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Aim. To identify and describe the factors that impact on the performance of scrub nurses' non-technical skills performance during the intra-operative phase of surgery. Background. Non-technical skills have been identified as important precursors to errors in the operating room. However, few studies have investigated factors influencing non-technical skills of scrub nurses. Design. Prospective observational study. Methods. Structured observations were performed on a sample of 182 surgical procedures across eight specialities by two trained observers from August 2012-April 2013 at two hospital sites. Participants were purposively selected scrub nurses. Bivariate correlations and a multiple linear regression model were used to identify associations among length of surgery, patients' acuity using the American Society of Anesthesiologists classification system, team familiarity, number of occasions scout nurses leave the operating room, change of scout nurse and the outcome, the non-technical skills performance of scrub nurses. Results. Patient acuity and team familiarity were the strongest predictors of scrub nurses' non-technical skills performance at hospital site A. There were no correlations between the predictors and the performance of scrub nurses at hospital site B. Conclusion. A dedicated surgical team and patient acuity potentially influence the performance of scrub nurses' non-technical skills. Familiarity with team members foster advanced planning, thus minimizing distractions and interruptions that impact on scrub nurses' performance. Development of interventions aimed at improving non-technical skills has the potential to make a substantial difference and enhance patient care. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives A range of strategies have been proposed to identify and address operating theatre delays, including preoperative checklists, post-delay audits and staff education. These strategies provide a useful starting point in addressing delay, but their effectiveness can be increased through more detailed consideration of sources of surgical delay. Method A qualitative, observational study was conducted at two Australian hospitals, one a metropolitan site and the other a regional hospital. Thirty surgeries were observed involving general, vascular and orthopaedic procedures which ranged in time from 20 minutes to almost 4 hours. Approximately 40 hours of observations were conducted in total. Results The research findings suggest that there are two key challenges involved in addressing operating theatre delays: unanticipated problems in the clinical condition of patients, and the capacity of surgeons to regulate their own time. These challenges create unavoidable delays due to the contingencies of surgical work and competing demands on surgeons' time. The results also found that surgical staff play a critical role in averting and anticipating delays. Differences in professional authority are significant in influencing how operating theatre time is managed. Conclusions Strategies aimed at addressing operating theatre delays are unlikely to achieve their desired aims without a more detailed understanding of medical decision making and work practices, and the intra- as well as inter-professional hierarchies underpinning them. While the nature of surgical work poses some challenges for measures designed to address delays, it is also necessary to focus on surgical practice in devising workable solutions. [ABSTRACT FROM AUTHOR]

ABSTRACT: Despite having well-established clinical roles in many specialties, hospital pharmacists have not traditionally provided clinical services in the operating suite (OS). This paper describes the introduction of a clinical pharmacy service in the OS of a large metropolitan public hospital network. The initial focus of the service was on non-clinical issues that were priorities for pharmacy and OS staff, such as medication supply, waste minimisation, expenditure, inter-departmental communication and legal compliance. Once ongoing funding for the positions was secured, cognitive clinical pharmacy services have become the focus. Benefits of the service have been demonstrated in medication safety, antibiotic stewardship and quality use of medicines. The 2 pharmacists have now become essential members of the OS. Work is underway to further develop pharmacists' roles in areas such as perioperative antimicrobial prescribing and perioperative management of patient's regular medication regimens to optimise the continuum of care. [ABSTRACT FROM AUTHOR]