Title. Non-technical skills of the operating theatre scrub nurse: literature review. Aim. This paper is a report of a review to identify the non-technical (cognitive and social) skills used by scrub nurses. Background. Recognition that failures in non-technical skills contributed to accidents in high-risk industries led to the development of research programmes to study the role of cognition and social interactions in operational safety. Recently, psychological research in operating theatres has revealed the importance of non-technical skills in safe and efficient performance. Most of the studies to date have focused on anaesthetists and surgeons. Data sources. On-line sources and university library catalogues, publications of the Association for Perioperative Practice, National Association of Theatre Nurses and Association of Peri-Operative Registered Nurses were searched in 2007. Review methods. Studies were included in the review if they presented data from scrub nurses on one or more of their non-technical skills. These findings were examined in relation to an existing medical non-technical skills framework with categories of communication, teamwork, leadership, situation awareness and decision-making. Results. Of 424 publications retrieved, 13 were reviewed in detail. Ten concerned communication and eight of those also had data on teamwork. In 11 papers teamwork was examined, and one focused on nurses’ situation awareness, teamwork and communication. None of the papers we reviewed examined leadership or decision-making by scrub nurses. Conclusion. Further work is needed to identify formally the non-technical skills which are important to the role of scrub nurse and then to design training in the identified non-technical skills during the education and development of scrub nurses.

Non-technical skills of the operating theatre scrub nurse: literature review.

Recommended Practices for Maintaining a Sterile Field

Robotic-assisted Minimally Invasive Surgery (MIS) is adopted more and more as it overcomes the shortcomings of classic MIS for surgeons while keeping the benefits of small incisions for patients. However, introducing new technology oftentimes affects the work of skilled practitioners. Our goals are to investigate the impacts of telemanipulated surgical robots on the work practices of surgical teams and to understand their cause. We conducted a field study observing 21 surgeries, conducting 12 interviews and performing 3 data validation sessions with surgeons. Using Thematic Analysis, we find that physically separating surgeons from their teams makes them more autonomous, shifts their use of perceptual senses, and turns the surgeon's assistant into the robot's assistant. We open design opportunities for the HCI field by questioning the telemanipulated approach and discussing alternatives that keep surgeons on the surgical field.

https://hal.archives-ouvertes.fr/hal-02024723/document

Impacts of Telemanipulation in Robotic Assisted Surgery

While its technical feasibility has been illustrated over a decade ago, today, robot-assisted telesurgery is not a part of everyday surgical practice. The thresholds for adoption of telesurgery are mostly seen as technical, legal and financial challenges. However, the aim of this paper is to understand collaboration within distributed OR teams, which seems to be under examined in research on telesurgery. By means of a proxy-technology assessment and a series of interviews, collaborative challenges for telesurgery have been identified. These include the unfamiliarity of the remote surgeon with the practices of the local operating room team and the patient. In addition, verbal and non-verbal communication have to be mediated in a telesurgery setting, making it difficult for the remote surgeon to have an overview and stay in control during surgery. With this research, we illustrate how trust issues in distributed teams manifest in OR teams in a telesurgery setting.

Exploring the social-technological gap in telesurgery: collaboration within distributed or teams

Informed consent: a study of the OR consenting process in New Zealand.

Excellent communication skills, both verbal and nonverbal, are needed throughout the perioperative experience to educate patients undergoing surgery and so ease their anxiety. In addition, good communication with theatre colleagues, the multidisciplinary team, and other departments is vital to achieve technical excellence and individualised, holistic patient care. This article discusses the importance of effective communication and describes how it can be improved in the perioperative setting.

Why good communication skills are important for theatre nurses.

Nurses play an essential role in preparing patients for surgical procedures, whether the operation is planned or an emergency. Part of this preparation may include administration of premedication. Government initiatives such as The NHS Plan (Department of Health, 2000) and Essence of Care (DoH, 2001) emphasise the need to get the fundamental aspects of nursing care right, and nurses have a professional responsibility to deliver evidence-based care (NMC, 2002). Additionally, the publication of Building a Safer NHS for Patients: Improving Medication Safety (DoH, 2004) aims to improve patient safety by reducing the incidence of drug errors. This article looks at why pharmacological intervention is no longer a routine preoperative preparation. It will discuss drugs that are used to aid anaesthesia and those used as prophylaxis to aid postoperative recovery, consider the ways in which premedication can now include psychological interventions, and look at the nurse's role.

The effective management and administration of premedication.

It is essential for nurses to be aware of their legal and professional obligations regarding health and safety issues in the operating theatre. There should be strict policies and procedures in place to ensure a safe environment and to maintain the sterile field for the benefit of patients, staff and visitors.

Sue Saunders

Papers

Why good communication skills are important for theatre nurses.

The effective management and administration of premedication.

Practical measures to ensure health and safety in theatres.