ASPAN National Conference Abstracts
providers, and members of the patient care delivery team, both patient care
and organizational goals can be met. The option of 30 day blood bands is
expanding to other surgical services to avoid delays the morning of surgery.
https://doi.org/10.1016/j.jopan.2021.06.049
BREAKIN’ UP IS HARD TO DO! - STANDARDIZED PRE-OPERATIVE
PHONE CALL
Team Leader: Amy Berardinelli, DNP RN NE-BC CPAN
University Hospitals Cleveland Medical Center, Cleveland, Ohio
Team Member: Melissa Koteles, RN-BC
Background Information: The University Hospitals Cleveland Medical Center
(UH CMC) operative services perioperative nursing and reception departments
identified concerns related to patient complaints of day-of surgery delays and
cancellations. At UH CMC there are over 130 surgeons representing 20 special-
ties that perform over 25,000 surgeries annually. Each surgeon’s office would
call the surgical patients the day prior to their surgery with a surgical time,
arrival time, and where to report for registration. There are two adult surgery
centers located at UH CMC on different floors quite far from one other. Differ-
ent sets of instructions were given from each specialty with conflicting instruc-
tions related to NPO guidelines, arrival times, correct surgical center,
registration location, and personal items needed day-of-surgery.
Objectives of Project: Pre-operative phone call ownership and standardiza-
tion was needed to improve patient satisfaction, reduce day-of-surgery can-
cellations, optimize first case on-time starts, as well as ensure patients and
families were properly instructed for their surgical procedures.
Process of Implementation: Urology patients were identified as the single-
service pilot population. The perioperative nurses created a script based on
this population’s pre-operative questions and concerns during the pre-op
calls. After 4 weeks, a script was developed by the nurses who conducted the
calls. The nurses conducting the calls educated their peers, as well as the
department secretaries. The information was then shared with each surgical
specialty, to include a soft and hard rollout date.
Statement of Successful Practice: One month after the hard rollout date, the
perioperative nurses and secretaries are conducting approximately 75 pre-
operative phone calls to surgical patients daily. Outcomes to celebrate
include improved first case on-time starts, decreased day-of-surgery cancel-
lations, and increased patient satisfaction.
Implications for Advancing the Practice of Perianesthesia Nursing: Having
one owner and a standardized process for pre-operative phone calls and
communication with our patients may lead to improved quality, safety, and
satisfaction.
https://doi.org/10.1016/j.jopan.2021.06.050
IN THE ZONE: A TEAM APPROACH TO PRE- AND POST-
OPERATIVE PATIENT CARE
Team Leader: Shannon Goold, BSN RN CPAN
The University of Kansas Health System-Indian Creek Campus, Overland Park,
Kansas
Team Members: Nichole Anderson, MSN RN CMSRN,
Anissa Rachel Edmonson Christian, BSN RN CAPA,
Cindy Ladner, BSN RN MBA CASC CAPA
Background Information: Staffing in a Perianesthesia unit is a continuous
challenge with an ever-changing surgery schedule. An offsite surgical
hospital for a large academic medical center previously had separate pre-
operative and postoperative units. With the opening of a new hospital in
2018, a zone staffing model was used to implement a blended perianes-
thesia unit.
Note: All abstracts are printed as received from the authors.
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Journal of PeriAnesthesia Nursing 36 (2021) e1−e19
Objectives of Project: To increase nurse competencies throughout the peria-
nesthesia continuum, coordinate varied staffing schedules with fluctuating
surgery schedules to optimize efficiency and safety, adhere to ASPAN stand-
ards and avoid OR delays.
Process of Implementation: The Unit Coordinator and Educator shadowed
other blended perianesthesia units within the system to evaluate their pro-
cesses. A new perianesthesia unit zone staffing model was designed to meet
our unique patient population, as well as the physical layout of the new unit.
This unit has 24 bays with the capacity to staff up to four zones. When mak-
ing the daily staffing schedule, bays are clustered together by anesthesiolo-
gist and surgeon. Nursing staff is then assigned with the latest scheduled
nursing staff assigned to the latest OR end times. The assignments are made
in such a manner to decrease overall staff footprint and utilize Lean
processes.
Statement of Successful Practice: Competency in all aspects of perianes-
thesia care has increased nursing proficiencies and improved delivery of
patient care. Clustering of physicians and nurses by zones has enhanced
the ability to respond to changes in the surgical schedule and prevented
surgical delays. The same pre/post staff and OR staff work together for
continuity of care through the day. Despite the magnitude of these
changes, all members of the interdisciplinary team have embraced the
zone staffing model and Press Ganey outpatient scores have sustained
above the 90th percentile rank.
Implications for Advancing the Practice of Perianesthesia Nursing: Zone
staffing increases nurse autonomy, providing an opportunity for
bedside nurses to use critical thinking and problem-solving skills. Zone staff-
ing also promotes accountability, teamwork, and inter- and intra-profes-
sional communication, as members of the zone are accountable to each other
in real time. Increased nurse autonomy and improved accountability, team-
work, and communication yield better patient experiences.
https://doi.org/10.1016/j.jopan.2021.06.051
IMPLEMENTING A MEDICAL EMERGENCY AND RAPID
INTERVENTION TEAM
Team Leader: Mahroz Mohammed, BSN RN CMSRN
The University of Texas MD Anderson Cancer Center
Team Members: Staci Eguia, MSN RN CCRN, Kimberly Potts, MSN RN CNOR,
Kimberly Hermis, DNP RN OCN
Background Information: Failure to rescue accounts for approximately
60,000 deaths each year in Medicare patients under the age of 75. In a large
outpatient oncology facility that encompasses an infusion center, multimo-
dality procedure unit, radiation treatment center & multidisciplinary clinic,
the need to implement a rapid rescue team was identified to mitigate the
risk of failure to rescue.
Objectives of Project: The goal of this initiative was to implement a Medical
Emergency and Rapid Intervention Team (MERIT) service to care for patients
undergoing chemotherapy, blood transfusions, procedures, radiation and
other oncology treatments. A standardized process was developed for MERIT
activation by healthcare providers within the facility. In-Service all employ-
ees in the facility and empower them to activate MERIT for identified
patients.
Process of Implementation: The current MERIT policy for inpatients was
reviewed and collaboration was formed with institutional leaders to revise it
for an ambulatory center. A needs assessment was conducted and knowledge
deficits were identified. The skill mix of PACU nurses was reviewed to iden-
tify those with a high acuity background to be a core member of the MERIT
team. An orientation and competency check-off was developed, which
included requiring members to have Advanced Cardiac Life Support (ACLS),
Pediatric Advanced Life Support (PALS) and High Acuity Training. A post-
implementation survey was conducted to assess needs and knowledge gaps.
Statement of Successful Practice: The assessment survey indicated 83% of
staff were able to identify all the correct situations to call MERIT, 9% of staff
ASPAN National Conference Abstracts
were not sure what situations require MERIT and 25% of staff did not know the
correct extension to request MERIT. Post implementation of MERIT service, the
building team members indicated 84.4% of the staff were able to identify cor-
rect situations to call MERIT, and 98% of the staff knew the correct extension
to request MERIT. Post education survey was done 2 weeks after go live and
showed improvement in knowledge and comfort level in calling MERIT.
Implications for Advancing the Practice of Perianesthesia Nursing: Pro-
viding a MERIT service in an outpatient facility could mitigate the risk of fail-
ure to rescue, and improve patient outcomes.
https://doi.org/10.1016/j.jopan.2021.06.052
PREPARING FOR THE UNKNOWN: SIMULATION-BASED TRAINING
IN A NEW PROCEDURAL /PACU AREA TO INCREASE PATIENT
SAFETY
Team Leader: Kimberly Potts, MSN RN CNOR
The University of Texas MD Anderson Cancer Center, Houston, Texas
Team Members: Staci Eguia, MSN RN CCRN,
Mahroz Mohammed, BSN RN CMSRN
Background Information: Opening a new procedural area and post anesthe-
sia care unit (PACU) can present potential risk of complications. An education
need was identified to establish and test workflows for 3 new procedural
areas to ensure patient safety measures. Simulation-based team training was
developed for all interdisciplinary team members working in the new
setting.
Objectives of Project: The goal of this training was to test new workflows to
ensure efficiency and to establish patient safety measures in a new ambula-
tory procedural and PACU environment.
Process of Implementation: All interdisciplinary team members were sur-
veyed prior to the simulation regarding their experience with simulation
training and to assess primary patient safety concerns.
Nursing leadership and informatics analysts coordinated the simulation
planning. A test patient was developed in the customized electronic health
record (EHR) template for the procedural and PACU area. A detailed work-
flow was developed covering the multiple roles impacting the patient’s visit.
Test patients were created with three separate scenarios for the different
modalities. An additional scenario was included for the activation of the insti-
tutional Medical Emergency Rapid Intervention Team (MERIT).
A brief was provided prior to each simulation scenario and tasks were
assigned based on roles. The scenarios followed the patient from check-in
through discharge. Each simulation included several anticipated workflow
challenges such as laboratory testing, specimen collection, chest X-rays and
MERIT team activation.
At the completion of each simulation activity, a debrief session led by
PACU nursing leadership was held to discuss identified areas of improve-
ment, patient safety concerns, workflow challenges and team collaboration.
Feedback forms were provided during the simulation to record specific
patient safety concerns and barriers to providing safe care. A list was com-
piled to address critical needs prior to the scheduled go-live date.
A post-survey was provided to evaluate the effectiveness of the simulation
activity.
Statement of Successful Practice: Post-survey results revealed that 91% of
participants felt confident and prepared; 76% felt safety concerns were
addressed; 18% identified patient safety concerns and all participants felt
that their learning needs were met.
Implications for Advancing the Practice of Perianesthesia Nursing: Pro-
viding simulation training for multidisciplinary teams in a new procedural
and PACU area could improve patient outcomes, establish cohesive work-
flows, and increase knowledge and confidence.
https://doi.org/10.1016/j.jopan.2021.06.053
Note: All abstracts are printed as received from the authors.
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Journal of PeriAnesthesia Nursing 36 (2021) e1−e19
CREATING LVAD (LEFT VENTRICULAR ASSIST DEVICE)
KNOWLEDGEABLE TOOL AND TRAINING FOR UNLICENSED
ASSISTIVE PERSONNEL IN THE PERIANESTHESIA SETTING
Team Leaders: Randy Joheson, RN4 BS ADN, Cathy Lee, RN4 BSN CPAN CAPA
Vanderbilt Medical Center Nashville, Tennessee
Team Members: Kim Alfeldt, RN3 BSN, Claire Hamilton, RN4 BSN
Background Information: LVAD (Left Ventricular Assist Device) is an electro-
mechanical device which augments the cardiac circulation and output used as
a bridge to replace a patient’s failing heart function with end stage heart dis-
ease and/or failure awaiting either a heart transplant or destination therapy
(determination of end of life care). The LVAD is surgically attached to the heart
to help maintain left ventricle contractility. American Heart Association esti-
mates 50,000 − 100,000 advanced heart failure patients that with an LVAD
could experience an increased chance of survival with improved lifestyle qual-
ity. An increase of LVAD patients are needing surgical treatments; thereby see-
ing an increase number of patients in the perianesthesia area. While training
has been established for registered nurses, no formal training has been imple-
mented for unlicensed assistive perianesthesia nursing personnel.
Objectives of Project: Assess unlicensed perianesthesia nursing personnel
with regards to LVAD knowledge. Determine knowledge deficits to educate
and increase awareness of complications, nursing care, and reporting of per-
tinent facts to licensed staff.
Process of Implementation: Formulated questionnaire to determine knowl-
edge base and implications of LVADs. PowerPoint presentation, training fact
sheets, and in-services of unlicensed assistive perianesthesia personnel
implemented. Follow up questionnaire to determine knowledge gained. Pol-
icy and procedure manual on unit. FAQ sheet done. Unlicensed nursing per-
sonnel algorithm posted at nursing desk.
Statement of Successful Practice: Post educational data results and
observed changes in practice revealed an increased knowledge base and
awareness by unlicensed assistive personnel of LVADs in identifying issues
related to LVADs to report to perianesthesia registered nurses and to assist
the RNs with care of LVAD patients and their families. Increased comfort level
and competency in assisting LVAD patients noted.
Implications for Advancing the Practice of Perianesthesia Nursing: A
future tool implemented for orientation and competency checklist for unli-
censed assistive perianesthesia personnel.
https://doi.org/10.1016/j.jopan.2021.06.054
PERIOPERATIVE NURSING SIMULATION AND ITS INFLUENCE ON
STUDENT NURSES’ CAREER INTEREST
Team Leader: Jennifer Jessen, EdD MSN RN, Assistant ProfessorANC Track
Leader
Creighton University, Omaha, Nebraska
Team Members: Christine Smith, MSN RN CPAN,
Kristy Iwansky, MSN RN CPAN CAPA, Nicola Moreland, MHA BSHM RN CPAN,
LeaAnn Palmer, MSN RN
Background Information: Perioperative nurses are key personnel in manag-
ing safety risk and preventing patient harm. With significant nursing short-
ages, there is a critical need to train and recruit nurses to this complex area.
Limited curricular exposure, clinical opportunities, and perioperative instruc-
tion in undergraduate nursing programs have led to a decline in nurses seek-
ing perioperative positions and an increased staff turnover.
Objectives of Project: The specific aim of this exploratory quantitative study
was to determine if perioperative nursing educational activities, particularly
simulation, influence student interest in pursuing perioperative nursing careers.
Process of Implementation: Students in two different nursing tracks, on
campuses in two different states, and at various points in their nursing educa-
tion participated in a perioperative simulation. Due to COVID-19 challenges,
this in-person simulation was converted to a virtual simulation mid-way