Identifying the nontechnical skills required of nurses in general surgical wards

Marshall, Dianne; Finlayson, Mary

doi:10.1111/jocn.14290

Cited by 13 publications

(11 citation statements)

References 58 publications

(72 reference statements)

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“…They identified “preparation and technical competence” and “communication” as two major themes underlying role behaviors in the OR . The distinction between experience and communication skills is established as well and further underlies our means of OR staff assessment …”

Section: Discussionmentioning

confidence: 98%

Airway Surgery Communication Protocol: A Quality Initiative for Safe Performance of Jet Ventilation

et al. 2019

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Objectives: To assess whether manual jet ventilation can safely be performed with variable anesthesia and operating room (OR) staff experience levels and communication skills.Methods: Jet ventilation procedures for airway stenosis at a single institution over 35 months were retrospectively reviewed. OR and anesthesia staff were assigned scores based on experience level and communication skills. Data were analyzed for any association between the experience or communication skills of the staff and the successful use of jet ventilation, complication rate, or ultimate patient outcome, controlling for intraoperative variables and patient and airway complexity. A detailed preoperative surgeon-led communication protocol was followed in all cases.Results: Seventy procedures in 46 patients were performed. Jet ventilation was successful in 69 of 70 cases. No relationship was found between staff experience or communication scores and the successful use of jet ventilation, complication rate, or ultimate patient outcome. The percentage of cases performed with a fully experienced team was low, at 7.1%. The experience level of the certified registered nurse anesthetist was significantly associated with likelihood of using an adequate paralytic dose upfront (P = 0.017), which in turn correlated with shorter anesthesia time by 19.7 minutes (P = 0.0131); however, neither affected complication rate nor ultimate patient outcome. The statements above remained true in cases of medically complex patients, difficult airways with high degrees of stenosis, and multiple shift changes.Conclusions: Manual jet ventilation can be performed safely even in settings of lower staff experience level or communication skills given a surgeon experienced in the technique and a strict communication protocol.Key Words: Manual subglottic jet ventilation, operating room communication, anesthesia and surgeon cooperation, experience level in jet ventilation, endoscopic surgery for airway stenosis.

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Section: Discussionmentioning

confidence: 98%

Airway Surgery Communication Protocol: A Quality Initiative for Safe Performance of Jet Ventilation

et al. 2019

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“…The labelling and identifying of the clinical communication goals or activities, and tasks, and of the contextual variables was informed by the healthcare communication literature: for example, handover (Eggins & Slade, ; Levett‐Jones et al, ; Marshall & Finlayson, ) and coordinating care (Stein‐Parbury, ).…”

Section: Methodsmentioning

confidence: 99%

Overseas qualified nurses’ communication with other nurses and health professionals: An observational study

Philip

Woodward‐Kron

Manias

2019

Journal of Clinical Nursing

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Aims and objectives To understand the interprofessional and intraprofessional communication patterns of overseas qualified nurses as they coordinate care for patients in Australian hospitals. Background Numerous studies have informed the transitioning experiences of overseas qualified nurses with non‐English‐speaking backgrounds working in English‐speaking workplaces. Only a few observational studies have involved examining the intercultural communication experiences of overseas qualified nurses, and none have considered their intra‐ and interprofessional communication patterns. Design A qualitative design was adopted, using participant observation and discourse analysis. Methods This study was from January 2017 to March 2017. Thirteen overseas qualified nurses working in acute, subacute and interventional cardiology settings in a Melbourne metropolitan hospital were shadowed over a period of 12 weeks to collect data that inform their communication patterns. The COREQ checklist was used. Results This observational study informed by genre analysis revealed that intra‐ and interprofessional communication occurred more commonly under the clinical communication goals of coordinating care and less commonly under facilitating intervention. Communication strategies ranged from structured interactions with use of communication tools to unstructured ad hoc interactions. Analysis of the discourse patterns demonstrated that effectiveness of interactions was affected by hesitancy, lack of assertion and few strategies to manage inadequate or aggressive communication by other team members. Poor clinical communication with peers was not always caused by the nurses from non‐English‐speaking backgrounds. Positive interpersonal interactions with laughter, language‐switching and small talk were evident in interactions with nurses from similar cultural backgrounds but were rare with local colleagues. Conclusion The linguistic evidence from this study shows variations in communication competency between participants, which emphasises the importance of not viewing overseas qualified nurses’ communication training needs as homogenous. With the growing multicultural nature of healthcare teams, this study underscores the need for intercultural communication training for team integration and patient safety. Relevance to clinical practice Continuous professional development should incorporate intercultural communication training to ensure team effectiveness within nursing teams as well as interprofessional teams.

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“…Healthcare professionals working in wards are generalists. Clinical work requires a broad spectrum of competencies, and healthcare professionals are often working under high time pressure [11].…”

Section: Introductionmentioning

confidence: 99%

A Human Factors Intervention in a Hospital - Evaluating the Outcome of a TeamSTEPPS Program in a Surgical Ward

Aaberg

Hall‐Lord

Husebø

et al. 2021

Preprint

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Background: Patient safety in hospitals is being jeopardized, since too many patients experience adverse events. Most of these adverse events arise from human factors, such as inefficient teamwork and communication failures, and the incidence of adverse events is greatest in the surgical area. Previous research has shown the effect of team training on patient safety culture and on different areas of teamwork. Limited research has investigated teamwork in surgical wards. The aim of this study was to evaluate the professional and organizational outcomes of a team training intervention among healthcare professionals in a surgical ward after 6 and 12 months. Systems Engineering Initiative for Patient Safety 2.0 was used as a conceptual framework for the study. Methods: This study had a pre-post design with measurements at baseline and after 6 months and 12 months of intervention. The intervention was conducted in a urology and gastrointestinal surgery ward in Norway, and the study site was selected based on convenience and the leaders’ willingness to participate in the project. Survey data from healthcare professionals were used to evaluate the intervention. The organizational outcomes were measured by the unit-based sections of the Hospital Survey of Patient Safety Culture Questionnaire, and professional outcomes were measured by the TeamSTEPPS Teamwork Perceptions Questionnaire and the Collaboration and Satisfaction about Care Decisions in Teams Questionnaire. A paired t-test, a Wilcoxon signed-rank test, a generalized linear mixed model and linear regression analysis were used to analyze the data. Results: After six months, improvements were found in organizational outcomes in two patient safety dimensions. After 12 months, improvements were found in both organizational and professional outcomes, and these improvements occurred in three patient safety culture dimensions and in three teamwork dimensions. Furthermore, the results showed that one of the significant improved teamwork dimensions “Mutual Support” was associated with the Patient Safety Grade, after 12 months of intervention.Conclusion: These results demonstrate that the team training program had effect after 12 months of intervention. Future studies with larger sample sizes and stronger study designs are necessary to examine the causal effect of a team training intervention in this context.

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Identifying the nontechnical skills required of nurses in general surgical wards

Abstract: Identifying general surgical nurses' NTS enables the development of teaching strategies that target the learning of those skills to achieve successful work outcomes and improve patient safety.

Cited by 13 publications

References 58 publications

Airway Surgery Communication Protocol: A Quality Initiative for Safe Performance of Jet Ventilation

Airway Surgery Communication Protocol: A Quality Initiative for Safe Performance of Jet Ventilation

Overseas qualified nurses’ communication with other nurses and health professionals: An observational study

A Human Factors Intervention in a Hospital - Evaluating the Outcome of a TeamSTEPPS Program in a Surgical Ward

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