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Improving Patient and Family Satisfaction During the Perioperative Experience
ASPAN NATIONAL CONFERENCE ABSTRACTS Statement of Successful Practice: After educating staff on appropriate alarm management and making the bundled set of targeted interventions, the Pediatric PACU noise level and alarm fatigue were reduced Staff satisfaction was improved per survey Implications: After the implementation of alarm management best practices, patient safety was improved. Pediatric PACU staff reported a decrease in alarm fatigue. There was an improved alarm response due to a decrease in alarm burden and unit noise. Patient safety was improved with a reduction of missed patient events.
IMPROVING PATIENT AND FAMILY SATISFACTION DURING THE PERIOPERATIVE EXPERIENCE Team Leader: Barbara U. Ochampaugh, RN BSN CPAN St. Peter’s Health Partners, Albany, New York Team Members: Deborah Marra, RN BSN CPAN, Lisa Machovec, RN Background Information: Patient Satisfaction scores have been in the low 90%. In 2014, phone calls to patient families and visits in Phase I recovery were inconsistent and did not improve satisfaction scores. Phase I nurses were surveyed on their attitudes regarding visitors in the recovery area. They were not in favor of visits. Purposeful hourly rounding has proven useful in preventing falls and raising patient satisfaction scores on the in-patient units. Hourly rounding is easily adaptable for the ambulatory setting. Objectives of Project: The objectives of this project was to introduce Purposeful Hourly Rounding on the Ambulatory Care Unit. Reinforce phone calls to patient families and increase the number of visitors in Perianesthesia Care Unit (PACU). Process of Implementation: The Ambulatory Care Unit (ASU) staff were educated on Hourly Rounding and the data collection tool. The PACU staff were interviewed to determine better times for visits and phone calls. They were also instructed on the use of the data collection tool. They were again surveyed on their attitudes regarding visitors and best times for visits and phone calls. Statement of Successful Practice: Despite all our efforts, satisfaction scores have not increased. Staff in ASU and PACU are supportive of the initiatives. Ongoing education and encouragement are provided to the staff as all these interventions are patient satisfiers and lend themselves to improved customer service. Implications for Advancing the Practice of Perianesthesia Nursing: Improving patient and family satisfaction is an ongoing goal of all institutions. Hourly rounding, phone calls and visits are simple cost effective tools that have been effective in other institutions.
DOES A COLORECTAL BUNDLE REDUCE SURGICAL SITE INFECTIONS? Team Leader: Barbara Ochampaugh, RN BSN CPAN St. Peter’s Health Partners, Albany, New York Team Members: Helen Krajick, RN MS CNOR, Dawn Morrill, RN, Jennifer Penton, RN BSN, Amy Steenburgh, RN Note: All abstracts are printed as received from the authors.
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Background Information: Surgical Site Infections (SSI) and deep organ infections in the surgical population are a known risk. It is especially high in the colorectal population ranging from 15-30%. Bundles have been used with success in reducing SSI’s and are consider best practice. Bundles vary among institutions. SSI’s cause increased length of stay, increased cost for facilities and reduces quality of life for patients. Bundles include chlorhexidine showers, smoking cessation, gown and glove changing, double gloving, appropriate use of antibiotics, limit operating room traffic, glycemic control, normothermia and 100% non-rebreather for 2 hour postoperatively. Objectives of Project: Implement a Colorectal Bundle and introduce the bundle to other surgical populations. Process of Implementation: The Colorectal Bundle was introduced in November of 2013 along with continued compliance to the Surgical Care Improvement Initiatives (SCIP). Operating room and PACU staffs were educated about the Bundle. Collaboration was done through the Colorectal Surgeons office who instructed the patient on the need chlorhexidine showers and smoking cessation. Bowel prep and antibiotics were administered per SCIP protocols. Observation was done of the operating room teams to ensure all elements of the Bundle were followed. Statement of Successful Practice: Our SSI rate was 10.1% for a total of 376 patients prior to implementation of the Bundle. In 2014 the rate was 5.7% for 419 cases. Data is collected through the New York State Colon SSI analysis and the National Surgical Quality Improvement Project. Data collection is ongoing for 2015. Implications for Advancing the Practice of Perianesthesia Nursing: Through a collaborative effort with physicians’ offices the operating room staff, PACU and the post-operative units we can improve patient care and outcomes.
OBSTRUCTIVE SLEEP APNEA: USING STOP BANG TO HELP PREVENT POST-OPERATIVE COMPLICATIONS Team Leaders: Kerrie Brewer, BSN RN CPAN, Megan Templeman, BSN RN University of Kentucky Healthcare, Lexington, Kentucky Team Members: Amanda Carney, BSN RN CCRN, Amanda Pascal, BSN
Identification of the problem-Overview: Patients with obstructive sleep apnea (OSA) are at higher risk for fatal postoperative complications including: death, stroke, myocardial infarction, and respiratory failure. Upon investigating postoperative respiratory failure within our enterprise, it was determined that we were not identifying patients who were at risk for OSA complications. EP Question/Purpose: The purpose was to conduct an evidence-based project to determine the gap between current practice and best practice standards to identify patients in the perianesthesia area that likely had OSA and thus, were at risk of developing OSA-related postoperative complications. Our goal was to implement an initiative that would educate perianesthesia nurses about the importance of screening for OSA, the high risk for developing postoperative severe or fatal complications, and interventions to mitigate complications of OSA. Methods/Evidence: Review of the current literature was performed and best practices identified. Our review supported the STOP BANG tool for detecting OSA, a tool our facility already
IMPROVING PATIENT AND FAMILY SATISFACTION DURING THE PERIOPERATIVE EXPERIENCE Team Leader: Barbara U. Ochampaugh, RN BSN CPAN St. Peter’s Health Partners, Albany, New York Team Members: Deborah Marra, RN BSN CPAN, Lisa Machovec, RN Background Information: Patient Satisfaction scores have been in the low 90%. In 2014, phone calls to patient families and visits in Phase I recovery were inconsistent and did not improve satisfaction scores. Phase I nurses were surveyed on their attitudes regarding visitors in the recovery area. They were not in favor of visits. Purposeful hourly rounding has proven useful in preventing falls and raising patient satisfaction scores on the in-patient units. Hourly rounding is easily adaptable for the ambulatory setting. Objectives of Project: The objectives of this project was to introduce Purposeful Hourly Rounding on the Ambulatory Care Unit. Reinforce phone calls to patient families and increase the number of visitors in Perianesthesia Care Unit (PACU). Process of Implementation: The Ambulatory Care Unit (ASU) staff were educated on Hourly Rounding and the data collection tool. The PACU staff were interviewed to determine better times for visits and phone calls. They were also instructed on the use of the data collection tool. They were again surveyed on their attitudes regarding visitors and best times for visits and phone calls. Statement of Successful Practice: Despite all our efforts, satisfaction scores have not increased. Staff in ASU and PACU are supportive of the initiatives. Ongoing education and encouragement are provided to the staff as all these interventions are patient satisfiers and lend themselves to improved customer service. Implications for Advancing the Practice of Perianesthesia Nursing: Improving patient and family satisfaction is an ongoing goal of all institutions. Hourly rounding, phone calls and visits are simple cost effective tools that have been effective in other institutions.
DOES A COLORECTAL BUNDLE REDUCE SURGICAL SITE INFECTIONS? Team Leader: Barbara Ochampaugh, RN BSN CPAN St. Peter’s Health Partners, Albany, New York Team Members: Helen Krajick, RN MS CNOR, Dawn Morrill, RN, Jennifer Penton, RN BSN, Amy Steenburgh, RN Note: All abstracts are printed as received from the authors.
e35
Background Information: Surgical Site Infections (SSI) and deep organ infections in the surgical population are a known risk. It is especially high in the colorectal population ranging from 15-30%. Bundles have been used with success in reducing SSI’s and are consider best practice. Bundles vary among institutions. SSI’s cause increased length of stay, increased cost for facilities and reduces quality of life for patients. Bundles include chlorhexidine showers, smoking cessation, gown and glove changing, double gloving, appropriate use of antibiotics, limit operating room traffic, glycemic control, normothermia and 100% non-rebreather for 2 hour postoperatively. Objectives of Project: Implement a Colorectal Bundle and introduce the bundle to other surgical populations. Process of Implementation: The Colorectal Bundle was introduced in November of 2013 along with continued compliance to the Surgical Care Improvement Initiatives (SCIP). Operating room and PACU staffs were educated about the Bundle. Collaboration was done through the Colorectal Surgeons office who instructed the patient on the need chlorhexidine showers and smoking cessation. Bowel prep and antibiotics were administered per SCIP protocols. Observation was done of the operating room teams to ensure all elements of the Bundle were followed. Statement of Successful Practice: Our SSI rate was 10.1% for a total of 376 patients prior to implementation of the Bundle. In 2014 the rate was 5.7% for 419 cases. Data is collected through the New York State Colon SSI analysis and the National Surgical Quality Improvement Project. Data collection is ongoing for 2015. Implications for Advancing the Practice of Perianesthesia Nursing: Through a collaborative effort with physicians’ offices the operating room staff, PACU and the post-operative units we can improve patient care and outcomes.
OBSTRUCTIVE SLEEP APNEA: USING STOP BANG TO HELP PREVENT POST-OPERATIVE COMPLICATIONS Team Leaders: Kerrie Brewer, BSN RN CPAN, Megan Templeman, BSN RN University of Kentucky Healthcare, Lexington, Kentucky Team Members: Amanda Carney, BSN RN CCRN, Amanda Pascal, BSN
Identification of the problem-Overview: Patients with obstructive sleep apnea (OSA) are at higher risk for fatal postoperative complications including: death, stroke, myocardial infarction, and respiratory failure. Upon investigating postoperative respiratory failure within our enterprise, it was determined that we were not identifying patients who were at risk for OSA complications. EP Question/Purpose: The purpose was to conduct an evidence-based project to determine the gap between current practice and best practice standards to identify patients in the perianesthesia area that likely had OSA and thus, were at risk of developing OSA-related postoperative complications. Our goal was to implement an initiative that would educate perianesthesia nurses about the importance of screening for OSA, the high risk for developing postoperative severe or fatal complications, and interventions to mitigate complications of OSA. Methods/Evidence: Review of the current literature was performed and best practices identified. Our review supported the STOP BANG tool for detecting OSA, a tool our facility already