ANNUAL ASPAN CONFERENCE ABSTRACTS e9

STAFF PERCEPTIONS REGARDING FAMILY VISITATION INTHE PACUMaria Walls, BSN, RN

Barnes-Jewish Hospital, St. Louis, MO 63110

Purpose: The purpose of this project was to examine staff perceptions

and beliefs regarding visitation with post-surgical patients in the peri-

operative care unit (PACU).

Description: A Visitor policy was initiated in October of 2007 in our re-

covery room. Staff voiced concerns regarding the initiation of this pro-

cess. A 10-item questionnaire was distributed and collected from each

staff member. They were asked their opinions on the emotional support

provided to families in the PACU, their personal feelings regarding visita-

tion, and what barriers to visitation were perceived.

Evaluation/Outcome: Results showed that even though 87% of em-

ployees would want the option to visit their family member in the

PACU, only 47% of employees felt families should have the option to visit

in their own PACU. The perceived barriers to visitation were allocation

of staff, privacy, and interfering with the care given to the patients. Em-

ployees also reported exposure to infection, staff anxiety, families poten-

tially witnessing resuscitations, and lack of education of families as

barriers. The results show an additional education exists. Family mem-

bers need education on what to expect when visiting the patient. Staff

would benefit from additional education on how to effectively commu-

nicate with family members.

PACU PREPARATION FOR MAGNETISMWhitney Payne, MS, RN

Barnes-Jewish Hospital, St. Louis, MO 63110

Purpose: The Magnet Recognition Program was developed by the Amer-

ican Nurses Credentialing Center to recognize hospitals for excellence in

nursing. Recognition is appraised based on the ‘‘forces of magnetism.’’

This includes areas of leadership, quality of care, and autonomy. Our hos-

pital achieved Magnet status on 10/14/03 and applied for re-certification

in 2007. A site survey was planned for April of 2008. This involved re-

viewing all nursing area, including perianesthesia care unit (PACU). Mag-

net appraisers would be interviewing and observing nurses. It was our

duty to develop a PACU specific Magnet education program.

Description: In order to effectively educate staff in PACU prior to the

Magnet site survey, a ‘‘Magnet Champion’’ was chosen as a liaison be-

tween the Magnet Advisory Council and the PACU. A Magnet binder

was developed to tie unit specific accomplishments and activities to

the 14 forces of magnetism. This was a reference during magnet ap-

praisal. A ‘‘Magnet Moments’’ presentation was held at Perioperative

grand rounds and highlighted PACU specific achievements. Various in-

services were held in the PACU to educate staff regarding the 14 forces

of magnetism and Magnet history.

Evaluation/Outcomes: PACU preparation for the Magnet re-designa-

tion was successful. Staff reported increased confidence due to the var-

ious in-services, presentations, and binder reviews that were held prior

to the appraisal. The PACU will continue to have a ‘‘Magnet Champion’’

to maintain Magnet education for future site visits.

PACU/ANESTHESIA PI COMMITTEEElizabeth Cox, MSN, RN, CMSRN, Gail Davis, ACNS-BC, CCRN,

Christopher Werner, BSN, RN, Kelli Thaman, BSN, RN,

Elizabeth L’Hommedieu, BSN, RN

Barnes-Jewish Hospital, St. Louis, MO 63110

Purpose: The perianesthesia care unit (PACU) recovers 80 to 100 pa-

tients a day. The volume of patients that require recovery also require

an attending anesthesia provider to discharge the patient to an inpatient

bed or to Phase 2. The working relationship with anesthesia and the

PACU is intricate in promoting quality improvement and providing

safe, efficient care.

Description: The PACU staff and the PACU Anesthesia Medical Director

formulated a PACU and Anesthesia Performance Improvement (PI)

Team. The team meets monthly. The team consists of PACU staff nurses,

PACU Medical Director, Attending Anesthesia Providers, Clinical Nurse

Specialist and the nurse manager. The team has a PI plan that is used

as the agenda for each meeting. Data discussed are post-op phone calls,

isolation precaution audit and clinical indicators. Also discussed at the

meetings are recovery room holds, code reviews, concerns, and ques-

tions. The meeting minutes are posted on the PACU website, so staff

may read and provide input.

Evaluation: The relationship between anesthesia and nursing in the

PACU has improved. Communication about concerns has provided

a route to be more proactive. The PI plan is interdisciplinary and pro-

motes accountability within the departments.

ROUNDING ON SURGICAL SATISFACTIONElizabeth L’Hommediue, BSN, RN, Elizabeth Cox, MSN, RN, CMSRN,

Gail Davis, ACNS-BC, CCRN, Chari Williams, BS

Barnes-Jewish Hospital, St. Louis, MO 63110

Purpose: In order to assess patient satisfaction regarding post-operative

care, our PACU (perianesthesia care unit) developed an audit tool to use

when rounding on the divisions while checking on patient’s first day

post-operative follow-up visit.

Description: A questionnaire was developed to ask subjective ques-

tions of patients. Visiting post-operative patients within twenty four

hours on the divisions was established to obtain information on percep-

tions of their post operative care experience. Examples of questions in-

cluded: ‘‘Do you remember your stay in our recovery room?’’, ‘‘How well

did we control your pain?’’, and ‘‘Did you have nausea after surgery?’’

Answers were on a scale of one to four, one being poor and four being

excellent. Data is entered into a database and trends are reviewed

monthly. The PI (performance improvement) team reviews the trends

at monthly PI meetings.

Evaluation/Outcomes: Upon review, we have found that 51% of our

patients remember their PACU stay. 18% reported nausea post-opera-

tively; on a scale of 1 to 4, Patients rated we cared for their nausea and

pain issues at a level of 3.4. On average, when interviewed on their first

postoperative day they felt their ‘‘level of wellness’’ was at the level of 2.9

out of 4. We plan to use this information to identify areas which need im-

provement. Our goal is to increase patient satisfaction through identifi-

cation of patient needs.