Nursing Times editor Alastair McLellan on theatre nursing and improving patient safety
Effectiveness, safety, patient experience: the holy trinity of modern NHS care, courtesy of Lord Darzi.
The way in which these factors interrelate to produce good health care and how the lack of any one can undermine it is well illustrated in our analysis of elective surgery and the role of theatre nursing.
The drive to reduce waiting times for elective surgery has increased the pressure on theatres. Greater throughput always raises questions of safety - as the rate of repetition sometimes leads to complacency and the pace of operation to oversights and mistakes.
The National Patient Safety Agency’s surgery checklist provides a simple and effective way to guard against standards slipping - it also crucially empowers nurses to speak when they believe something has gone amiss.
However, safety could also be improved by reducing the intensity of theatre operation. In any case, it is not acceptable that the NHS invests millions in theatres and the very expensive equipment that fills them then allows them to lie unused for most evenings and weekends. No business would allow such a paltry return on an investment - and the same level of value for money should be demanded in the public sector. Of course, more capacity in operating theatres would also realise the potential to reduce waiting times - a key element to improve patient experience.
One of the ways to unlock unused theatre time is to employ more theatre nurses.
The short-term solution to this undersupply is to find a way to make evening and weekend working more financially rewarding. The more long-lasting solution would be to simply increase the number of theatre nurses.
Key to achieving that goal is changing the view of theatre nurses as surgical handmaidens. That change in perception would require providing more theatre placements for student nurses - and making these placements fulfilling.
Ironically many nurses turn away from theatre nursing because they believe it offers less patient contact. It is ironic because not only does modern theatre nursing require and provide significant patient contact but also that contact is key to enhancing patient experience - which is, perhaps, the biggest challenge for hospital nursing and the source of satisfaction for so many in the profession.