CONTEXTEurope Room nurses do not necessarily follow a specialized training before entering a block! The specialized trainings are heterogeneous or non-existent as in France. The mortality rate at 60 days in the blocks also varies from 0.5% to 5% in European countries.Significant pressure on the blocks is clear: more and more aging surgical patients, staff turnover, and multiculturalism blocks. The staff and especially the block managers are subject to requirements of increasingly strong. In addition, ambulatory surgery (patient leaves the hospital the day of its operation) develops a permanent just-in-time process. That enhanced new requirements on personnel practices.How to address these public health issues which affects room nurses and also the patient? KSM: FIRST PROJECT APPRECIATEDIn a precedent European project, UNAIBODE (national association of Room nurse in France) and several European partners have experienced and adapt the method KSM to surgical units.With KSM, block leaders have a method, centered on key practices used in high-risk environments. For 3 years, three hundred executives were aware of this approach in seminars organized by the UNAIBODE.KSMOR: THE CHALLENGES OF NEW PROJECTIn 2015, la HAS (National Health Authority) strengthened the requirements for certification auditors on monitoring human resources in a surgical unit . Now HAS requires: a documented coaching during the first years, regular individual assessment, and updated training.That’s why HAS wants to experience the approach KMS on a large scale.In addition, room managers and UNAIBODE want to use a self-diagnostic tool to assess learning paths for room nurses. They have indeed to manage between 1500 and 2000 specific practices for each Room nurse.It is to address these issues monitoring skills and human resources in a surgical unit that CEPPRAL decided to submit the KSMOR project.THE INTELLECTUAL PRODUCTIONS of THE PROJECT-Evaluate and demonstrate the positive impacts of the KSM approach in the surgical room with an experiment in 10 hospitals and university hospitals.-Build a self-diagnosis to evaluate room nurse’s skills, accessible on the web, for the activities of circulating nurse and instrumentalist .This self-diagnosis should concern all surgical specialties (more than 1500 online practices).- Develop a guide to using the global KSM approach that takes into account the achievements of experimentation and self-diagnostic tool.FRENCH partners-CEPPRAL, regional structure of support for improving the quality of care, was established in 2005 under the leadership of the High Authority of Health. He is leader at national level for research and experimentation to improve the quality of care in surgery.- UNAIBODE is the national professional organization of room nurses in France and DPG the structure that carries the expertise of the designer of the KSM method.EUROPEAN partnersCountries renowned for their high level of professionalism in training and safety in surgical unit as Finland (Savonia University), PARNASSE VINCI group in Belgium, whose representatives participated in the first project.The representative of the University of Pardubice in the Czech Republic is also vice-president of the European association of Room nurses (EORNA).A Greek partner (IDEC) specialized in quality and skills, having worked on these issues with the designer of the project, is also a partner.DISSEMINATIONThe project results are translated into English and distributed to all the professional organizations of the country as well as in public and private training centers (universities).The national nursing congress, professional newspapers and institutional organizations part of the information policy.A communication will be done regularly to the fifty members of the "Board" EORNA representing room nurses’ associations of 28 European countries.SUSTAINABILITY OF RESULTSAll the products of the project, thanks to the presence of European organization EORNA, is intended to be distributed free of charge in all European countries. As a working tool and given the involvement of professional organizations in the project, it is likely that the results will be of lasting use in France and Europe.
CONTEXT: In Europe, Operating Room nurses don’t have necessarily a specific training before working in operating room. Specific trainings are heterogeneous or nonexistent. The 60-day mortality rate in operating rooms is substantially different between European countries ranging from 0.5% to 5%. Significant pressure on operating rooms is clear: staff turnover, development of ambulatory surgery, operating rooms multiculturalism. Staff and especially Head Operating Room Nurses (HORN) are subject to more and more demanding requirements on their practices. How to respond to these public health issues affecting operating room nurses (ORN) and therefore the patient? KSM, A FIRST PROJECT APPRECIATED: UNAIBODE (French national association of operating room nurses) and several European partners experimented and adapted the KSM (Key Skills Management) method in a previous project. KSM approach has been presented in ten European congresses. With KSM, HORN have a method, focused on key practices, used in high-risk environments. KSMOR, THE ISSUES OF THE NEW PROJECT: In 2015, the HAS (National Health Authority) strengthened requirements for certification auditors on human resources management in operating rooms. HAS made documented integration, regular individual assessment and updated training mandatories. Therefore HAS and ANAP (French National Agency for Performance Support) want a large scale KSM approach experimentation. In addition, HORN and UNAIBODE want to have a self-assessment tool to evaluate new ORN pedagogical paths in a field where they will have to master between 1500 and 2000 practices. To respond to these issues of skills and human resources management in OR, the CEPPRAAL (health quality and security regional support structure in France) decided to set up the KSMOR project. THE GOALS OF KSMOR project are: to elaborate an online self-assessment tool of OR nurses' practices allowing Head Operating Room Nurses (HORN) and nurse to position themselves in their practices and to evaluate their autonomy and thus their training course both for the common core and for surgical specialties. To experiment KSM approach in 5 to 10 French hospitals. Disseminate KSM approach to target audiences at congresses, professional journals, professional organizations and training organizations. PARTICIPATING ORGANIZATIONS: the project brings together 7 European partners. France is represented by CEPPRAAL: a health quality and security regional support structure; the UNAIBODE: the French national association of operating room nurses and DPG, a structure that brings the expertise of the KSM method designer. Professionals from leading countries in training and OR safety like Finland (Savonia University) combined Parnasse Vinci group (Belgium) whose representatives have participated at the first project. The University of Pardubice in the Czech Republic has experience in international research programs. A Greek partner (IDEC) specialized in quality and skills, has already worked on these issues with the project designer. DESCRIPTION OF MAIN ACTIVITIES IMPLEMENTATION: 4 European countries (Belgium, Finland, Greece, Czech Republic) have tested and assessed the “progression table” tool with working groups composed by nurses and head operating room nurses. A user guide has been written and an online application with the tools has been created. An experimentation of the KSM approach took place in 8 French hospitals in order to teste and evaluate the impact of KSM approach on the OR process. RESULTS AND IMPACTS: recommendations on the use of the tool emerged from workgroups; the online application is functional, the user guide is written and the implementation of KSM approach have been tested and evaluated in 8 French hospitals. The experimentation impact is positive with a better integration of the new nurses and the optimization of the skills management in OR. IDENTIFIED BENEFITS : French hospitals who have experimented KSM approach want to continue to use it and extend it to OR not included in the experimentation. The application and the user guide will allow any hospital to deploy the KSM approach within its OR. The long-term benefits are a better skill management in OR with benefits for staff, life quality at work and patient safety.