The impact of a dedicated perioperative nursing team on workflow efficiency in robotic-assisted spinal surgery

Abstract

This study evaluated the impact of a dedicated perioperative nursing team on operating theatre efficiency in robotic-assisted spinal surgery. A structured training programme was developed for a team of four perioperative nurses to achieve competence and autonomy in robotic system management across all phases of care. Operative data were retrospectively collected and compared between a pre-implementation phase and a post-implementation phase. A total of 130 robotic-assisted spinal procedures were analysed, including 47 performed before and 83 after team implementation. Following introduction of the specialised nursing team, mean time to surgical start decreased from 67.5 to 61.1 min, and overall operative duration was significantly reduced from 253.9 to 195.0 min. Implant execution time remained stable (30.0 min) despite a significant increase in the mean number of pedicle screws implanted per procedure from 4.9 to 6.4. Efficiency per screw improved markedly, with time per screw decreasing from 7.0 to 4.8 min. Three robotic procedures were abandoned in the pre-implementation period due to workflow-related issues, whereas no procedures were abandoned after introduction of the dedicated team. These findings demonstrate that the implementation of a specialised perioperative nursing team is associated with substantial improvements in workflow efficiency in robotic-assisted spinal surgery.