Pharmacists and Nurses Collaborate to Improve Patient Care in the Post Anesthesia Care Unit (PACU)

Pharmacists and Nurses Collaborate to Improve Patient Care in the Post Anesthesia Care Unit (PACU)

ANNUAL ASPAN CONFERENCE ABSTRACTS 189 ‘‘CONNECTING WITH OUR COMMUNITY’’ EFFECTIVE COMMUNICATION BETWEEN PHYSICIAN’S, PARENT’S AND NURSE’S CREATING ...

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ANNUAL ASPAN CONFERENCE ABSTRACTS

189

‘‘CONNECTING WITH OUR COMMUNITY’’ EFFECTIVE COMMUNICATION BETWEEN PHYSICIAN’S, PARENT’S AND NURSE’S

CREATING A SAFER PERIOPERATIVE ENVIRONMENT FOR THE OBSTRUCTIVE SLEEP APNEA PATIENT: IMPLEMENTATION OF A SCREENING TOOL

Sue Kussro, RN, MSN, CPAN, A/GNP Mission Hospital, Mission Viejo, CA

Linda Lakdawala, MSN, RN, CPAN University of Pittsburgh Medical Center Shadyside Hospital, Pittsburgh, PA

Problem Identification: Research data states approximately 60% of the pediatric population demonstrate preoperative anxiety. This number is consistent regardless of country, surgical procedure or health care system. Objectives: 1. Promote Family Centered Care as a strategy to implement The Joint Commission’s National Patient Safety goal #13: 2. Effective communication is verbal and non-verbal 3. Efficient education post operatively must facilitate learning and awareness of cultural competencies’ Process of Implementation: 1. Evaluation of Pres Ganey Reports 2. The Operating Room RN establishing identification, trust, and relationship with their child 3. Educating nursing staff Statement of Successful Practice: Effective communication implemented in the perioperative arena reduces anxiety and promotes patient/family satisfaction. Implications for Advancing the Practice of Perianesthesia Nursing: Successful communication between the health care team and family facilitates collaboration and optimizes patient care.

‘‘CONNECTING WITH OUR COMMUNITY’’ EFFECTIVE COMMUNICATION BETWEEN PHYSICIAN’S, PARENT’S AND NURSE’S

Introduction: The focus for the Quality Improvement project was to promote best practice for nurses to screen patients with obstructive sleep apnea, (OSA) in the perioperative setting. Identification of the Problem: The literature revealed the vulnerable state of patient safety when diagnosed or undiagnosed OSA patients were exposed to anesthesia and/or narcotic analgesia in the perioperative environment. Purpose of the Project: An OSA screening tool and follow through was not being used to provide the safest care for the perioperative OSA patient. Methodology: The Iowa Model of Evidence Based Practice, (EBP) in a shared leadership facility was used for an organizational timeline. The STOP-Bang scoring model was implemented as a pilot project for one month to evaluate the process. Nurses were trained. A physician order set assured safe postoperative respiratory and cardiac monitoring. Results: Patients diagnosed with OSA using the STOP-Bang scoring model increased from 3% to 17%. In addition, no acute respiratory events were reported. Discussion: A screening tool was an EBP method to assess for OSA. A definitive diagnosis and follow through is warranted. Conclusion: As a result, the OSA patient would receive the safest monitoring and care throughout their surgical intervention. Implications for Perianesthesia nurses Future Research: Compiling follow up data for completion of a formal sleep study could further enhance patient compliance and quality outcomes.

Sue Kussro, RN, MSN, CPAN.A/GNP Objectives: 1. Promote Family Centered Care as a strategy to implement The Joint Commission’s National Patient Safety goal #13: Encourage the patient’s active involvement in their own care 2. Recognize effective communication includes both verbal and nonverbal communication. 3. Utilize communication strategies to facilitate learning; understanding, educational level, culture and method demonstrating positive patient outcomes. 4. Recognize and understand how cultural safety and knowledge can direct your success as a health care provider. Process of Implementation: 1. Evaluation of Pres Ganey Reports 2. Child Life pre-operative visits if possible 3. Dialogue with parents to validate understanding of pre-post operative care 4. Utilize interpreter services 5. Educating nursing staff Statement of Successful Practice: Effective communication implemented in the perioperative arena reduces anxiety and improves patient/family satisfaction.

PHARMACISTS AND NURSES COLLABORATE TO IMPROVE PATIENT CARE IN THE POST ANESTHESIA CARE UNIT (PACU) Leanne LeClair, RN, BSN, CPAN, Emmeline Igboekwe, PharmD, MSN Rex Healthcare, Raleigh, NC Our hospital, a 409-bed acute care facility, performs approximately 35,000 surgical cases per year. Before 2008, the central pharmacy provided services to the PACU. Many issues led to nursing dissatisfaction with pharmacy services: prolonged medication delivery time of drugs not stocked in PYXIS, patient care interruptions for order clarification, and incorrect delivery locations for medications. Nursing conducted a four-month study, determining that the average delivery time for STAT drugs was 48 minutes. The chairperson of the PACU Practice Council met with pharmacy management to discuss service improvement strategies. In response, a pharmacist workstation was incorporated into the PACU. A pharmacist now works in PACU five days per week. The pharmacist processes post-operative orders, expedites medication delivery, verifies orders, and provides medication reconciliation. A follow-up study showed an average time of stat drug delivery of 18.9 minutes. A nursing survey indicated greatly improved satisfaction in timelines of drug delivery, ease of order clarification, and overall rating of pharmacy services. Physical proximity of the pharmacist to nurses and patients in PACU is a relatively new concept in decentralized pharmacy services with demonstrable positive outcomes. This process change, inspired by staff nurses, exemplifies the benefits of collaboration between disciplines to enact process improvement.