Role transition: A descriptive exploratory study of assistant nurse clinicians in Singapore.

AIM: To explore the role-transition experiences of assistant nurse clinicians after their first year of appointment. BACKGROUND: The National Nursing Taskforce was set up in Singapore to examine the professional development and recognition of nurses. It created the assistant nurse clinician role as an avenue for the nurses' career development. The role was intended to assist nurse managers to guide the nursing team in the assessment, planning, and delivery of patient care. METHODS: A qualitative descriptive study design was adopted. A purposive sample of 22 registered nurses from six acute care institutions and two polyclinics in Singapore participated in the face-to-face interviews. An inductive content analysis approach was used to analyse the data. RESULTS: Four themes emerged: (a) promotion to assistant nurse clinician is a form of recognition and vindication; (b) there was uncertainty about the expected role of the assistant nurse clinician; (c) experience eases transition; and (d) there was a need for peer support, mentorship, and training. CONCLUSIONS: The job description of the assistant nurse clinician needs to be better defined to provide greater clarity about their clinical and administrative duties and what is expected of their performance. IMPLICATIONS FOR NURSING MANAGEMENT: It is essential for nurse managers to provide successful role-transition strategies to help the newly appointed assistant nurse clinicians to become efficient and effective leaders.

[Pre-operative Verification, Site Marking and Time Out - Spreading Patient Safety Culture from Major Operating Theatre to Day Surgery].

In this article, we describe how we spread safety culture of correct site surgery from Major Operating Theatre to Day Surgery. We discuss how we integrated the High 5s Project Correct Site Surgery protocol into the Day Surgery Operating Theatre (DSOT) workflow and monitored compliance through audit and feedback. We also reflect on how human factors analysis (HFACS) helps in bridging the gaps by providing a tool for recognizing possible causes of non-compliance. Background: The High 5s Project, established by World Health Organization (WHO), in 2007, is an international collaboration carried out in seven countries - Australia, Germany, France, the Netherlands, Singapore, Trinidad & Tobago and the United States of America - and coordinated by the WHO Collaborating Centre on Patient Safety, The Joint Commission. Its mission is to facilitate implementation and evaluation of standardized patient safety solutions within a global learning community, to achieve measurable, significant and sustainable reductions in high-risk patient safety problems.

Process reengineering of preoperative verification, site marking and time-out for patient safety.

In this article, we describe our hospital's journey in implementing the WHO High 5s Project Correct Site Surgery Standard (CSS) protocol. We discuss how we incorporated the protocol into our system by revising the pre-existing checklist, reengineering the existing processes on preoperative verification, site marking and time-out at the Major Operating Theatre (MOT), and performing audit and feedback to ensure effective compliance. We also reflect on the importance of leadership and ministry support, benchmarking and tailoring the practice for each discipline in the pursuit of improving patient safety within the hospital.

Differences in attentional strategies by novice and experienced operating theatre scrub nurses.

This study investigated the effect of nursing experience on attention allocation and task performance during surgery. The prevention of cases of retained foreign bodies after surgery typically depends on scrub nurses, who are responsible for performing multiple tasks that impose heavy demands on the nurses' cognitive resources. However, the relationship between the level of experiences and attention allocation strategies has not been extensively studied. Eye movement data were collected from 10 novice and 10 experienced scrub nurses in the operating theater for caesarean section surgeries. Visual scanning data, analyzed by dividing the workstation into four main areas and the surgery into four stages, were compared to the optimum expected value estimated by SEEV (Salience, Effort, Expectancy, and Value) model. Both experienced and novice nurses showed significant correlations to the optimal percentage dwell time values, and significant differences were found in attention allocation optimality between experienced and novice nurses, with experienced nurses adhering significantly more to the optimal in the stages of high workload. Experienced nurses spent less time on the final count and encountered fewer interruptions during the count than novices indicating better performance in task management, whereas novice nurses switched attention between areas of interest more than experienced nurses. The results provide empirical evidence of a relationship between the application of optimal visual attention management strategies and performance, opening up possibilities to the development of visual attention and interruption training for better performance.