An observational study of surgery-related activities between nurses and surgeons during laparoscopic surgery

In the operating room (OR), nurse-surgeon coordination is essential to the success of a surgery.

This observational field study was conducted in the OR for selected laparoscopic surgeries to record surgery-related activities (SRAs) performed by the scrub nurses with different levels of OR experience. Those SRAs performed without instruction were defined as anticipatory movements.

The scrub nurse spent 74% of OR time watching surgery and 35% of OR time performing SRAs. The intermediate skill nurses watch surgeon on 76% of the OR time and they performed 16 counts of anticipatory movements per procedure. Experienced nurses spent shorter amount of OR time (72%) watching surgery but they performed more anticipatory movements (20 counts) than the intermediate skill nurses. With basic cases, experienced and intermediate-skill nurses performed equal amounts of anticipatory movements; however, when assisting in complex cases, the experienced nurses performed significantly more anticipatory movements (24 counts) than the intermediate-skill nurses (16 counts).

Experienced nurses develop sophisticated cognition during their careers in the OR, which allows them to maintain their involvement with the surgical team consistently. The anticipatory movement and the eye gaze are 2 valuable behavioral markers for assessing team performance.