title: Factors that influence the non-technical skills performance of scrub nurses: a prospective study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: NHMRC Research Centre for Clinical Excellence in Nursing Interventions (NCREN) & Centre for Healthcare Practice Innovation (HPI), Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Kang
authors.affiliation: School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia.
authors.forename: Debbie
authors.initials: D
authors.lastname: Massey
authors.affiliation: NHMRC Research Centre for Clinical Excellence in Nursing Interventions (NCREN) & Centre for Healthcare Practice Innovation (HPI), Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia.
authors.forename: Brigid M
authors.initials: BM
authors.lastname: Gillespie
mesh_terms: D000328:Adult; D001315:Australia; D002983:Clinical Competence / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000592:standards*; D013527:Perioperative Nursing / Q000592:standards*; D011446:Prospective Studies
keywords: circulating nurse; instrument nurse; non-technical skills; operating room; patient safety; performance; peri-operative; scout nurse; scrub nurse