Crossing the Red Line? A Balanced Decision for Parental Presence During Induction in the OR
Parental use of the Induction Room (IR) prior to surgery/procedures has been in effect at Children ’s Hospital Colorado since 1986. Recently our orthopedic team decided to stop all parental inductions, citing the success of their SSI spinal fusion bundle which includes no Parental Presence for Induction for Anesthesia (PPIA). This decision was brought to all multidisciplinary surgical teams for evaluation and potential ramifications. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Terry Chaulk Lee, Bree Justus, Jennifer Staab, Erin Fishburn, Georgia Guerra Tags: ASPAN National Conference Abstract Source Type: research

Increasing Patient Satisfaction by Decreasing Waiting Room Times
Several research studies have linked the time patients must spend in the waiting room to patient dissatisfaction. This became a concern at an intercity pediatric outpatient surgery center after reviewing surveys and listening to patient/ family comments. In the initial review of waiting room times, this surgery center had 40% of their patients waiting over ten minutes after they were registered for surgery. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Kelley Kelly, Penny Ebert Tags: ASPAN National Conference Abstract Source Type: research

Using Aromatherapy After Surgery to Reduce Anxiety
There is a link between mental and physical health. Anxiety is one of the most common problems before surgery. Studies have shown stress reduction to be important before and after surgery. Stress after surgery can cause increase in pain, nausea, it affects the vital signs, decreases patient satisfaction, and increases length of stay in the PACU. Aromatherapy has been used in the PACU for nausea and pain with shown success in previous studies. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Beverly J. Ryan Tags: ASPAN National Conference Abstract Source Type: research

Management of Patients with Insulin Pumps in the Perioperative Setting
The implementation of an institutional policy regarding diabetic patients with insulin pumps in the Perioperative setting posed concerns among nursing team members. Perioperative nursing team observed and identified knowledge deficits and inconsistent management related to the insulin pump dependent patient population. An opportunity was identified to initiate educational in-services and insulin pump resource nurses with a goal to improve patient care. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Anna Mae Josue, Katherine Coll, Staci Eguia, Cori Kopecky, Elizabeth Trejo, Sara Maes, David Reams, Llana Saquiton, Reshma Thomas, Monica Climaco Tags: ASPAN National Conference Abstract Source Type: research

Pain Reassessment & Documentation
The Joint Commission standards guides nursing documentation of pain reassessment to enable staff to appropriately recognize and treat patient ’s post-surgical pain. A need was identified to increase nursing knowledge and compliance about pain reassessment documentation in the electronic health record (EHR). (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Katelyn Lilienthal, Camillia Goodwin, Katie Berg, Kim Kitchen, Llana Saquiton, Cori Kopecky, Staci Eguia Tags: ASPAN National Conference Abstract Source Type: research

Document it Done
Surgical site infections (SSI) are the most common and costly hospital acquired infection. Decreasing the incidence of SSI is an ongoing goal of our surgical unit. Measures toward reaching this goal begin in pre-admission testing and continue through post anesthesia care. One of the ways the perianesthesia nurse can help prevent this complication is to promote normothermia. In pre-op, we have both BAIR paw gowns, and a supply of blankets kept in a stand-alone warmer. The OR manager presented to our Professional Nurse Council meeting literature from the National AORN conference on Best methods to promote normothermia. (Sour...
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Susan Bartlett, Terry Collard Tags: ASPAN National Conference Abstract Source Type: research

Ensuring a Safe Surgical Experience for the Patient Likely to Require an Intraoperative Blood Transfusion
We serve a patient population which includes many complex pediatric patients who often present for surgery with an extensive list of comorbidities. When the surgical plan includes a spinal fusion, pelvic or femoral osteotomy, calvarial vault remodeling, or the patient has a known coagulopathy, there is a great likelihood that the patient will require a blood transfusion intraoperatively. Patients who have had previous blood transfusions are at risk for developing antibodies, which can make cross matching blood difficult and time consuming. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Mary E. Reak, Katherine Houle, Sondra Tschumperlin, Nancy Kase Tags: ASPAN National Conference Abstract Source Type: research

Invasive Ventilation Sedation Protocol
With patients having more diverse and complex co-morbidities, the Post Anesthesia Care Unit (PACU) has had an increased number of patients requiring long term intubation. These patients are staying  in PACU for prolonged periods of time. Prior to this plan the PACU had very few strategies to care for these patients. No clear protocol was in place for long term intubation and the roles of the PACU staff and the Anesthesiologist. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Janet Fricker, Joyce Burke, Jordyn Boise, Mark Scherer Tags: ASPAN National Conference Abstract Source Type: research

How to Protect Our Largest Organ: Perioperative Skin Impairment Initiative
Prevention and identification of patients ’ skin integrity and measures to promote skin integrity in the perioperative setting is imperative for patient safety. Significant government guidelines, financial implications and national nursing initiatives assist in measuring and improving patient outcomes. An institutional initiative was impl emented to reduce the incidence of hospital acquired pressure ulcers and improve nursing competency on pressure ulcer prevention through education. The perioperative setting focused on improving nursing care related to skin impairment, documentation, and decrease skin impairment inc...
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Terry Kohlleppel, Staci Eguia, Cori Kopecki, Kim Kitchen, LIlibeth Dequito, Josy Sunil, Katelyn Lilienthal, Nelyn Cortez, Saramma John, Jaya Sanjo, Cecilia Rodriguez, Daryl Anildes Gumban, Jaya Mathew, Miguel Laxa, Katherine Simpson-Giwa, Tabitha Zahradni Tags: ASPAN National Conference Abstract Source Type: research

Nurse-driven Early Identification of Post Operative Urinary Retention (POUR) and Decreased Length of Stay in the Ambulatory Surgery Population
In the post-anesthesia care unit (PACU), successful urinary void trials are a discharge requirement for many ambulatory surgery patients. In many instances, patients are delayed from being discharged home despite meeting PACU criteria due to the inability to pass a void trial. Failed void trials can result in patients being admitted and/or having an indwelling catheter placed. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Angela Patruno, Toni Velasquez Tags: ASPAN National Conference Abstract Source Type: research

Optimizing the Post-operative Experience for Mismanaged Chronic Pain Patients by Initiating Pain Consultations Preoperatively
Chronic pain patients are often mismanaged regarding post-operative pain. They are often under-treated and overlooked because their home regimens are put on hold or not continued once admitted. Pain consultations are usually only requested when patients are writhing in pain on the floor, when it is often too late. When pain specialists were notified of the consult, it would often be after patients have been discharged. These opioid tolerant patients saw a longer length of stay in PACU due to difficulty managing their pain post-operatively. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Michelle Marmol Tags: ASPAN National Conference Abstract Source Type: research

Multi-modal Analgesia and the Peri-operative Staff
The majority of patients report inadequate postoperative pain relief that can lead to adverse physiological consequences and impaired recovery, decreased function, chronic pain and reduced quality of life1. The American Pain Society recently published practice guidelines recommended use of multimodal analgesia (MMA) to achieve effective post-operative pain management2. MMA includes a selection of analgesic medications and techniques provided across the different phases of the perioperative setting. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Laura Martinez, Beth Nardi, David Dickerson, Sherri Genis, Daniel Martinez Tags: ASPAN National Conference Abstract Source Type: research

Evaluating the Effectiveness of Aromatherapy to Decrease the Amount of Anti-emetic Used in the Treatment of PONV in PACU
Despite the use of conventional pharmaceutical treatment modalities prophylactically, post op nausea and vomiting (PONV) continues to be a problem in the PACU. Mission Hospital ’s RN staff was introduced to an aromatherapy product specifically meant to decrease PONV at a recent conference. Moreover, staff was interested in using treatment modalities that did not require a physician’s order. Since stewardship is a priority and the introduction of new products in practic e is highly scrutinized, we were interested in evaluating if there was a decrease in the use of anti-emetics when the aromatherapy was utilized ...
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Catherine Nolte Slupik, Margie Whittaker, Debbie Busby-Edebiri, Jeanie Hanamura Tags: ASPAN National Conference Abstract Source Type: research

Reducing PACU Length of Stay in the Post-operative Inguinal Hernia Patient
Nurses were challenged with delays in discharging patients post-inguinal hernia repair due to inability to void. The problem contributed to average stays of four hours or more consuming nursing resources and frustrating patients. To optimize patient outcomes and promote nursing excellence, nurse-driven protocols were developed to standardize care, thus decreasing length of stay. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Melody Hillstrom, Julie Mills Tags: ASPAN National Conference Abstract Source Type: research

30-Second Pause: An Evidence Based PACU Handoff Process
Due to the palpable dissatisfaction of our PACU (Post Anesthesia Care Unit) nurses with the existing handoff process between the OR nurse, anesthesiologist, and the PACU receiving nurse, the Perioperative Unit Based Council recommended identifying and implementing an effective evidence-based handoff process. The literature suggests that a pause upon arrival from the OR (Operating Room) into the PACU, before the handoff process begins, increases the PACU nurses ’ satisfaction with the SBAR (Situation, Background, Assessment, Recommendation) report. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: C.J. Marshak, Sadeeka Al-Majid Tags: ASPAN National Conference Abstract Source Type: research

Pediatric Perioperative Surgical Home
Historically, pediatric outpatient surgery patients at Akron Children ’s Hospital (ACH) were seen by an Advanced Practice Provider (APP) prior to their scheduled surgery. This visit occurred two hours before the surgery was scheduled. This APP visit was not best practice, especially for children with comorbidities. This practice placed patients at risk for unnecessa ry cancellations and family dissatisfaction. In 2015, with the opening of the new Outpatient Surgery Center (OSC), a structured pediatric PSH was initiated. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Margie Gaydos, Tara Wright Tags: ASPAN National Conference Abstract Source Type: research

A Grassroots Initiative That Successfully Strengthened Professional Practice and Engagement in a Post Anesthesia Care Unit
In 2015 the post-anesthesia care unit (PACU) participated in an Employee Engagement Survey. Results, shared by the manager at staff meetings, indicated 29% of staff were engaged, 57% content, and 14% ambivalent; zero of seven ANCC-approved categories for nurse satisfaction outperformed the national mean benchmark. A clinical RN identified the opportunity to partner with the manager to lead development and implementation of an action plan to improve engagement. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Shelley Reber, Elizabeth Adams Tags: ASPAN National Conference Abstract Source Type: research

Preoperative Time-Out Communication Process
The focus on surgical risk has evolved from solely considering the patient ’s disease process and complexity of the procedure to including additional focus on the health provider’s impact when evaluating surgical outcomes. From November 2015 to November 2016, thirty-three patients were reported to have entered the operating room (OR) with incomplete or missing required documentation. Other concerns included: strained employee relations, error due to time restraints and pressures of efficiency, absent handoff from the preoperative RN to the OR circulator, perioperative staff not valuing the need of a handoff, an...
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Katharine Day, Marianne Soderman Tags: ASPAN National Conference Abstract Source Type: research

Traditional Hospital Bed Versus Recliner Chair in Post Surgical Phase 2 Recovery Time for Laparscopic Cholecystectomy
Healthcare costs are steadily climbing at an alarming rate. The goal set forth by Department of Health was to achieve ¾ of all surgeries be performed in an ambulatory setting while maintaining and providing safe and effective care. One key factor was any delay in the discharge process would result in additional charges. Most delays documented centered on personal costs, secondary to post op pain and nausea. Nursin g care and interventions in this study assisted patients in a safe and quicker recovery within the ambulatory setting. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Becky Burnett, Carmen Mars, Janice Frerichs Tags: ASPAN National Conference Abstract Source Type: research

Lean Daily Management Supports Perioperative Team in Achieving Safe Quality Patient Care
Teamwork and clear, effective communication is fundamental in providing safe and reliable health care. Organizations rely on fluent collaboration among its many essential disciplines to decrease potential risks and ensure positive patient outcomes. Lean Daily Management (LDM) is an innovative approach used by hospitals to engage their care providers and evaluate unit specific goals aimed at excellence in service delivery. LDM provides a framework for systematic daily briefings. As a result all team members, from executives to front-line stakeholders, are empowered to impact performance. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Tracy Timmons, Stephanie Bondarenko, Justin Chura Tags: ASPAN National Conference Abstract Source Type: research

The Patient Passport: Using RPIW to Improve Team Handoffs
The need for a better way to share Preoperative patient information among the Periop team (Preop RN, OR circulator RN, CRNA) was identified. A previous handoff attempt with an in-person 3-team huddle was not effective or sustainable. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Patty Rapini, Ashley Hilliard, Rapid Process Improvement Workshop (RPIW) Team, Patty Rapini, Gayle Person, Rich Leyh, Jessie Schumacher, Chrissy Schotl, Kathy Plakut, Jean Kelly, Greg Veenendaal Tags: ASPAN National Conference Abstract Source Type: research

Successful LAVH and Discectomy Same Day Discharges
Implications for Advancing the Practice of Perianesthesia Nursing: (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Paula Duval, Jill Carlson, Judy Smith, Colleen Steinhauer, Kay Carlsrud Tags: ASPAN National Conference Abstract Source Type: research

Improving Patient Flow
A problem known to many recovery rooms is extended holding times due to unavailability of beds or nurses on inpatient units. At the beginning of our project, the average wait time from when the patient was ready to transfer until leaving the PACU was 2 hours and 26 minutes. The institution ’s goal was 60 minutes or less. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Maria Gutierrez, Kirsten Berk Tags: ASPAN National Conference Abstract Source Type: research

My Patient, My Chart!
Prior to implementation, the Charge Registered Nurse (RN) reviewed all Pre-Operative charts on day of surgery, and ensured the necessary elements were present prior to the patient going to surgery. The Charge RN was responsible for reviewing all lab work, diagnostic testing, and confirmed the presence of documented clearances (Cardiac, Pulmonary, etc.) if indicated. The Charge RN would communicate any abnormalities to the Surgeon and Anesthesiologist. The Pre-Operative Admitting RN would perform patient care and enter data into the Electronic Medical Record. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Maria Gutierrez, Patty Mendoza, Amor Eluna, Shannon Biehn Tags: ASPAN National Conference Abstract Source Type: research

Placing Regional Anesthesia Blocks in the Preoperative Unit
The use of regional anesthesia can have a profound effect in a patient's postoperative course. Patients receiving them emerge from anesthesia with less pain, decreasing the need for opioids. Placing regional blocks in the pre-operative department is gaining recognition as a means to increase productivity in the OR. With turnover times averaging 45 minutes, the surgical department of Saddleback Medical Center collaborated to improve productivity. The initiation of regional anesthesia in the pre-operative department was implemented to decrease turnover times in the OR. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Maria Gutierrez, Shannon Biehn, Amor Eluna, Patricia Mendoza Tags: ASPAN National Conference Abstract Source Type: research

Start Early - Improving Quality of Care With Standardized Discharge Education Prior to Ambulatory Surgery
The United States performs 75% of all surgeries in outpatient settings. Patients are discharged within hours of surgery and rely on post-operative education for guidance of safe home care. However, most discharge education is delivered after administration of amnesic drugs and quality/retention of education varies based on teaching/learning style. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Stephanie Al-Adhami, Sarah Trandel Tags: ASPAN National Conference Abstract Source Type: research

Bridging the Gap: Increasing Critical Care Knowledge and Skills in PACU Nurse Residents
A recent development of a Post-Anesthesia Care Unit (PACU) Nurse Residency Program (NRP) at a large teaching institution placed new graduate Nurse Residents (NR) in the PACU. The extent of NR Critical Care (CC) experience is limited to the time spent during nursing school clinical rotations, and observational CC shifts during the NRP. As a result, PACU stakeholders voiced concerns regarding NR lack of CC knowledge and skills. The PACU is a rapidly evolving unit that not only cares for post-surgical patients, but as also Intensive Care Unit (ICU) patients who necessitate hemodynamic monitoring, ventilator management, and va...
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Ayumi Fielden, Pamela Northrop, Laura Ortiz, Holly Rodriguez Tags: ASPAN National Conference Abstract Source Type: research

Destress With Discharge Education
The perioperative staff at the Ambulatory Surgery Center became aware of the need for changing our current practices when it came to patient discharge education. Preoperative education, in a quieter environment, helps to minimize anxiety and promote learning retention for patients and families. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Jaclyn Ivy, Sharon Knauss, Kimberly Platt Tags: ASPAN National Conference Abstract Source Type: research

Ready, Set, Breathe
Airway emergencies are infrequent in the PACU, but always a potential risk during the post-anesthesia period. Caring for a patient having respiratory difficulty and/or failure can be very stressful. In case of an emergency, it is important to have supplies and equipment readily available and prepared in an organized fashion. After an emergent reintubation event in the PACU, nurses discussed the need for practice to assist with becoming more efficient in these instances. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Brian Rann, Colleen Cummins, Joyce Bollas, Kris Sinclair Tags: ASPAN National Conference Abstract Source Type: research

Let ’s Take a Closer Look: Reviewing Safety Events at Annual Skills Day
Over many months we identified a need for staff to be knowledgeable of certain patient care occurrences that we found in our safety events management systems (SEMS) pertaining to perioperative services. Patient safety was being affected because the lack of knowledge of the specific incident or policy and procedure. Staff need the ability to critically think and problem solve in the moment in a busy environment. We wanted to provide an atmosphere that the staff could use teamwork, critical thinking skills, and have a comprehensive understanding of the SEMSs that were reviewed. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Janelle Holthaus, Shandra Edwards, Sandra Filla, Gail Davis Tags: ASPAN National Conference Abstract Source Type: research

Mock Codes in an Ambulatory Surgery Setting
Unexpected events can lead to cardiopulmonary arrest in a free-standing ambulatory surgery center (ASC). These events typically happen on an infrequent basis. Hospital-based rapid response teams and code teams do not exist in an ASC setting. The responsibility for managing cardiopulmonary arrest in the ASC relies on available staff with advanced life support and basic life support training. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Pamela Taulman, Marcia Turner Tags: ASPAN National Conference Abstract Source Type: research

Preparing Your Inpatient for Surgery
A need was identified in the surgical holding area to better prepare our inpatients for surgery/procedures. When patients arrive to the holding area unprepared, procedures are delayed and schedules are impacted. Unprepared patients result in delays for the OR which can impact the schedule for the entire day. In addition, delays can increase stress for the surgical patient, cause potential patient safety concerns, and tie up valuable nursing time on the floor, in the holding area, and in the OR. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Angel Ryan, Dawn Miller, Colleen Chiodo Tags: ASPAN National Conference Abstract Source Type: research

Post-Operative Pediatric Pain Management Education
Our surveys were consistently low in our pediatric population. We needed to improve our pediatric patient satisfaction scores found on our NRC Picker surveys. The question we evaluated was, “Did someone from the staff tell you accurately how your child might feel after surgery?” We decided to focus on the pain the patient might experience after their procedure. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Kelley Kelly, Maureen Palmer Tags: ASPAN National Conference Abstract Source Type: research

Enhancing Orientation Process: Tools for Success
New-hire RNs orienting into the Pre-Operative Unit require a well-designed and structured orientation process to successfully and independently prepare patients for surgery. Three RNs are currently identified as preceptors for the Pre-Op Unit; they also share in the role of Charge Nurse. Some are part-time which decreases their availability to precept; there are days when a formal preceptor is not available. Another barrier to a streamlined process is that RNs hired for part-time or per diem positions have difficulty committing to consistent and sequential work days. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: SangSun Lee, Arlene DeLaCruz, Diana Zirschky, Kathy Dureault Tags: ASPAN National Conference Abstract Source Type: research

Local Pre-Op, Local OR, Regional Local Education Tool/Competency
Healthcare quality improvement and clinical competence are priorities to ensure the safety of the patients. Due to the increase in surgical patients requiring regional/peripheral nerve blocks, digital local preop-block, and intraoperative monitoring for patients using only local anesthesia, staff expressed concerns for attaining knowledge and competency that reflects current nursing practice. Nurse Manager assessed the capabilities and competence of staff; providing educational opportunities and ensuring the implementation of staff performance evaluation. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Nickcole D. Price, Genevieve Cirineo Tags: ASPAN National Conference Abstract Source Type: research

Pre-Admission Testing in Person to Phone Conversion Project
Seventy Percent (70%) of Pre-admission Testing Assessments were done by phone within one to three days before surgery. This process resulted in occasional case cancellations, inability to receive clearances on time and delays in reviewing lab results. It also caused Patient, Physician and Employee dissatisfaction, staff overtime and low OR utilization, thus reducing organizational revenue. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Rose D. Ziffra, Terry Anne Booble, Patti Mulligan, Mariella Fortino, Rosemary Baer Tags: ASPAN National Conference Abstract Source Type: research

How We Built an Obstructive Sleep Apnea (OSA) Program at a Small Rural Hospital
The potential risk of adverse effects from OSA, known or suspected, potentiated by surgical anesthesia was recognized. Sauk Prairie Healthcare (SPH) decided to assess for this risk factor and create a policy and protocol for the specific needs of this patient population. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Terry Zeuske, Rita Selden, Robin Labeots, Charles Burnley, Cindy McCauley, Lois Oswald, Roy Wegert, Beth Ann Patterson, Suzanne Jacobs, Curtis Johnson, Denise Cole-Ouzounian, Theodore Parins, Ashley Lemmer Tags: ASPAN National Conference Abstract Source Type: research

2:1 Nurse-Patient Ratio Outside PACU Phase I: Implementing a Rn Tandem Approach in Caring for Preop/Preanesthesia Patients in an Ambulatory Procedure/Surgery Unit
The preanesthesia phase is the first segment of the perianesthesia continuum —improving the patient experience in this phase as well as the process are necessary in assuring safety and quality care. This process change has direct impact on staff accountability, enhanced collaboration/teamwork, and perioperative efficiency. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: McRomeo Libid, Jenn Collins, Erica Feldmann, Nolan Reyes, Lori Forsythe, Michelle Kennedy, Krista Hua, Jennifer Krick, Lilia Ruiz, Demetria Hayes, Helen Yee Tags: ASPAN National Conference Abstract Source Type: research

Uniting a Healthcare Delivery System Through Standardization
Currently, New York-Presbyterian Healthcare System (NYP) Post Anesthesia Care Unit (PACU) nurses document on a multi-system wide electronic health record (EHR). We utilize the PACU Admission and PACU Discharge/Transfer Note and five years ago designed the PACU Second Stage Admission and Discharge Notes. Reviews based on current practice revealed that all nurses chart differently and there is no standardized process for how nurses are documenting patient admissions and discharges. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Maria Katrina Eng, Alison Horan, Po Ngai, Sharanya Polisetti Tags: ASPAN National Conference Abstract Source Type: research

Performance Improvement for Pre-Admission Anesthesia Risk Screening of Pediatric Patients
Our pre-admission screening process is generally performed by our pre-admission testing (PAT) registered nurses (RN ’s). Pre-op and recovery room nurses often assist in screening patients during times of high census. We identified inconsistencies in obtaining pertinent information depending on which area was providing the screening. We were concerned that inconsistent information was not fully addressing anesth esia risk identification. To standardize this process, and consistently assess anesthesia risk, we developed an evidence-based screening tool for the pre-admit process. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Lucinda Sapikowski, Juleah Walsh, Michele Kincaid Tags: ASPAN National Conference Abstract Source Type: research

Revolutionizing Hand Hygiene With Institutional Clarity
Hand hygiene (HH) is the standard practice in health care. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Connie Hardy Tabet, Sarah Leister, Jessie Doerpers Tags: ASPAN National Conference Abstract Source Type: research

The Impact of the Perioperative Home Program on the Orthopedic Patient
The most common elective surgical procedure in the Medicare population is Total Joint Replacement (TJR) surgery. With an increase in patient volume, the goal was to decrease patient length of stay (LOS) and cost, while providing high quality, safe and efficient care and improve patient satisfaction. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Tanya Louis, Jennifer Leonardis, Maura Fallon, Irene Linzer Tags: ASPAN National Conference Abstract Source Type: research

Surgical Admissions Testing Center Chart Preparation Process
In the Pre-anesthesia testing and evaluation center for surgical outpatient/same day admit patients ’ surgical charts were not being prepared greater than three days prior to scheduled surgery, even when the surgery was posted several weeks in advance. There was repetition of work and unclear roles between nurses and medical office assistants (MOA). Patients needing anesthesia and medical cleara nce were not being identified until a day prior to scheduled surgery resulting in delayed scheduling of pre-anesthesia testing appointments. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Seema Hussain, Christine Boggerson, Catherine Jackson, Charlene Braswell-Jones, Lashaun Ray, Bridget Olson-Wright Tags: ASPAN National Conference Abstract Source Type: research

Improving Regional Anesthesia Education in Pre-Op and PACU: Development of a Standardized Regional Anesthesia Patient Education Protocol and Staff Education  Plan
Patient feedback from post-op calls indicated that patients are not only dissatisfied with the manner in which they are given regional anesthesia instructions, but are also unsure when to call the regional providers following discharge. A survey of the Pre-op/PACU nursing staff indicated a lack of consistency with patient education and a gap in knowledge regarding regional anesthesia. Current practice involved no patient education preoperatively and inconsistent discharge education from the PACU. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Jennifer Reiter, Maura Adams Tags: ASPAN National Conference Abstract Source Type: research

Nursing Shared Governance Helps Eliminate “Sacred Cow” Using an Evidence Based Rapid Cycle Improvement Process
Home instructions for clients who require an indwelling urinary catheter after a urologic surgical procedure have not changed significantly since the 1990 ’s despite the focus on Evidence Based Decision Making in healthcare. The practice of daily rinsing of the urinary drainage bag with a vinegar or bleach solution has been largely unquestioned until recently. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Robert Haney, Maureen McClellan, Dawn Huff, Joanne Matulewitz, Diane Newns, Donna Curran, Carol Byer, Erin Hughes, Teresa Bolden, Robert Levin Tags: ASPAN National Conference Abstract Source Type: research

Opioid Sparing-How Daring: Opioid Naive Patients Undergoing Knee or Hip Replacement Surgery Receive Minimal Opioids
With growing concern of opioid addiction, misuse and Opioid Related Adverse Drug Events (ORADE) in surgical patients, we evaluated the potential of decreasing the use of opioids on post-operative unilateral knee/hip arthroplasty patients. A high number of surgical patients experience ORADE while in the acute care facility. Initiating a protocol for opioid sparing regimen for the joint replacement patients was prudent. Surgical patients that receive less opioids experience less ORADE. This in turn decreases length of stay while achieving adequate pain management and maintaining high discharge home percentages without increa...
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Toni Milne, Amanda Charlton, Joyce Melius, Shelby Graf Tags: ASPAN National Conference Abstract Source Type: research

Enhanced Recovery After Surgery (Eras ®) Process and Continuous Improvement Methodology
Enhanced Recovery after Surgery is an international project noted for the implementation of key strategies to improve surgical patient outcomes. Many hospitals are developing ERAS ® protocols to provide improved safe patient care. ERAS® efforts are focused on decreased length of stay, preoperative consultation to enhance patient understanding of their role in recovery, and multimodal pain and post op nausea and vomiting (PONV) management. Anesthesiologist, surgeons and nurs es working together can make a difference. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Mary Korte, Tim Norman, Kristin Wheeler, Shelly Sykes, Erik Cooper, Nazar Kalivoshko, Kartik Gopal, Victoria Wells Tags: ASPAN National Conference Abstract Source Type: research

A Randomized Controlled Trial to Compare Pain Medications in Children Undergoing Strabismus Surgery
Children undergoing strabismus surgery often experience pain and post-operative nausea and vomiting. For many of these children, multiple strabismus surgeries are needed and past surgical experiences can contribute to both parental and child anxiety. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Hasima Hajdini Tags: ASPAN National Conference Abstract Source Type: research

A Retrospective Chart Review to  Explore the Differences in Opioid Naïve and Tolerant Patients
Patients who are opioid tolerant are difficult to manage perioperatively for pain while maintaining patient safety. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Alison Partridge, Christina Crook Tags: ASPAN National Conference Abstract Source Type: research

Tonsils with a Tune: A Randomized Control Trial Evaluating the Effects of Music Medicine on Pediatric Adenotonsillectomy Anxiety and Pain
Literature shows that music interventions exhibit positive effects in reducing patients ’ pain and anxiety. However, there are few research studies that examine the effect of music in pediatric patients’ pain and anxiety, specifically in perianesthesia settings. (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - August 1, 2018 Category: Nursing Authors: Summer Fitts, Angela Alexander Tags: ASPAN National Conference Abstract Source Type: research