Publication Date

Spring 2016

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Colleen O'Leary-Kelley

Second Advisor

Toni Armann

Third Advisor

Tina Bray


Preoperative, Education, Multicultural, Healthcare, Setting


The role of the professional nurse is integral in educating and ensuring that patients understand essential components of their plan of care. This is especially true for patients who are to undergo surgical interventions; evidence has demonstrated that preoperative education provided to patients is linked with positive patient outcomes and a decrease in post-operative complications (Blackstone, Garrett, & Hasselkus, 2011). This qualitative study investigated the barriers that nurses experience in providing preoperative education to diverse patients in a multicultural healthcare environment. Ten registered nurses at a private community hospital in the San Francisco Bay Area participated in an hour long one-on-one semi-structured interview over the course of six months to explore knowledge that nurses identify as important to teach patients before surgery, what they actually teach, and the barriers they experience in the delivery of this information. These interviews were coded using qualitative research software, and revealed challenges relating to language barriers, mistrust of translation services, and the perceived restrictions of time. The barriers resulted in sub-optimal delivery of preoperative information. Although nurses wanted to provide the best care they could, the barriers posed significant challenges. Consequently, nurses experienced moral distress under circumstances in which they are aware of the quality of the information they provide. The phenomenon of satisficing was identified as a coping strategy to the routine nursing practice of preoperative education.


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