e16 ANNUAL ASPAN CONFERENCE ABSTRACTS

IMPLEMENTATION OF A PERIOPERATIVE ETHICSCOMMITTEE IN A FREESTANDING PEDIATRICHOSPITALPresenter: Maureen Schnur, MS, RN, Team: Judi Friedson, MS,

RN, Sheila Curran-Campbell, BSN, RN, Jennifer Bradbury, BSN,

RN

Children’s Hospital, Boston, MA and Nurse Ethicist and Staff

Nurse III, Surgical Liaison Program and Staff Nurse II, PACU

In response to staff nurse requests for a forum to discuss ethical

concerns, the direction and involvement of a nurse ethicist new

to the institution was requested to guide this effort. The group

meets monthly, is led by the nurse ethicist and is composed of

members across the perioperative continuum including Preop-

erative areas, the Operating Room, the Surgical Liaison Area and

PACU.

Each month, a staff nurse works with the nurse ethicist to pres-

ent a case for discussion that poses an ethical dilemma or causes

moral distress. The group considers each case utilizing ethical

principles and the American Nurses Association Code of Ethics

to guide discussion. Outcomes achieved include heightened

awareness of effective strategies to advocate for patients from

an ethical standpoint, growing ability of members to support

staff in matters of ethical concern, and identification of repeat-

ing themes enabling a targeted approach to problem-solving

and quality improvements.

SUCCESSFUL IMPLEMENTATION OF A CONSULTTRIAGE NURSE ROLE IN A PEDIATRIC HOSPITALBASED DAY SURGERY UNITPresenter: Susan Sullivan, RN, BSN, Team: Gail Howie, BN,

Jean Silvia, RNC

Staff Nurse II, Day, Surgery Pre-Op Holding, Children’s Hospital,

Boston, MA and Staff Nurse II, Day Surgery Pre-Op, Holding,

Children’s Hospital, Boston, MA and Staff Nurse II, Day Surgery

Pre-Op Holding

In response to a need to improve utilization of clinic appoint-

ments for preoperative anesthesia consultation and patient/fam-

ily satisfaction with the process, a decision was made to trial

a consult triage nurse role. The purpose of this role was for an

experienced day surgery preoperative nurse to conduct a thor-

ough review of patient paper and electronic charts and a phone

interview with the family to discuss current health status in or-

der to make an informed decision about the need for the patient

to be seen prior to their surgical procedure. This process re-

quires collaboration between physician surgical schedulers

and the consult triage nurse team.

Goals achieved have been reduced unnecessary visits to the pre-

operative clinic, especially for children with chronic but stable

complex medical issues; improved dialogue between caregivers

and families to determine the best course of action; and greater

job satisfaction and autonomy for participating nurses in con-

tributing to the patient’s care. Data collected have shown that

approximately 10% of the referrals from surgical schedulers

needed preanesthetic consults.

BREATHING EASIER.STAFFING RESPIRATORYTHERAPY IN PACUPresented by Denise O’Brien, MSN, APRN, BC, CPAN, CAPA,

FAAN

Clinical Nurse Specialist, UH Perianesthesia Care Unit,

University of Michigan Health System, Ann Arbor, MI

Background: Respiratory compromise is a common complica-

tion in PACU. Patients with obstructive sleep apnea (OSA) have

an even higher risk of airway complications following surgery.

Many patients present for surgery with undiagnosed OSA. A risk

factor for OSA is obesity, which is prevalent in the United States.

Objectives: Anticipate, prevent, and treat airway complications

in the PACU.

Implementation: Nursing met with Respiratory Therapy (RT)

to discuss the increasing needs of PACU patients for respiratory

assistance. RT now assigns a therapist, with critical care experi-

ence, to PACU every day.

Successful Practice: Patients are screened for pre-existing and

potential airway issues before surgery; they are instructed to

bring personal respiratory equipment with them the day of sur-

gery. RT is informed of patients’ respiratory needs.

Positive Outcomes: RT works collaboratively with anesthesia

and nursing to assist with all airway issues. They are available to

apply respiratory devices, provide ventilator assistance, adminis-

ter breathing treatments, and help transport ventilated patients.

Implications: With an increase in patient obesity and OSA,

PACU nurses are faced with an increasing challenge in prevent-

ing respiratory complications following surgery. RT can play an

important role in PACU by assisting with airway management of

postoperative patients.

MAGNET JOURNEY DRAWS CERTIFICATIONJoyce Chase, RN., CAPA, Donna McKeehan, RN., CAPA,

Joanne King, RN., CAPA

MidState Medical Center, Meriden Connecticut

Our hospital was beginning the process toward Magnet Status

and due to the importance of professional development and ed-

ucation in the Magnet model certification was encouraged. This

was an opportunity to increase the number of certified nurses in

the Perioperative Department. With nurses passing the exam it

could motivate others to become certified. Each nurse in the de-

partment was approached and asked if they would take the

exam. CAPA Coach was identified, scholarship from the local

component was obtained, expenses were covered by the hospi-

tal. A study corner set up with many study materials and the hos-

pital Librarian used as a resource also. The hospital provided

a CAPA Review Course co-sponsored by ASP AN which was

available to all nurses. Three nurses prepared for the exam,

two took the exam and passed. Nurses in the Perioperative

area now see this as an attainable goal. With two nurses became

certified it doubled the number of CAPA nurses in the Perioper-

ative department. This is only the beginning! We hope that the

momentum will continue and that by the time our hospital ap-

plies for Magnet Status our unit will have more certified nurses.

Due to administrative changes at our hospital the Magnet Jour-

ney has been put on hold. So this objective will need to wait

to be evaluated. The project was a success, nurses becoming

certified, others have become motivated and see this as an at-

tainable goal. Our unit is very proud.