Development, initial reliability and validity testing of an observational tool for assessing technical skills of operating room nurses.

Background: The recent emergence of the Systems Approach to the safety and quality of surgical care has triggered individual and team skills training modules for surgeons and anaesthetists and relevant observational assessment tools have been developed.

Objective: To develop an observational tool that captures operating room (OR) nurses' technical skill and can be used for assessment and training.

Methods: The Imperial College Assessment of Technical Skills for Nurses (ICATS-N) assesses (i) gowning and gloving, (ii) setting up instrumentation, (iii) draping, and (iv) maintaining sterility. Three to five observable behaviours have been identified for each skill and are rated on 1-6 scales. Feasibility and aspects of reliability and validity were assessed in 20 simulation-based crisis management training modules for trainee nurses and doctors, carried out in a Simulated Operating Room.

Results: The tool was feasible to use in the context of simulation-based training. Satisfactory reliability (Cronbach alpha) was obtained across trainers' and trainees' scores (analysed jointly and separately). Moreover, trainer nurse's ratings of the four skills correlated positively, thus indicating adequate content validity. Trainer's and trainees' ratings did not correlate.

Conclusions: Assessment of OR nurses' technical skill is becoming a training priority. The present evidence suggests that the ICATS-N could be considered for use as an assessment/training tool for junior OR nurses.