Perioperative nurses' perceptions of competence: implications for migration.

BACKGROUND: Nurses' recognition of their own level of skills and abilities (ie perceived competence) is a prerequisite for ensuring they can practice in a safe manner. The demand for competence, in the operating room, may vary between clinical environments. It is, however, unclear what competency levels migrating nurses need in order to be deemed safe. AIM: This paper describes Canadian and Australian nurses' levels of perceived perioperative competence and discusses these results in the context of nurse migration. METHOD: A survey was distributed to operating room nurses in six hospital sites (three in Canada and three in Australia). Perioperative competence was measured with a 40-item self-report survey which consisted of six domain subscales: foundational knowledge and skills; leadership; collaboration; proficiency; empathy; and professional development. Non-parametric tests were used to describe differences between groups based on country of origin, years of experience and specialty qualifications. RESULTS: Canadian and Australian nurses reported their overall competency levels as high across all domains. Significant differences were found, between countries, in three of the six competency domains; foundational knowledge and skills (p < .001), collegiality (p = .023), and empathy (p < .0001). CONCLUSIONS: Describing perioperative competence cross-nationally represents the first step in generating international dialogue around educational preparation for migrating nurses. The increasing global mobility of nurses makes it imperative to further standardise, with an international perspective, knowledge and practice expectations in perioperative settings.

Medication safety in the operating room: teaming up to improve patient safety.

A medication safety project for operating rooms (ORs) was initiated under the leadership of the Departments of Anesthesia and Nursing with a representative from the Canadian Anesthesiologists' Society and the Institute for Safe Medication Practices Canada. The aims of the collaborative project were twofold: (1) to identify areas of exposure to risk and make recommendations to enhance medication safety within the hospital and (2) to inform the development of a medication safety checklist specific to the OR setting. The strategies developed and implemented during this project were aimed at reducing the risk of injury induced by medications. Attempts were made to use feasible best practices and managerial support systems for defined areas - in this case, medication-use systems for the ORs and associated patient care areas. The learning from this project will also inform the development of a medication safety checklist for use by other hospitals and OR settings.