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  • What can we do to improve safety in the theatre? Reflections from theatre nurse Kathy Nabbie

    Patient Safety Learning
    • UK
    • Interviews and reflections
    • New
    • Health and care staff, Patient safety leads


    We catch up with a regular contributor to the hub, theatre nurse Kathy Nabbie, to discuss how she is continuing to ensure patient's are kept safe in theatre, the challenges of COVID-19 and what else we can do to improve safety in the theatre.

    Kathy was a theatre sister for breast oncoplastic surgery and a practice development lead in a London private hospital group up until August 2017. She now works as a locum theatre bank scrub nurse practitioner and once a week as a non-medical surgical first assistant. She also works for an insourcing company on weekends around the country to help with the backlog of NHS patients who need surgery or treatment in clinics.

    Questions & Answers

    What does staff and patient safety mean to you?

    It means keeping myself, my patients and others free from harm and danger in a clinical or non-clinical environment, wherever patients are treated.

    How do you practice this in a theatre or non-clinical environment?

    By following hospital and theatre guidelines and policies, working as a team member, practicing safely and thinking of every patient as a member of my own family.

    How did care change with COVID-19 in theatres?

    During COVID-19 it was difficult getting the correct and adequate PPE, fit testing and other various issues. Private hospitals stopped elective surgery and stepped up to help the NHS with cancer surgery allowing the NHS to deal with the COVID-19 crisis. Speaking up about safety was frowned upon and posed a huge challenge in trying to create change in healthcare. However, thanks to Patient Safety Learning's hub sharing health professionals' experiences, our voices are more than echoes and these issues can be escalated and resolved quickly.

    As a bank nurse, how can you continue to make a difference on your shifts?

    I try to impart knowledge to make small changes on my bank shifts. It can be as simple as ensuring that the whiteboard in theatre is completed with the surgical team, the patient's name, registration number, operation and allergies, all of which help contribute to patient  safety.

    For me, also  knowing the name and role of each team member is essential, especially in an emergency, and one of my aims following COVID-19 is to implement this on theatre caps. This is called the Cap Challenge and it is well researched by Dr Rob Hackett, an anaesthetist from Australia, as an effective  communication tool and is now used in many hospitals in the UK and also worldwide.

    What else can we do to improve safety in theatres?

    We can continue to raise the awareness of surgical fires by implementing the Fire Risk Assessment Score as a tool to prevent fires during theatre procedures. We can also utilise the Swab Safe Management System to prevent retained swabs in surgical wounds.

    Theatre staff can further learn how to Speak Up by implementing the Below 10,000 feet – another safety communication tool which can help to save many lives, and presently taught by Robert Tomlinson in the UK.

    What else is on the horizon?

    One really important issue that we have been struggling with in theatres for over three decades is the emission of diathermy smoke. COVID-19 has helped us to further implement the use of diathermy tissue smoke evacuation equipment. We must therefore not lose this opportunity to make it mandatory in all hospital theatres for use in all procedures where diathermy smoke is emitted and not just in breast or plastic surgery. Work will continue with the CEO and President of Association for Perioperative Practice, Penny Smalley, the HSE, MHRA and WHO to press UK Parliament for a law.

    Final words...

    In conclusion, staff and patient safety will always be my number one priority, wherever I work as a theatre bank scrub nurse practitioner and surgical first assistant.

    I also have a quote by Henry Wadsworth Longfellow – I do not think Mr Longfellow meant this to apply to patient safety, but I think it does!

    "It takes less time to do a thing right than it does to explain why you did it wrong."

    What do you think?

    Read Kathy's other blogs

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