Standardized instrument setup shortens operating time and reduces interruptions in laparoscopic gastrointestinal surgery: A single-centre randomized control trial

Table 2 Specific content of the instrument management plan for the control group (traditional mode)

Dimension	Specific plan description	Potential problem analysis
Management philosophy	Instrument preparation and management are centered on the scrub nurse’s personal working memory, habits, and preferences	High variability, making it difficult to ensure the stability and consistency of quality
Instrument table layout	(1) No zoning planning: Instruments are placed without a fixed functional area division; (2) Disordered placement: Instruments are often piled up by model or type (e.g., all grasping forceps placed together); and (3) Random orientation: Instrument handles face different directions, with mixed front and reverse positions	Increases search time, raises the risk of taking the wrong instrument, and is not ergonomic. This leads to more unnecessary movements and higher fatigue levels for nurses
Instrument preparation logic	(1) Classify and place instruments of the same category (e.g., all grasping forceps, all dissecting forceps); and (2) When a specific instrument is needed during surgery, the surgeon gives an instruction, and the nurse then selects, identifies, and passes the instrument from the same category	Response lag and low passing efficiency. Delays are likely to occur during emergency or complex procedures
Handover and communication method	(1) Dependence on verbal instructions: Fully relies on the surgeon’s verbal requests (e.g., “Give me that long curved forceps”); (2) No confirmation process: There is usually no verbal confirmation or status check during handover; and (3) Possible communication ambiguity: Instructions may be misunderstood due to environmental noise or inconsistent terminology	High communication costs and high error risks. Surgical noise may mask instructions, leading to handover errors or delays, which affect the surgical rhythm and team morale
Staff training and onboarding	(1) Observational learning: New nurses learn by observing the operations of different senior nurses; (2) Diverse habits: Habits and methods of different trainers may conflict with each other; and (3) No standard assessment: Qualification for on-the-job work mainly depends on the subjective judgment of trainers	Long learning curve and unstable training outcomes. New nurses tend to be confused by different habits and find it hard to form a unified and efficient working mode
Emergency and special situation handling	When encountering instrument failures, the need for rare instruments, or sudden changes in surgical plans, it fully depends on the scrub nurse's personal experience, memory, and on-site adaptability	Insufficient preparation for emergency situations, making it easy to make mistakes in a hurry and prolong the surgical interruption time