PAGE 82 JOURNAL OF VASCULAR NURSING SEPTEMBER 2009

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Diagnoses included hypertension 56%(17); hypercholesterolemic

43%(13); and diabetes 10%(3). Five were current smokers. Partic-

ipants were contacted by phone at 6 months and asked specific

questions about their screening results, health status, and physi-

cian follow-up. Most patients (73%) reported an increase in exer-

cise activity and 33% reported significant dietary changes. There

was no change in smoking behavior. Only 2 patients did not

have follow-up appointments with their primary care physician

to discuss screening results. The majority (97%) of participants

stated that the screening was a positive experience. This study

shows that vascular screenings are beneficial and can have an

impact on behavioral changes.

P13

Withdrawn

P14

Evolving Roles of the Registered Nurse In OutcomesMeasurement

Alyson Flood, RN

Presbyterian Hospital, Charlotte, North Carolina

‘‘The roles of the registered nurses in the utilization of vascular

surgical and interventional outcome data analysis and presentation

are being revolutionized.’’

Greater emphasis on quality measures and following quality

practice guidelines initiatives or legislation, allows nurses the

opportunity to seek out new research and career possibilities.

Institutions are recognizing that nurses are in a valuable role

and that our expertise can indirectly result in better patient out-

comes. Clinical improvement departments are utilizing more

nurses in quality development, data collection and data analysis

roles.

Taking the knowledge or truth of your practice and sharing it

in a best practice team environment requires a well organized pro-

cess. This process is a powerful venue for advocating a movement

towards quality vascular best practice, resulting in a change

towards better patient outcomes.

It is essential to collect, analyze and present a clear picture of

your practice in order to advocate positive best practice initiatives

or change. Having the tools and clinical improvement support ser-

vices is a good place to start in this process. Opportunity to collect

and nationally benchmark vascular practice is now being pursued

in our country.

Vascular surgical and interventional registries are currently

in their infancy stages and awareness of the tools and techniques

to produce quality outcomes data is not as tough a bear to

tackle.

It is my goal through a poster presentation to open awareness

of what our institution is currently utilizing for data collection and

analysis to compliment our vascular best practice process im-

provement initiatives. The software created by AXIS PATS called

‘Merged Vascular Registry’ has been a powerful tool that has

enabled us to not only nationally benchmark our outcomes but,

monitor them over time. The nurses role in the utilization of

knowledge and truth in our practice is more then a rewarding

career opportunity, it encompasses a commitment to our patients

as ethical and professional advocates.

P15

Under Pressure: Abdominal Compartment Syndrome

Pamela Johnson, RN, Jennifer Speakman, RN, CPAN

Carilion Roanoke Memorial Hospital, Roanoke, Virginia

The purpose of this poster is to discuss nursing assessment and

care of patients at risk for and diagnosed with abdominal compart-

ment syndrome. ACS is a rare but potentially life threatening con-

dition that can be better managed through early identification of

symptoms. This is an increasingly recognized syndrome in criti-

cally ill patients, which can contribute to multiple system organ

dysfunction. It is essential that vascular nurses recognize and un-

derstand the signs, symptoms and pathophysiology of this syn-

drome to effectively care for these patients. Early detection of

this potential syndrome requires analysis of the physical assess-

ment, hemodynamic monitoring, lab results and physiologic pa-

rameters. Communication with the surgeon of findings is also

essential. Vascular nurses should demonstrate knowledge of early

interventions and continuing management of ACS. Two case stud-

ies of post-operative patients following abdominal aortic aneurysm

repair are included to illustrate application of these principle in

a Vascular Intensive Care Unit. Implications of nursing practices

are highlighted.

P16

Advanced Practice Nursing Role In Tertiary VascularCare

Julie Ross, MSN, CCNS, Lora Nizinski, MSN, CRNP,

Scott Oldfield, CRNP, DrNP(c)

Geisinger Medical Center, Danville, Pennsylvania

Geisinger’s Vascular Surgery team has developed an innova-

tive model of practice, driven by the Advanced Practice Nurse.

The Advanced Practice Nurse was first introduced as a member

of the Vascular Surgery out-patient clinic team at Geisinger Med-

ical Center in 2002. Since that time, the role has grown to include

a Board Certified Clinical Nurse Specialist and two Board Certi-

fied Nurse Practitioners championing patient centric care. In our

Vascular Surgery practice we comprehensively manage our

patients through education, overseeing the management of risk

factors and health care practices, and helping the client navigate

a complex healthcare system. The Society for Vascular Nursing

released a position statement in 2004 highlighting the valuable

role advanced practice nurses hold in the care of patients with

vascular disease. We have used this position in the development

of our own practice model. The Clinical Nurse Specialist and

Nurse Practitioners each have strengths that benefit our client

population. In addition to patient care, professional development

is one of the core constructs in our practice model. One example

of this is the initiation of a program of clinical research lead by

our DrNP candidate. Imminent future developments in our prac-

tice include the addition of a 4th Advanced Practice Nurse,

enabling us to expand our role to the inpatient arena, therefore

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allowing us to improve continuity of patient care across all transi-

tions of care.

P17

A Deadly Threat Becoming An UnpredictableRehabilitation - Patients’ Experience of Going ThroughOpen Surgery For Abdominal Aortic Aneurysm

Anna Letterstal, PhD Student

Karolinska Institutet, Stockholm, Sweden

In an ideal world, 100 percent of our patients would be admit-

ted to units where the employees are trained to care for their spe-

cific condition. Yet due to the high volume of patients and high

demand for beds, some patients inevitably get moved to beds out-

side their targeted unit because these are the only beds available.

Recently, Unit H51 partnered with employees in other units and

departments to help bring the right patients to their unit.

Research Led Them To A Solution: To organize their efforts

to bring more of the right patients to their unit, H51’s Shared Gover-

nance Q Board team created the ‘Right Patient, Right Unit’ project

a year ago. Both Shared Governance and Q Boards empower front-

line employees to make improvements in their areas Shared Gover-

nance is a decision-making tool, and a Q Board is a dedicated project.

Improved Channels of Communication Is Key To Success:

To improve communication, the Shared Governance team met with

representatives from other units and departments throughout the

hospital. Physician assistants and nurse clinicians encouraged open-

ing the channels of communication between our unit, the surgical

team, Cardiovascular ICU and Patient Access Services (PAS),

Patients, Medical Team Benefit From Project: When the

five-month pilot finished, the results reinforced the unit’s beliefs

that admitting the right patients to their unit would benefit both

the patients and the entire medical team.. It’s much more comfort-

ing, especially for new amputees, to be surrounded by patients

who are in the same situation.

P18

3pm Huddle Meeting

Mini Iype, RN, BSN, Mini Easo, RN,BSN, Francis Utley, RN

Baylor Heart And Vascular Hospital, Dallas, Texas

At Baylor Heart and Vascular Hospital, employees from every

different department gather for their huddle meeting at 3pm. The

team members come from virtually every department.

The Goal: Plan for a well organized and successful day ahead

and be able to work at maximum capacity and reduce unexpected

errors and surprises.

The Mission: Identify patient flow, safety issues and areas for im-

provement, recognize accomplishments and plan for the next day.

The meeting consists of one representative, usually the charge

person from almost each department, such as the scheduling, the

different procedure areas such as Cath lab, EP lab, Pharmacy,

Nutrition, Respiratory, and Patient care floors. The meeting covers

everything from admission to surgery to discharge planning. The

meeting discusses on the number of patients pre-scheduled for

procedure on the following day and talks about the type of

patients, their specific needs such as need for isolation, CPAP,

diabetics, hemodialysis, anticoagulation status and any other

needs so the different areas are ready to take care of the expected

needs. The meeting also identifies staffing issues and tries to

resolve that. Anything that went bad for the day is discussed

and resolution sought. Patient complaints are identified and

service recovery done. Accomplishments are identified and

recognized.

The team huddle approach to process and flow issues affecting

each of the departments has led to many improvements that impact

the hospital’s overall satisfaction scores that are currently in the

99th percentile nationally.

P19

Post-Op Vascular Assessment

Patty Flanagan, RN

Albany Medical Center, Broadalbin, New York

Post-op assessment, with a focus on identifing vascular com-

plications, in the post-op AAA, Carotid endarterectomy and lower

extremity bypass patients.

The assessment will focus on complications particular to the

type of vascular surgery done. General post-op complications

will not be included.

The presentation will be a tri fold poster presentation, with

each third focusing on an assessment for the particular surgery per-

formed. Identifing what is an abnormal finding, what it is an

indication of and what is the expected follow-up care.

P20

Technology vs. Nursing: Current Practices In CaringFor Beeping-Bedside Technology

Macnolia McKinney, RN, BSN

Barnes-Jewish Hospital, St. Louis, Missouri

Our inpatient vascular care unit at Barnes Jewish Hospital

explored various methods to reduce the number of technical

alarms which cause patients to loose sleep, become irritable,

and complain about the nursing staff. Members of the 6400

Unit Practice Committee discussed process improvement which

would benefit staff, patients, and families. UPC came up with

the slogan ‘NO PASS ZONE.’ No Pass Zone is division

6400’s commitment to not pass a beeping IV machine, Beeping

call light, or any request of help from any patient in any room. It

was decided to make colorful reminders for staff not to pass an

alarm. These signs were then placed on all of the room’s door

post. Each UPC member was assigned a group of employees

to discuss the meaning of the sign and the division’s commit-

ment to No Pass Zone. Each employee was empowered to re-

mind other staff members of No Pass Zone, when seen

passing a room with a beeping IV. Our Manager understood

that each employee had to be able to say ‘didn’t you hear that

beep’, to others without fear of retaliation. At this point in our

practice we have been 4 months without a letter about a patient

having to endure beeping equipment No Pass Zone has now

been expanded to include quick response to all bed alarms and

other nursing divisions. In our divisions attempt to prevent pa-

tient falls, we have committed that all staff will respond to