The Interruption Management Strategy “Stay S.A.F.E.” Program development and evaluation for operating nurses in China: a pre-post study design

Background Operating rooms are complex, high-risk environments where interruptions frequently occur, potentially compromising workflow reliability and patient safety. Training in interruption management, grounded in cognitive theory, may help nurses cope with unavoidable disruptions; however, evidence from perioperative practice remains limited. This study evaluated the effects of the Interruption Management Strategy Stay S.A.F.E. on operating room (OR) nurses’ interruption management, cognitive processing, and workload. Methods A quasi-experimental, single-group pre-test and post-test design was conducted in the central OR of a tertiary hospital in Jiangsu, China, with 82 registered nurses (≥ 1 year OR experience). The intervention, developed via a two-round Delphi process, combined didactic teaching and simulation of five interruption scenarios based on the Memory for Goals framework ( Stay, Say, Acknowledge, Fixate, Estimate ). Observations captured interruption characteristics, strategies, outcomes, and task resumption. Secondary outcomes included NASA-TLX and the Operating Room Nursing Interruption Cognitive Ability Inventory (ORNICAI). Chi-square/Fisher tests and paired t-tests were applied (α = 0.05). Results A total of 1,090 interruption events were recorded (541 vs 549). While event frequency was unchanged, strategy use shifted: slightly delayed interruptions increased (8.13%→17.85%), immediate interruptions (65.80%→58.29%) and multitasking (23.66%→22.04%) decreased (p < 0.0001). Positive outcomes rose (7.39%→10.75%) and negative outcomes declined (79.85%→72.86%, p = 0.023). Failures to resume tasks fell (4.81%→0.73%), while “original task completed” increased (4.99%→13.84%, p < 0.0001). ORNICAI scores improved significantly (112.40 ± 12.54→115.2 ± 12.52, p < 0.001). NASA-TLX scores slightly decreased (67.56 ± 13.31→67.12 ± 13.10, p = 0.003), mainly due to lower mental demand. Conclusions The Stay S.A.F.E. strategy improved OR nurses’ interruption cognition, promoted safer strategies, enhanced task resumption, and modestly reduced workload without affecting interruption frequency. Integration into OR training is warranted, with multi-center studies and longer follow-up recommended.