4 Steps to Grow Scrub-Ready RNs—and Strengthen Your Team

When an RN asked about learning the scrub role, a team of surgical educators in Austin, Texas, saw an opportunity. Working across several hospitals in the region, they looked for an RN-to-scrub training program—but didn’t find one. So, they decided to build one from the ground up.

Surgical clinical educators Allison Mayfield, BSN, RN, CNOR; AnneMarie Leung, BSN, RN, CNOR; and Lisa Bailey, BSN, RN, CNOR, developed a two-phase program to meet the need. “And the idea spread like wildfire,” said Mayfield.

One year after launching a dedicated Scrub-Ready RN training program, 24 nurses have graduated from Phase 1 training, and seven have graduated from Phase 2 and are now working in dual RN/scrub roles. As a result, the system enhanced nursing satisfaction by supporting the professional growth of several team members.

The program has also gained positive traction and shows strong potential for continued growth. Now, Mayfield and Leung are exploring possible ways to expand it further and reach beyond the OR space. “We are really excited to have this opportunity and keep growing to meet the needs of our nurses and facilities,” Mayfield said.

How to Shape a Scrub-Ready RN Training Program

Here’s a step-by-step look at how the educators are preparing RNs to take on the scrub role:

Step 1: Move from Concept to Class

They shaped the program over a two-month period using the ADDIE model as a guide. ADDIE—Analysis, Design, Development, Implementation, and Evaluation— is a systematic instructional design framework that educators use to create training programs through a phased approach centered around learner needs. This approach helped them develop a balanced training program that combines didactic, simulated, and hands-on scrub education.

Step 2: Take a Phased Training Approach

Before any in-person training, the trainee cohort of RNs from several different facilities is assigned to complete a series of online modules that cover the basics of the CST role, such as surgical hand scrubbing and how to don and doff sterile gowns appropriately.

Next, in Phase 1 training, dedicated RN to Scrub program educators teach the entire trainee cohort a one-day hybrid course in a simulation lab. The course includes educational presentations on key topics such as gowning and gloving, setting up a back table, safe sharps handling, instrument passing, basic draping, medication management, and counting. This is followed by hands-on practice with simulated scrub activities. After the training day, RNs complete 80 hours of hands-on training with CST preceptors at their respective facilities. “They are essentially trained to be second scrubs,” Mayfield said.

For Phase 2 training, the trainee cohort returns to the simulation classroom where they are taught more in-depth practices for draping, safe sharp handling, instrument identification with indications for use, point-of-use cleaning, specimen handling, medication management, and other topics. Phase 2 orientation includes approximately four weeks of continual training in the scrub role, ideally focused on one specific specialty.

“The overarching goal is for Phase 1 to get them from the room set up to surgery start, and Phase 2 is to get them from surgery start to surgery end,” Mayfield said.

Step 3: Accommodate Work Schedules

The simulated training classes are held on Saturdays to help busy RNs balance work with training. Mayfield said, “Saturday training has been nice for participants because it offers time away from a busy workday and off the unit to practice in a simulated clinical space.” The hands-on training in a nurse’s own work setting is designed to help them acclimate to the space where they will be scrubbing.

Step 4: Track Trainee Input and Long-term Benefits

While the program is still new, Mayfield and Leung are tracking the benefits it may offer—from increased nursing satisfaction to clinical advantages in the OR through dual-trained RN/scrub staff. They are also monitoring how internal professional development can support recruitment and retention. Seeking a potential added benefit, Mayfield says they will note any potential savings if there is a decreased need for contracted CSTs as the training program continues.

Why the Program is Working

Mayfield attributes the phased approach of the training as a key reason why it has been well received. “We have been able to meet the needs of the professional development from the nurse’s side as well as helping the unit needs with staffing for the scrub role,” she said.

Prepare Your Nurses for the Scrub Role with Evidence-Based Training

Efficiently onboard novice RNs with Periop 101: A Core Curriculum™ and enhance their training with AORN's Preparing for the Scrub Role course. The scrub course is also ideal for experienced nurses transitioning into the scrub role for the first time. This course combines online didactic training with hands-on elements to give nurses the essential knowledge and clinical skills they need to successfully transition into the scrubbing and sterile field role.

Learn what each of these programs can do for your facility and perioperative team.