Fiona Mary Flynn will defend her dissertation for the degree of philosophia doctor (PhD) in the programme Person-Centred Healthcare at the University of South-Eastern Norway.
The candidate is a nurse anaesthetist and has a master’s degree in clinical nursing. She is the program coordinator of the master’s degree in nurse anaesthesia at USN.
About the dissertation
Globally, an estimated 230 million patients undergo anaesthesia for surgical procedures each year. Anaesthesia and surgery are high risk areas where human error can have disastrous consequences. Between 44 and 54% of adverse events during surgery in high income countries could be avoided. There has therefore been increasing international focus on the importance of non-technical skills such as situation awareness, decision-making, task management and teamwork in ensuring patient safety and promoting clinical excellence. However, non-technical skills are currently not systematically integrated into nurse anaesthesia education. There is also a need for standardized and reliable tools for developing and assessing these skills.
The primary aim of this research project was to promote clinical excellence and improve patient safety in nurse anesthesia education through developing non-technical skills. The first study tested the reliability of a tool for systematically developing and assessing student nurse anaesthetists’ non-technical skills, while the second and third studies explored its use in clinical practice. The Nurse Anaesthetists’ Non-Technical Skills – Norway (NANTS-no) tool is a structured taxonomy with objective criteria and examples, which can be used for providing feedback and making assessments in nurse anaesthesia.
NANTS-no demonstrated high reliability both in a controlled setting and when used to assess students’ non-technical skills in the operating room. Twenty students were assessed by their mentors and clinical supervisors using the NANTS-no 5-point rating scale during their education, achieving near excellent non-technical skills at their final assessment (4.5). In the focus group interviews, mentors and students described NANTS-no as providing a standard of excellence for ensuring newly qualified nurse anaesthetists had the required skill-set. It also led to a more professional learning partnership between mentors and students, that encouraged critical reflection, structured feedback and a more objective evaluation. However, further work is needed to encourage a wider use of NANTS-no and implement it fully in clinical practice.
These findings encourage the hope that systematically integrating NANTS-no in the education of nurse anaesthetists throughout Norway, can foster new generations of nurse anaesthetists with excellent non-technical skills, as well as improved patient safety in anaesthesia.