Objective: To develop an understanding of the knowledge, skills and qualities the Perioperative Nurse Surgeon’s Assistant (PNSA) role contributes to surgical service delivery in Australia. Background: The benefits and attributes of the PNSA or Non-Medical Surgical Assistant (NMSA) have been explored globally. Previous research demonstrates the PNSA or NMSA as effective providers of safe and effective delivery of surgical assisting care. The PNSA as an advanced practice nurse (APN) has been identified as improving both the quality and accessibility of surgical care, although this is yet to be fully acknowledged in the Australian context. Greater exploration of the benefits and contributions of the PNSA to surgical service delivery in Australia is required. Study design and methods: A mixed method design study was undertaken across four healthcare facilities in South Australia; including a quantitative, cross-sectional survey of perioperative nurses, as well as semi-structured, qualitative interviews with surgeons who work with a PNSA. Results: From a survey of 55 perioperative nurses and five surgeons who work with PNSAs, the seven attributes or qualities deemed to be important of the PNSA included knowledge of anatomy, instrumentation and surgical procedure, consistency, theatre efficiency, collaboration, educational resource, patient advocacy and leadership. Discussion: The identified benefits and attributes of the PNSA clearly demonstrate the advanced level of perioperative expertise they bring to the surgical team, but also that they have the ability to change the culture of the team, embracing a more unified working environment. Consistency of practice and collegiality between medical, PNSA and nursing teams can offer advanced perioperative care to the surgical patient. Surgical assisting knowledge and skills often require a protracted learning curve to attain expertise, a role suitable to be undertaken by PNSAs practicing in APN roles. Where consistency of a qualified medical assistant is not routinely available the consistency and dependability of the PNSA is particularly suited to highly technical specialist surgical domains and sought after by the surgeons interviewed. Conclusion: The PNSA can positively affect the operating theatre environment and offer multiple individual benefits to the patient’s surgical journey. The consistency the PNSA conveys offers a more streamlined process for the operative team, reassurance for the surgeon and the potential for improved theatre efficiency. This consistency is seen to enhance communication across the surgical team increasing patient safety, increasing efficiencies in both the individual patients’ surgical journey and across the surgical service. Implications for research, policy, and practice: The PNSA is a valued member of the Perioperative team from both medical and nursing perspectives, who contributes qualities of specialist knowledge, a positive and collaborative team culture and continuity attributes to the operative team and environment. The healthcare benefits and impacts from these positive qualities needs to be explored further.

What is already known about the topic?

Previous research demonstrates the PNSA or NMSA as effective providers of safe and effective delivery of surgical assisting care.
The PNSA has been identified as improving both the quality and accessibility of surgical care in Australia and globally.
There is limited evidence identifying the qualities the Perioperative Nurse Surgeon’s Assistant (PNSA) role contributes to surgical care in Australia, compared to international settings.

What this paper adds

The knowledge, skills and qualities of the PNSA provide a nexus within the operating team, with the surgeons they assist and to develop a positive culture with the surgical environment.
The role of the PNSA is highly valued from both medical and nursing specialties.