# Strengthening surgical outcomes through nursing education: an evidence-based training model in Laos

## TL;DR

This paper presents a training model to improve perioperative nursing care in Laos, aiming to enhance surgical outcomes through better education and practices.

## Contribution

The novel contribution is the development of a localized training model, STEP-CARE, to improve perioperative nursing quality in low-resource settings.

## Key findings

- The training model improved hand hygiene compliance and nursing performance.
- A STEP-CARE model was developed to ensure quality improvement in perioperative care.
- Training enhanced nurses' knowledge, attitudes, and practices in preoperative, intraoperative, and postoperative care.

## Abstract

The quality of perioperative care is closely linked to postoperative recovery. The level of care in low- and middle-income countries hinders the pace and quality of postoperative recovery. It is essential to understand the perioperative situation and needs of local hospitals to target the development of localized professional training programs, thereby enhancing the professionalism of nursing staff in providing high-quality care to patients.

To study issues related to the quality of perioperative nursing in hospitals in Lao and improve the threshold of holistic care.

Qualitative and quantitative studies were used to design the training program. In total, 25 nurses from a hospital were selected between December 2024 and May 2025. A survey was conducted to understand issues with the targeted construction of training programs and their implementation, evaluation, and continuous supervision. A comparative analysis of operation scores and the competence level of each nurse before and after the training was conducted to evaluate the training’s effectiveness.

A total of 11 aspects were identified using the Knowledge, Attitude, and Practice model. In total, 30 theoretical and 12 operational training topics were designed, and a training strategy was developed to enhance the quality of perioperative care, based on preoperative, intraoperative, and postoperative data. A STEP-CARE model was designed to ensure overall quality improvement and training effects. Hand hygiene compliance, accuracy, and performance were also improved.

The study recommends using knowledge, attitudes, and actions as starting points for continuous quality improvement. Training qualified professionals, improving institutional processes, strengthening disciplinary collaboration, and improving facilities are imperative to enhance the overall outcome.