Enhancing anaesthetic nurse competence and day surgery safety through in situ simulation: a lean-thinking business plan

This article presents a quality improvement-informed business plan for implementing in situ simulation-based education within a day surgery unit. The plan was informed by a local learning needs assessment, existing literature and the ‘lean’ methodology. It outlines the design, rationale and anticipated practical implications of implementing this quality improvement initiative in the future. The day surgery unit, a standalone elective care hub, performs approximately 2100 non-complex surgical procedures annually.

A learning needs assessment identified variable levels of staff confidence, particularly in responding to rare but high-risk events such as difficult airway scenarios. Applying the lean thinking principles enabled the design of a cost-effective, sustainable and collaborative training programme that leveraged existing resources and clinical expertise. The planned introduction of in situ simulation-based education aimed to enhance patient safety, prepare nurses for clinical challenges, foster teamwork and improve technical and non-technical skills. Ongoing evaluation through structured debriefing using cognitive frameworks such as PEARLS, alongside participant feedback, will support continuous improvement and long-term sustainability.