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.