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Perianesthesia Nurses: Making a Difference in One Unit, One Hospital and One Community
ASPAN NATIONAL CONFERENCE ABSTRACTS levels. Our unit is unique in that we have a lot of traffic through our unit and our patients are only separated by a curtain, making it difficult to control the noise level. We need to decrease the noise level in the PACU to improve patient satisfaction and patient care. Research has shown that quiet surroundings promote healing. We surveyed the employees in the PACU to rate the noise level and what measures were needed to reduce noise and stress. We then implemented strategies to control and decrease the noise level which included decreasing the sound of alarms and eliminating the use of cell phones. We educated the staff and gave a letter to patients and families educating them on the need for a quiet healing environment. We initiated Quiet Time between specific hours when we play background music and dim the lights. We dim the lights as a universal signal to everyone when the unit gets too loud. We have placed signs in and around the unit to remind everyone to lower their voice. After implementation of the PACU Quiet Time, we surveyed staff. Most staff agreed that the interventions have decreased the noise levels in the PACU with significantly less noise caused by staff voices and alarms. Patients, families and staff feedback are positive. A quiet calm environment improves patient and staff satisfaction and promotes healing.
PERIANESTHESIA NURSES: MAKING A DIFFERENCE IN ONE UNIT, ONE HOSPITAL AND ONE COMMUNITY Team Leaders: Sara Shubert, RN, Diane Janakovich, RN, Linda Marr, RN Cleveland Clinic, Cleveland, Ohio Team Members: Renee Blankenburg, RN, BSN, Susan Mastrandrea, RN, BSN, Lidiya Brown, LPN, Helga Anthony, Cherryl Chapman, Stephanie Davis, Eleonora Pascu, Denise Slovan
Preoperative nurses at Cleveland Clinic have many opportunities for leadership both in the hospital setting and in the community through the Community Outreach Committee. Through the committee several populations in need were identified. In the past year nurses in the preoperative department have initiated several projects of their own. Several bake sales and raffles were held to raise money for several projects. The funds were used to purchase fleece material to make blankets for the pediatric cardiac operating room patients. Food was also purchased with the money raised, and members of the committee then served the food at a local hospice facility solely funded by donations and volunteers. Halloween items and healthy snacks were collected to make Halloween bags for 75 children and their families in the Cleveland Clinic Children’s Hospital. Two food drives for Thanksgiving and Christmas were also organized, resulting in a collection of 89 pounds of food for the Cleveland Food Bank. Several other projects that the preoperative staff was involved in include volunteering during Perioperative Week at a local science center, March of Dimes Walk, Hands on Northeast Ohio, Cleveland Clinic Teddy Bear Drive, toiletry collection for hospice, and Cleveland Pride. Through these initiatives and others, perioperative nurses are able to continually provide leadership in their units, facilities, and surrounding communities.
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INCREASING PATIENT SATISFACTION BY EMPOWERING STAFF TO MANAGE DELAYS Team Leaders: Sandra Price, BSN, RN, CAPA, Vickie Lauffer, BSN, RN University of Rochester Medical Center, Rochester, New York
Background: A challenge nurses face working in a high volume, fast-paced, perioperative same day surgery unit is managing patient procedure delays. Procedure delays can increase patients’ anxiety and decrease their overall satisfaction. Nurses may feel helpless and limited in their options to improve the patient and family-centered care experience. Orlando’s Nursing Process Theory guided this initiative by meeting patients’ immediate needs for help and responding with an intervention. Objective: Manage patient delays to their satisfaction by keeping them informed and offering service recovery. The new service recovery option coined as the “courtesy bag” provided diversional activities, such as a puzzle book, deck of cards, pen, pad, and lip balm. The bag was given by the nurse with an apology card that recognizes the patient’s time and empowered the nurse to make a difference. Implementation: This pilot included 372 patients over a 14 month period in which the bag was given to any patient who experienced a delay beyond an hour. The patients and nurses were surveyed regarding their satisfaction with the new service recovery option. Statement of Successful Practice: Patients (98%, n5366) felt the bags were helpful, utilized the contents, and reported we managed their delay to their satisfaction. The nurses felt empowered to manage patient wait times (95%, n520) and would like to continue their use (100%, n522). Implications for Advancing Practice in Perianesthesia: The total cost of each bag is $2.84, which is a nominal amount given the gain in satisfaction by patients and nurses. The pilot evolved into a change of practice.the “courtesy bag” is here to stay!
EXTENDING BEYOND PACU CARE Team Leader: Pamela E. Windle, MS, RN, CPAN, CAPA, FAAN St. Luke’s Episcopal Hospital, Houston, Texas Team Members: Flordeliza Magdadaro, MN, BSN, RN, CPAN, Sonia Caliston, BSN, RN, CCRN, Marissa Aquino, BSN, RN, Jaiza Vistan, BSN, RN, CVRN, Amelia Pacardo, BSN, RN, CCRN, CPAN, Tessie Santiago, BSN, RN, CPAN
Communication is an important aspect of continuity patient care. Through effective and good communication among hospital providers that excellent care to our patients are provided effectively.It is through this context that our PACU staff decided to implement Rounding with patients through postoperative visits and discharge calls; hoping to find positive and negative feedback so input from patients can be discussed within our department for improvement and find new ways to improve communication. Most surgical patients recovered in PACU do not remember their stay in our department which result lower satisfaction scores upon discharge.The PACU staff decided to extend the PACU caring atmosphere by rounding patients to the surgical floors, the following day after surgery, asking for feedback on how we can improve the overall rating of care.Another improvement process implemented to get feedback is through
PERIANESTHESIA NURSES: MAKING A DIFFERENCE IN ONE UNIT, ONE HOSPITAL AND ONE COMMUNITY Team Leaders: Sara Shubert, RN, Diane Janakovich, RN, Linda Marr, RN Cleveland Clinic, Cleveland, Ohio Team Members: Renee Blankenburg, RN, BSN, Susan Mastrandrea, RN, BSN, Lidiya Brown, LPN, Helga Anthony, Cherryl Chapman, Stephanie Davis, Eleonora Pascu, Denise Slovan
Preoperative nurses at Cleveland Clinic have many opportunities for leadership both in the hospital setting and in the community through the Community Outreach Committee. Through the committee several populations in need were identified. In the past year nurses in the preoperative department have initiated several projects of their own. Several bake sales and raffles were held to raise money for several projects. The funds were used to purchase fleece material to make blankets for the pediatric cardiac operating room patients. Food was also purchased with the money raised, and members of the committee then served the food at a local hospice facility solely funded by donations and volunteers. Halloween items and healthy snacks were collected to make Halloween bags for 75 children and their families in the Cleveland Clinic Children’s Hospital. Two food drives for Thanksgiving and Christmas were also organized, resulting in a collection of 89 pounds of food for the Cleveland Food Bank. Several other projects that the preoperative staff was involved in include volunteering during Perioperative Week at a local science center, March of Dimes Walk, Hands on Northeast Ohio, Cleveland Clinic Teddy Bear Drive, toiletry collection for hospice, and Cleveland Pride. Through these initiatives and others, perioperative nurses are able to continually provide leadership in their units, facilities, and surrounding communities.
e25
INCREASING PATIENT SATISFACTION BY EMPOWERING STAFF TO MANAGE DELAYS Team Leaders: Sandra Price, BSN, RN, CAPA, Vickie Lauffer, BSN, RN University of Rochester Medical Center, Rochester, New York
Background: A challenge nurses face working in a high volume, fast-paced, perioperative same day surgery unit is managing patient procedure delays. Procedure delays can increase patients’ anxiety and decrease their overall satisfaction. Nurses may feel helpless and limited in their options to improve the patient and family-centered care experience. Orlando’s Nursing Process Theory guided this initiative by meeting patients’ immediate needs for help and responding with an intervention. Objective: Manage patient delays to their satisfaction by keeping them informed and offering service recovery. The new service recovery option coined as the “courtesy bag” provided diversional activities, such as a puzzle book, deck of cards, pen, pad, and lip balm. The bag was given by the nurse with an apology card that recognizes the patient’s time and empowered the nurse to make a difference. Implementation: This pilot included 372 patients over a 14 month period in which the bag was given to any patient who experienced a delay beyond an hour. The patients and nurses were surveyed regarding their satisfaction with the new service recovery option. Statement of Successful Practice: Patients (98%, n5366) felt the bags were helpful, utilized the contents, and reported we managed their delay to their satisfaction. The nurses felt empowered to manage patient wait times (95%, n520) and would like to continue their use (100%, n522). Implications for Advancing Practice in Perianesthesia: The total cost of each bag is $2.84, which is a nominal amount given the gain in satisfaction by patients and nurses. The pilot evolved into a change of practice.the “courtesy bag” is here to stay!
EXTENDING BEYOND PACU CARE Team Leader: Pamela E. Windle, MS, RN, CPAN, CAPA, FAAN St. Luke’s Episcopal Hospital, Houston, Texas Team Members: Flordeliza Magdadaro, MN, BSN, RN, CPAN, Sonia Caliston, BSN, RN, CCRN, Marissa Aquino, BSN, RN, Jaiza Vistan, BSN, RN, CVRN, Amelia Pacardo, BSN, RN, CCRN, CPAN, Tessie Santiago, BSN, RN, CPAN
Communication is an important aspect of continuity patient care. Through effective and good communication among hospital providers that excellent care to our patients are provided effectively.It is through this context that our PACU staff decided to implement Rounding with patients through postoperative visits and discharge calls; hoping to find positive and negative feedback so input from patients can be discussed within our department for improvement and find new ways to improve communication. Most surgical patients recovered in PACU do not remember their stay in our department which result lower satisfaction scores upon discharge.The PACU staff decided to extend the PACU caring atmosphere by rounding patients to the surgical floors, the following day after surgery, asking for feedback on how we can improve the overall rating of care.Another improvement process implemented to get feedback is through