Non-technical skills of the operating theatre scrub nurse: literature review.

AIM This paper is a report of a review to identify the non-technical (cognitive and social) skills used by scrub nurses. BACKGROUND Recognition that failures in non-technical skills contributed to accidents in high-risk industries led to the development of research programmes to study the role of cognition and social interactions in operational safety. Recently, psychological research in operating theatres has revealed the importance of non-technical skills in safe and efficient performance. Most of the studies to date have focused on anaesthetists and surgeons. DATA SOURCES On-line sources and university library catalogues, publications of the Association for Perioperative Practice, National Association of Theatre Nurses and Association of Peri-Operative Registered Nurses were searched in 2007. REVIEW METHODS Studies were included in the review if they presented data from scrub nurses on one or more of their non-technical skills. These findings were examined in relation to an existing medical non-technical skills framework with categories of communication, teamwork, leadership, situation awareness and decision-making. RESULTS Of 424 publications retrieved, 13 were reviewed in detail. Ten concerned communication and eight of those also had data on teamwork. In 11 papers teamwork was examined, and one focused on nurses' situation awareness, teamwork and communication. None of the papers we reviewed examined leadership or decision-making by scrub nurses. CONCLUSION Further work is needed to identify formally the non-technical skills which are important to the role of scrub nurse and then to design training in the identified non-technical skills during the education and development of scrub nurses.