Surgical Clinical Nurse Reviewer, Moira MacDonald, continues to support quality surgical care from outside operating rooms

Every surgery offers an opportunity to learn, improve, and make care safer for patients. At Nova Scotia Health, a team of registered nurses known as surgical clinical nurse reviewers (SCNRs) help turn these opportunities into action by identifying trends in patient recovery and applying this  knowledge to support improvements in surgical services.

For Moira MacDonald, an SCNR at Antigonish Memorial Regional Hospital (formerly St. Martha’s Regional Hospital), this work brings together her years of experience in perioperative (surgical) nursing and her interest in problem solving and finding practical solutions.

MacDonald knew she wanted to be a nurse straight out of high school and has worked in and around surgical services ever since graduating in 2009. Her experience spans operating rooms, labour and delivery, and recovery. She draws on her clinical background to help surgical teams understand patients' experiences and identify improvements to care throughout the surgical journey, from pre-admission to recovery at home.

“I like that I’m still in a perioperative setting, because that is where my heart is,” said MacDonald. “As an SCNR, I see different opportunities to make surgical care better for our patients and support our surgical teams in finding solutions that they can apply in the operating room and beyond.”

SCNRs support surgical quality improvement by collecting and reviewing information about patient care and recovery through Nova Scotia Health's participation in three quality registry programs: National Surgical Quality Improvement Program (NSQIP), Vascular Quality Initiative (VQI), and The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACDS).

These quality registries help surgical teams examine outcomes, identify trends, and better understand where changes could improve patient care. For example, evidence-informed practices such as keeping patients warm during surgery or removing catheters as early as possible can help reduce complications like surgical site or urinary tract infections, and support recovery.

The work calls for clinical knowledge, attention to detail, and collaboration with surgical teams. For MacDonald, reviewing surgical information is also like solving a puzzle.  

"It's detailed work, but it serves an important purpose in identifying changes that can benefit patients undergoing surgery."

While registry work happens behind the scenes, patients play a vital role. By participating in follow-up conversations, SCNRs can better understand how patients are recovering after surgery.  

By helping surgical teams have better insight where care is working well and where improvements may be needed, SCNRs like MacDonald are contributing to the ongoing effort to provide safe, high-quality surgical care for Nova Scotians. 

Photo of Moira MacDonald.