KNOWLEDGE, SKILLS, ATTITUDE

of an OR Nurse

Competence has been described using divergent perspectives; from a

reductionalist perspective that is based on a checklist of psychomotor behaviors

through to a broader understanding of the elements that underpin competence in

relation to knowledge, skills and attitudes (Benner 1984).
But, competence is just one part of the whole. To be able to provide quality
care and ensure safety to patients in the operating room, KSA (knowledge, Skills,
Attitude) is highly essential in any aspect inside the theatre. The following are some
of the aspects which highlights the KSA of an OR nurse:

a. Patient-centered care
The nurse must recognize the patient as the source of control and full
partner in providing compassionate and coordinated care based on respect
for patients preferences, values, and needs. A knowledgeable nurse
integrates understanding of multiple dimensions of patient- centered care
such as patient preferences, values, coordination and integration of care,
information, communication, and education, physical comfort and emotional
support especially when patient is anxious while inside the operating room.
Skills needed include communicating patient values, preferences and
expressed needs to other members of health care team and provide care with
sensitivity and respect for the diversity of the patient. The nurse must also
ensure that the care must not only for short- term but for continuity of care
until recovery phase. Monitoring of patient before, during and after surgery is
essential. Attitude accounts for respect, valuing the patients expertise with
own health, putting patient as the focus and acknowledging that patient
expectations influence outcomes in management of pain or suffering. The
nurse must put him/ herself as the feet of the patient while he is/ she is week.

b. Team work and Collaboration

The nurse must function effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and
shared decision-making to achieve quality patient care. Knowledge includes
describing strategies for identifying and managing overlaps in team member
roles and accountabilities and being able to recognize contributions of other
individuals and groups in the success of the procedure undertaken by the
patient. Skills demand the assumption of individual role as a team member or

leader based on the situation, initiation of requests for help when needed.
Also, a skillful nurse clarifies roles and accountabilities under conditions of
potential overlap in team member functioning and integrates the
contributions of others. The attitude aligns the contribution of the OR nurse to
resolution of conflict and disagreement and anticipation of needs before,
during and after the procedure.

c. Quality improvement
The OR nurse must have the knowledge to recognize that nursing and
other health professions such as students are parts of the OR team and not
just another instruments. Skills include the use of appropriate tools, devices
or paraphernalia in determining the status of patients pre- op, intra- op and
post- operatively. An attitude of appreciating that continuous quality
improvement is an essential part of the daily work of all health professionals
helps in the assurance of patients best care.

d. Safety
The OR nurse minimizes risk of harm to patients and providers through
both system effectiveness and individual performance. A knowledgeable
nurse must examine human factors and other basic safety design principles
as well as commonly used unsafe practices in handling patients. The nurse
must describe factors that create a culture of safety such as, open
communication strategies. The nurse must be knowledgeable of the
instruments being used in the procedure such as the numbers of each
instruments, sponges and the like. A nurse is skillful if she/ he employs
correct handling, proper counting, etc. of the instruments ensuring safety to
own self, other team members and to the patient for a smooth operation.
Anticipation and presence of mind weigh much as attitudes when inside the
theatre.