changes in equipment and processes. Understanding these effects is important in the context of global nurse shortages, where improving working conditions may be essential for retention. This study aimed to assess how transitioning from a reusable-only gastroscope setup to a hybrid setup implementing single-use gastroscopes impacts nurses’ perceived organizational conditions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e A cross-sectional survey was conducted among nurses working in gastrointestinal operating theatre at Copenhagen University Hospital Hvidovre, Denmark. Eligible participants had experience handling both reusable and single-use gastroscopes. The survey, based on the organizational impact framework by Roussel et al., included closed-ended questions across nine domains such as workflow, training, communication, safety, and logistics. Responses were scored on a 0–10 scale and converted to percentages. Paired t-tests were used to compare perceptions between reusable-only and hybrid setups, with significance set at p\u0026lt;0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e Of the 30 nurses invited, 27 (90%) initiated the survey, and 25 completed it and were included in the final analysis. Across all assessed domains, the single-use gastroscope/hybrid setup was rated more favorably compared to the reusable-only endoscope/setup. Work processes (77% vs. 43%, p\u0026lt;0.0001), Cooperation and Communication (80% vs. 53%, p\u0026lt;0.0001), Vigilance and Monitoring (90% vs. 45%, p\u0026lt;0.0001), Logistics (85% vs. 37%, p\u0026lt;0.0001), Training Requirements (60% vs. 45%, p=0.0037), Working Conditions and Safety (73% vs. 37%), and Patient Flow (52% vs. 47%, p = 0.0437).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e Nurses perceived the introduction of single-use gastroscopes as a supplement to the reusable gastroscopes as offering substantial organizational advantages. These findings underscore the importance of evaluating medical devices beyond clinical performance, incorporating organizational and workforce perspectives to support sustainable healthcare delivery. Hybrid implementation models may contribute to improved working conditions and nurse satisfaction, which are critical in addressing workforce challenges.\u003c/p\u003e","manuscriptTitle":"Nurses' Perception of Introducing Single-Use Gastroscopes in an Operating Theatre","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-25 06:09:48","doi":"10.21203/rs.3.rs-8422977/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4ba3b820-fb7e-4cfa-87c8-44cf171b48d0","owner":[],"postedDate":"February 25th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-03T19:39:21+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-25 06:09:48","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8422977","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8422977","identity":"rs-8422977","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}