Non-technical Skills of Operating Room Nurses in University Hospital

Main Article Content

Wanvimol Kongsuwan
Rattima Sirihorachai
Thanapan Kunalasiri
Manunpat Tongbunkular
Watanyuta Wianchai

Abstract

          Purpose: To examine the behavior of non-technical skills of scrub nurses during intra -operative phase, and the relationship between age, work experience and type of surgery of scrub nurses.


          Design: Descriptive correlation study.


          Methods: Non-technical skills of ninety-nine scrub nurses in operating rooms at University hospital in Thailand were observed using SPLINT System consisting of 3 subscales (situation awareness, communication and teamwork, task management). Inter-rater reliability using Cohen’s kappa was .99. Data were analyzed by using descriptive statistics, Pearson product moment correlation and one-way ANOVA.


          Main findings: The sample had non-technical skills at a standard level for each subscale; 1) task management, gif.latex?\bar{X} = 3.21, SD = .46) 2) situation awareness, gif.latex?\bar{X} = 3.15, SD = .56 and 3) communication and teamwork, gif.latex?\bar{X} = 3.05, SD = .53 respectively. Age and work experience were found to be positively correlated with non-technical skills at significance level .05. (r = .263, p < .01; r = .386, p < .01,  respectively). Surgery with high procedure complexity needs more overall non-technical skills and task management domain than other type of surgery (F = 3.609, p < .05 and F = 5.787, p < .01, respectively)


          Conclusion and recommendations: Non-technical skills are important skills scrub nurses in operating rooms must require; thus, there is a need to maintain standard non-technical skills for the scrub nurses in the setting. A workshop or training to enhance these nurses to achieve such skills beyond the standard level is suggested in order to improve patient safety in the operating rooms and being a role model for others to follow.

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How to Cite
Kongsuwan, W., Sirihorachai, R., Kunalasiri, T., Tongbunkular, M., & Wianchai, W. (2019). Non-technical Skills of Operating Room Nurses in University Hospital. Nursing Science Journal of Thailand, 37(4), 42-53. Retrieved from https://he02.tci-thaijo.org/index.php/ns/article/view/200528
Section
Research Papers

References

1. World Health Organization. The second global patient safety challenge: safe surgery saves lives. WHO Press: Geneva, Switzerland; 2008. 28 p.

2. The Association of periOperative Registered Nurses (AORN). Guidelines for perioperative practice 2018. 1st ed. Denver, CO: AORN, Inc.; 2018. 994 p.

3. Serino MF. Quality and patient safety teams in the perioperative setting. AORN J. 2015;102(6):617-28. doi: 10.1016/j.aorn.2015.10.006.

4. Kirk LM. Professionalism in medicine: definitions and considerations for teaching. Proc (Bayl Univ Med Cent). 2007;20(1):13-6. doi: 10.1080/08998280.2007.11928225.

5. Onler E, Yildiz T, Bahar S. Evaluation of the communication skills of operating room staff. J Interprof Educ Pract. 2018;10:44-6. doi: 10.1016/j.xjep.2017.11.004.

6. Mitchell L, Flin R. Non-technical skills of the operating theatre scrub nurse: literature review. J Adv Nurs. 2008;63(1):15-24. doi: 10.1111/j.1365-2648.2008.04695.x.

7. Reader T, Flin R, Lauche K, Cuthbertson BH. Non-technical skills in the intensive care unit. Br J Anaesth. 006;96(5):551-9. doi: 10.1093/bja/ael067.

8. Bell L. Using OR patient classification for staffing assignment. AORN J. 2015;101(6):639-45. doi: 10.1016/j.aorn.2015.03.003.

9. Fletcher G, Flin R, McGeorge P, Glavin R, Maran N, Patey R. Rating non-technical skills: developing a behavioural marker system for use in anaesthesia. Cogn Technol Work. 2004;6(3):165-71. doi: 10.1007/s10111-004-0158-y.

10. Yule S, Flin R, Paterson-Brown S, Maran N, Rowley D. Development of a rating system for surgeons’ non-technical skills. Med Educ. 2006;40(11):1098-104. doi: 10.1111/j.1365-2929.2006.02610.x.

11. Mitchell L, Flin R, Yule S, Mitchell J, Coutts K, Youngson G. Thinking ahead of the surgeon. An interview study to identify scrub nurses’ non-technical skills. Int J Nurs Stud. 2011;48(7):818-28. doi: 10.1016/j.ijnurstu.2010.11.005.

12. Mitchell L, Flin R, Yule S, Mitchell J, Coutts K, Youngson G. Development of a behavioural marker system for scrub practitioners’ non-technical skill (SPLINTS system). J Eval Clin Pract. 2013;19(2):317-23. doi: 10.1111/j.1365-2753.2012.01825.x.

13. Mitchell L, Flin R, Yule S, Mitchell J, Coutts K, Youngson G. Evaluation of Scrub practitioner’s List of Intraoperative Non-Technical Skill (SPLINTS) system. Int J Nurs Stud. 2012;49(2):201-11. doi: 10.1016/j.ijnurstu.2011.08.012.

14. Joint Commission. Sentinel event statistics data - root causes by event type (2004-2015) [Internet]. Oak Brook, Illinois: Joint Commission Resources; 2016 [cited 2016 May 31]. Available from: https://www.jointcommission.org/assets/1/18/Root_Causes_by_Event_Type_2004-2015.pdf.

15. Fletcher G, Flin R, McGeorge P, Glavin R, Maran N, Patey R. Anaesthetists’ Non-Technical Skills (ANTS): evaluation of a behavioural marker system. Br J Anaesth. 2003;90(5):580-8. doi: 10.1093/bja/aeg112.

16. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Mahwah, NJ: Lawrence Erlbaum Associates; 1988. 527 p.

17. Waltz CF, Strickland OL, Lenz ER. Measurement in nursing and health research. 4th ed. New York: Springer Publishing; 2010. 477 p.

18. Lingard L, Espin S, Whyte S, Regehr G, Baker GR, Reznick R, et al. Communication failures in the operating room: an observational classification of recurrent types and effects. Qual Saf Health Care. 2004;13(5):330-4. doi: 10.1136/qhc.13.5.330.

19. Sevdalis N, Healey AN, Vincent CA. Distracting communications in the operating theatre. J Eval Clin Pract. 2007;13(3):390-4. doi: 10.1111/j.1365-2753.2006.00712.x.

20. Lingard L, Espin S, Rubin B, Whyte S, Colmenares M, Baker GR, et al. Getting teams to talk: development and pilot implementation of a checklist to promote interprofessional communication in the OR. Qual Saf Health Care. 2005;14(5):340-6. doi: 10.1136/qshc.2004.012377.

21. Lark ME, Kirkpatrick K, Chung KC. Patient safety movement: history and future directions. J Hand Surg Am. 2018;43(2):174-8. doi: 10.1016/j.jhsa.2017.11.006.

22. Caney BT, West P, Neily J, Bagian C. Difference in nurse and surgeon perceptions of teamwork: implications for use of a briefing checklist in the OR. AORN J. 2010;91(6):722-9. doi: 10.1016/j.aorn.2009.11.066.

23. Carvalho PA, Gottems LB, Pires MR. de Oliveria ML. Safety culture in the operating room of a public hospital in the perception of healthcare professionals. Rev Lat Am Enfermagem. 2015;23(6):1041-8. doi: 10.1590/0104-1169.0669.2647.

24. Phitayakorn R, Minehart RD, Hemingway MW, Pian-Smith MCM, Petrusa E. The relationship between intraoperative teamwork and management skill in patient care. Surgery. 2015:158(5):1434-40. doi: 10.1007/s00464-007-9346-1.

25. Siu J, Maran N, Paterson-Brown S. Observation of behavioral markers of non-technical skills in the operating room and their relationship to intra-operative incidents. Surgeon. 2016;14(3):119-28. doi: 10.1016/j.surge.2014.06.005.