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Title: Development of a behavioural rating system for the non-technical skills used by anaesthetic nurses and operating department practitioners
Author: Rutherford, John
Awarding Body: University of Aberdeen
Current Institution: University of Aberdeen
Date of Award: 2015
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Unintentional harm due to healthcare is common, especially in the operating theatre. Previous research, aiming to reduce harm to patients in the operating theatre, has not examined the non-technical skills of anaesthetic assistants. The aim of this project was to identify the essential non-technical skills required by anaesthetic assistants for safe and effective practice, and to develop a behavioural marking system to assess these skills. A literature review identified three articles which described anaesthetic assistants' non-technical skills. An interview study with anaesthetic assistants (n=22) and anaesthetists (n=23) described the use of situation awareness, teamwork and task management more commonly than leadership or decision making. This was corroborated by a critical incident database review of the Australian Incident Monitoring System from 2002 to 2008. The material identified in the interview study was considered by focus groups of anaesthetic assistants (n=6,7,3,4) to generate headings. These themes were considered by anaesthetic assistant lecturers (n=6) in a Delphi questionnaire, and positive and negative behavioural markers proposed. The Anaesthetic Non-Technical Skills for Anaesthetic Practitioners (ANTS-AP) behavioural marker system was completed by a research panel. The prototype ANTS-AP system had three categories: 'situation awareness', 'communication and teamwork', and 'task management', each with three elements. The reliability, validity and usability of the ANTS-AP system were evaluated by anaesthetic assistants (n=48) observing videos of simulated theatre work at a 3.5 hour workshop. The system had good internal consistency, and was able to discriminate good, average and poor behaviours. The element 'coping with pressure' was removed due to its poor inter-rater reliability. Future work will assess the inter-rater reliability of the ANTS-AP system, when observers have the opportunity for calibration. This project has provided anaesthetic assistants a means of structuring observation and feedback for training and reflection with the goal of improving patient care.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Operating room nurses ; Operating room technicians ; Nurse anesthetists ; Behaviorism (Psychology)