Facilitators of and Barriers to OR Teamwork: A Meta-Synthesis of Qualitative Studies

This qualitative meta-synthesis identifies facilitators and barriers to teamwork between operating room nurses (ORNs) and other practitioners. Across 29 studies published 2014–2025 from predominantly high-income settings, key facilitators included professional skills, role awareness, team familiarity, patient-centered culture, and effective leadership.

Barriers encompassed individualistic behaviors, punitive or hierarchical management, environmental constraints, and insufficient resources. These factors operated at individual, interpersonal, and systemic levels to shape OR teamwork and perioperative safety.

The review followed Joanna Briggs Institute methods and ENTREQ guidance, with data managed in NVivo 15. Studies used interviews, focus groups, or subjective questionnaires to capture experiences and perceptions.

Although the synthesis incorporated diverse settings, transferability may be limited to non–high-income contexts due to the geographic distribution of included studies. The authors advocate multifaceted interventions addressing personal competencies, team dynamics, and systemic issues to optimize OR teamwork and potentially improve perioperative outcomes.

Uncertainty: while the themes are consistently reported, exact effect sizes or relative impact of specific facilitators versus barriers are not quantified in the included qualitative evidence. All data are available in the article and supplementary information.