Thinking ahead of the surgeon. An interview study to identify scrub nurses' non-technical skills

Lucy Mitchell, Rhona Flin, Steven Yule, Janet Mitchell, Kathy Coutts, George Youngson
International Journal of Nursing Studies 2011, 48 (7): 818-28

BACKGROUND: Efforts to reduce adverse event rates in healthcare have revealed the importance of identifying the essential non-technical (cognitive and social) skills for safe and effective performance. Previous research on non-technical skills for operating theatre staff has concentrated on doctors rather than nursing professionals.

OBJECTIVES: The aim of the study was to identify the critical non-technical skills that are essential for safe and effective performance as an operating theatre scrub nurse.

METHODS: Experienced scrub nurses (n = 25) and consultant surgeons (n = 9) from four Scottish hospitals were interviewed using a semi-structured format. The protocols were designed to identify the main social and cognitive skills required by scrub nurses. Interviews were digitally recorded, transcribed verbatim and independently coded to extract behaviours in order to produce a list of the main non-technical skills for safe and effective scrub nurse performance.

RESULTS: The non-technical skills of situation awareness, communication, teamwork, task management and coping with stress were identified as key to successful scrub nurse task performance. Component sets of behaviours for each of these categories were also noted.

CONCLUSION: The interviews with subject matter experts from scrub nursing and surgery produced preliminary evidence that situation awareness, communication, teamwork and coping with stress are the principal non-technical skills required for effective performance as a scrub nurse.

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