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We got Spirit. Yes We Do! – Inside the PACU Huddle
ASPAN NATIONAL CONFERENCE ABSTRACTS Statement of Successful Practice: The first meeting of the Northwest Houston Chapter of TAPAN was held on August 27, 2011, at 10:00 am. Susan Norris, TAPAN President, presented an in-service on ASPAN, TAPAN and Certification: What’s in it for me? A CEU was provided for those who attended. The first meeting of the chapter had 33 PeriAnesthesia nurses in attendance indicating a need for organizations like ASPAN/ TAPAN to migrate from central locations out to the community hospitals. Implications for the PeriAnesthesia Nurse: The development of the Northwest Houston TAPAN Chapter enables nurses who live and work on the Northwest side of Houston to get involved in the ASPAN/TAPAN organization. This has allowed more nurses to advance PeriAnesthesia nursing practice through education, research and ASPAN standards.
WE GOT SPIRIT. YES WE DO! e INSIDE THE PACU HUDDLE Team Leader: Tina Sanzone, BSN, RN Akron Children’s Hospital Akron, OH Team Member: Tera Casenhiser, BSN, RN
Background information related to problem identification: Staff satisfaction surveys in 2010 identified that communication was less than satisfactory. Staff felt that they were “out of the loop” in reference to events in the PACU and the organization as a whole. The PACU leadership team recognized that a unit that fosters communication and collaboration promotes quality practice and enables the team to be cohesive and provide excellent patient care. Objectives of project: Review of the plan for today. Identify any hurdles encountered yesterday. Recognize staff members’ accomplishments. Provide inspiration. Communicate any news or updates regarding events within the organization. Identify meeting times and the staff that will need coverage to attend. Allow staff to identify the need for time to work on committee assignments or projects. A daily roundtable to allow staff to share information or recognize another staff member for a job well done. Process of Implementation: The PACU began having a daily huddle in March 2011. The huddle lasts for five minutes in the morning. The huddle is led by the Clinical Coordinator or nurse in charge for the day but everyone has the opportunity to share information. Statement of Successful Practice: The huddle has been in place for over six months. A daily huddle survey was completed after three months with positive results. Most of the staff believes the huddle has helped improve communication and teambuilding. Implications: Implementing a daily huddle has resulted in increased daily communication within the PACU team. This has led to greater staff satisfaction that empowers the staff to provide excellent patient care.
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TAP INTO PAIN CONTROL Team Leader: Janet Fricker, BSN, RN-BC, CPAN The Christ Hospital, Cincinnati, OH Barbara Berling, BSN, RN-BC, CAPA, Melissa Dwyer, BSN, RN-BC, Amanda Murray, BSN, RN, Douglas Stewart, M.D., Anesthesiology Associates of Cincinnati, Brian Vaughan, M.D. Anesthesiology Associates of Cincinnati, Mark Manley, M.D. Anesthesiology Associates of Cincinnati
A multidisciplinary team approach was implemented in the educational process for the care of the patient with Transversus Abdominis Plane (TAP) blocks. Coordinating pharmacy, surgeons, PACU, OR and Surgical floor staff to facilitate optimal care for the patient receiving TAP blocks was imperative to the success of our process. TAP blocks are new type of pain management adjuvant used in place of an epidural and used to decrease opioid usage in the postoperative abdominal surgical patient (ex: Anterior spinal fusions, Total Abdominal Hysterectomy and various colon surgeries).This block can be done pre-operatively, intra-operatively and in PACU. Local anesthetic is injected into the TAP layer. Using continuous ultrasound guidance, a continuous catheter is placed. A pain ball is attached to the TAP catheter in PACU and infused over several days. The key to this successful practice was formulating an action plan for an efficient method to disseminate the information about caring for the patients receiving TAP blocks. Educating the patient and family was done pre-operatively by the Anesthesiologist and Acute Pain Management RN team. We reinforced to the patients their role in achieving their pain management goals and improving their outcomes by better utilizing the various pain management adjuvants . Educating the various staff members involved by a using a PowerPoint in-service and handouts with general information about TAP blocks was utilized. The handout was placed conveniently on the front of the chart and was instrumental in reaching all nursing staff members in the patient care departments.
USING E-LEARNING WITH ORIENTATION AT THE BEDSIDE Pamela Taulman, RN, MA, CPAN, Mary Briggs, RN, BAN, CAPA University of Minnesota Medical Center, Fairview, Minneapolis, MN; and University of Minnesota Amplatz Children’s Hospital, Minneapolis, MN
Background: A new orientation program was developed at UMMC, Fairview to allow more time at the bedside and less time in the classroom by providing just-in-time learning. It uses resources linked to an intranet and electronic learning management system to track the completion of competencies. The design includes standard tools so preceptors do not need to rely on their memory when teaching and reinforcing content; and it allows orientees to skip certain elements of the orientation curriculum if competency can be demonstrated. Orientees spend a portion of their clinical shift reviewing e-Learning content and then apply it immediately in the practice setting with the preceptor. The program incorporates skills and knowledge checks to help the preceptor make an objective evaluation of the orientee’s progress.
WE GOT SPIRIT. YES WE DO! e INSIDE THE PACU HUDDLE Team Leader: Tina Sanzone, BSN, RN Akron Children’s Hospital Akron, OH Team Member: Tera Casenhiser, BSN, RN
Background information related to problem identification: Staff satisfaction surveys in 2010 identified that communication was less than satisfactory. Staff felt that they were “out of the loop” in reference to events in the PACU and the organization as a whole. The PACU leadership team recognized that a unit that fosters communication and collaboration promotes quality practice and enables the team to be cohesive and provide excellent patient care. Objectives of project: Review of the plan for today. Identify any hurdles encountered yesterday. Recognize staff members’ accomplishments. Provide inspiration. Communicate any news or updates regarding events within the organization. Identify meeting times and the staff that will need coverage to attend. Allow staff to identify the need for time to work on committee assignments or projects. A daily roundtable to allow staff to share information or recognize another staff member for a job well done. Process of Implementation: The PACU began having a daily huddle in March 2011. The huddle lasts for five minutes in the morning. The huddle is led by the Clinical Coordinator or nurse in charge for the day but everyone has the opportunity to share information. Statement of Successful Practice: The huddle has been in place for over six months. A daily huddle survey was completed after three months with positive results. Most of the staff believes the huddle has helped improve communication and teambuilding. Implications: Implementing a daily huddle has resulted in increased daily communication within the PACU team. This has led to greater staff satisfaction that empowers the staff to provide excellent patient care.
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TAP INTO PAIN CONTROL Team Leader: Janet Fricker, BSN, RN-BC, CPAN The Christ Hospital, Cincinnati, OH Barbara Berling, BSN, RN-BC, CAPA, Melissa Dwyer, BSN, RN-BC, Amanda Murray, BSN, RN, Douglas Stewart, M.D., Anesthesiology Associates of Cincinnati, Brian Vaughan, M.D. Anesthesiology Associates of Cincinnati, Mark Manley, M.D. Anesthesiology Associates of Cincinnati
A multidisciplinary team approach was implemented in the educational process for the care of the patient with Transversus Abdominis Plane (TAP) blocks. Coordinating pharmacy, surgeons, PACU, OR and Surgical floor staff to facilitate optimal care for the patient receiving TAP blocks was imperative to the success of our process. TAP blocks are new type of pain management adjuvant used in place of an epidural and used to decrease opioid usage in the postoperative abdominal surgical patient (ex: Anterior spinal fusions, Total Abdominal Hysterectomy and various colon surgeries).This block can be done pre-operatively, intra-operatively and in PACU. Local anesthetic is injected into the TAP layer. Using continuous ultrasound guidance, a continuous catheter is placed. A pain ball is attached to the TAP catheter in PACU and infused over several days. The key to this successful practice was formulating an action plan for an efficient method to disseminate the information about caring for the patients receiving TAP blocks. Educating the patient and family was done pre-operatively by the Anesthesiologist and Acute Pain Management RN team. We reinforced to the patients their role in achieving their pain management goals and improving their outcomes by better utilizing the various pain management adjuvants . Educating the various staff members involved by a using a PowerPoint in-service and handouts with general information about TAP blocks was utilized. The handout was placed conveniently on the front of the chart and was instrumental in reaching all nursing staff members in the patient care departments.
USING E-LEARNING WITH ORIENTATION AT THE BEDSIDE Pamela Taulman, RN, MA, CPAN, Mary Briggs, RN, BAN, CAPA University of Minnesota Medical Center, Fairview, Minneapolis, MN; and University of Minnesota Amplatz Children’s Hospital, Minneapolis, MN
Background: A new orientation program was developed at UMMC, Fairview to allow more time at the bedside and less time in the classroom by providing just-in-time learning. It uses resources linked to an intranet and electronic learning management system to track the completion of competencies. The design includes standard tools so preceptors do not need to rely on their memory when teaching and reinforcing content; and it allows orientees to skip certain elements of the orientation curriculum if competency can be demonstrated. Orientees spend a portion of their clinical shift reviewing e-Learning content and then apply it immediately in the practice setting with the preceptor. The program incorporates skills and knowledge checks to help the preceptor make an objective evaluation of the orientee’s progress.