Development of Non-Technical Skills of Nurse Anesthetists to Enhance Patient Safety in the Operating Room at Sisaket Hospital
Article Sidebar
Main Article Content
Abstract
This research aimed to 1) assess the current situation of non-technical skills among nurse anesthetists, 2) develop a model for improving these skills, and 3) evaluate the effectiveness of the model at Sisaket Hospital. This research and development study involved two sample groups:17 purposively selected multidisciplinary healthcare professionals involved in operating room patient care and quality assurance, and 15 nurse anesthetists selected through simple random sampling. Data collection methods included in-depth interviews and focus group discussions. Research instruments comprised structured interview forms, the developed non-technical skills improvement model, a non-technical skills assessment form, and a satisfaction questionnaire. Content validity was verified by five experts, with a reliability coefficient of 0.86. The findings revealed limitations in four non-technical skill domains: situation awareness, decision-making, teamwork, and communication. The developed model employed two simulation scenarios: preoperative patient assessment and preparation, and prevention of reintubation within two hours following extubation in the operating room/recovery room. After implementing the model, there was a reduction in incidents of surgery postponement due to inadequate patient preparation and reintubation within two hours after extubation. Average scores in all four non-technical skill domains increased significantly (p < .001). Nurse anesthetists expressed the highest level of satisfaction with the model, particularly regarding overall performance efficiency. The model enhanced emergency decision-making processes, improved communication between anesthesia and surgical teams, increased awareness of critical situations during anesthesia administration, and strengthened effective teamwork in the operating room. These outcomes ultimately contributed to higher standards of patient safety in the operating environment.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The content and information in the articles published in the Journal of Science and Technology, Sisaket Rajabhat University reflect the opinions and responsibilities of the respective authors. The editorial board of the journal does not necessarily agree with, nor share responsibility for, these views.
Articles, information, content, images, etc., published in the Journal of Science and Technology, Sisaket Rajabhat University are copyrighted by the Faculty of Science and Technology, Sisaket Rajabhat University. If any individual or organization wishes to republish all or part of the content, or use it for any other purpose, they must obtain written permission from the Journal of Science and Technology, Sisaket Rajabhat University beforehand.
References
Best, JW., & Kahn, JV. (2016). Research in education. Chennai: Pearson Education India.
Boonphatum, Y., Daovijit, J., & Chaichomphu, A. (2021). Outcome of Assessment and Preparation for Patients Undergoing Anesthesia at Preoperative Clinic. Journal of Health Science of Thailand, 30(4), 706. (in Thai)
Flin, R., & O'Connor, P. (2017). Safety at the sharp end: a guide to non-technical skills. CRC Press.
Flin, R., Martin, L., Goeters, KM., Hörmann, HJ., Amalberti, R., Valot, C., & Nijhuis, H. (2018). Development of the NOTECHS (non-technical skills) system for assessing pilots’ CRM skills. In Human factors and aerospace safety (pp. 97-119). Routledge.
Flynn, FM., Bing-Jonsson, PC., Falk, RS., Tønnessen, S., & Valeberg, BT. (2022). Educating for excellence: A cohort study on assessing student nurse anesthetist non technical skills in clinical practice.
Gordon, M., Darbyshire, D., & Baker, P. (2012). Non‐technical skills training to enhance patient safety: a systematic review. Medical education, 46(11), 1042-1054.
Hospital Accreditation Institute (Public Organization). (2018). Patient safety goals: SIMPLE Thailand 2018. Bangkok: Femmas and Success Full. (in Thai)
Jones, CPL., Fawker‐Corbett, J., Groom, P., Morton, B., Lister, C., & Mercer, SJ. (2018). Human factors in preventing complications in anaesthesia: A systematic review. Anaesthesia, 73, 12-24.
Kohn, LT., Corrigan, JM., & Donaldson, MS. (1999). To err is human: Building a safer health system National Academy Press. Washington, DC.
Kumkong, M. (2020). Non-technical skills: Practical learning management in nursing education. Southern Network Nursing and Public Health Journal, 7(2), 312-323. (in Thai)
Peffers, K., Tuunanen, T., Rothenberger, MA., & Chatterjee, S. (2007). A design science research methodology for information systems research. Journal of management information systems, 24(3), 45-77.
Phoson, P. (2020). The Online Learning Anesthetist’s Non-technical Skills (ANTS) in Nurse Anesthetist Students during COVID-19. Thai Journal of Anesthesiology, 46(3), 119-125. (in Thai)
Polit, DF., & Hungler, BP. (1999). Nursing research: Principles and methods. 6th ed. Pennsylvania: Lippincott Williams & Wilkins.
Radhakrishnan, K., Roche, JP., & Cunningham, H. (2022). Importance of non-technical skills in anaesthesia education. Indian Journal of Anaesthesia, 66(1), 64-69.
Raksamani, K. (2022). Ready for crisis in anesthesia. Bangkok: Siriraj Books. (in Thai)
Salas, E., Reyes, DL., & McDaniel, SH. (2015). On teamwork: Theories, methods, and applications. Annual Review of Organizational Psychology and Organizational Behavior, 2, 275-297.
Schulz, CM., Burden, A., Posner, KL., Mincer, SL., Steadman, R., Wagner, K., & Domino, K. B. (2017). The frequency and type of situational awareness errors contributing to death and brain damage: A closed claims analysis. Anesthesiology, 127(2), 326-337.
Sidi, A. (2020). Challenges in learning and assessing anesthesia cognitive and non-technical skills of anesthesiologists and residents in anesthesia. Harefuah, 159(6), 432-439.
Tettanom, P. (2018). Patient safety and overcrowding in emergency room. Public Health & Health Laws Journal, 4(2), 237-249. (in Thai)
Weiser, TG., Regenbogen, SE., Thompson, KD., Haynes, AB., Lipsitz, SR., Berry, WR., & Gawande, AA. (2008). An estimation of the global volume of surgery: A modelling strategy based on available data. The Lancet, 372(9633), 139-144.
