349 - Ready Set Surgery: Team Approach Improves Patient Readiness
Description: Clinical IssueClinical staff identified issues regarding inpatients who were coming down for surgery without everything completed, resulting in increased surgical delays and decreased patient, staff/surgeon satisfaction in the preoperative unit of one hospital.Description of the Team/PlanThe preoperative nurses were empowered to enhance clinical practice in surgical preparedness for a smoother transition from inpatient units to preop/surgery, the goal being to improve mutual communication, increase patient and staff satisfaction and decrease surgical delays. The plan was to investigate and identity processes and/or barriers that prevent appropriate surgical inpatient readiness. Then, to collaborate, educate and implement positive change to improve clinical inpatient processes within nursing practice utilizing an interprofessional team approach. AssessmentThe preoperative nurses and educator, with management support, examined current processes/practices in getting inpatients ready for surgery and sought input from other system hospitals via an email query to the cooperate perioperative education council to see if they had useful strategies/practices to share. Due to a lack of best practices the decision to track, identify issues and collaborate with health team members to improve processes at one hospital began.ImplementationA tracking form was first created, with data entry into an event reporting system and received access to run a report called Improper Preparation, to help identify trends and issues of inpatients not completely ready. Over several months, numerous meetings were held with a team of inpatient and preoperative nurses, risk management, electronic medical record team, unit-based educators, clinical resource educators & management. Data was shared, issues identified & educational opportunities found, developed & implemented to staff nurses. This education was completed via huddles, face-face sessions & newly developed handouts. The EMR preoperative checklist was also updated & standardized for both inpatients & outpatients, per the EMR team. OutcomesThe baseline audit to assess the prevalence of issues with patients preoperatively showed 73% of patients were improperly prepared; no checklist, 47 %, no PCD, 36%, IV issues,31%, incomplete permits, 21%, belongings/clothes on, 21%: Only 1 of 8 units had 50% of patients ready. Post education data revealed an average 25% improvement. Also, nurses demonstrated autonomy, networked & collaborated with team members. The mutual desire to improve preoperative processes was realized with a heightened awareness & improvement in preoperative patient readiness. Implications for Perioperative Nursing Processes and barriers that prevented appropriate patient readiness for surgery were identified. Best practices were recognized & staff were reeducated. The heightened awareness throughout the hospital helped with communication, increased staff satisfaction & gradually improved clinical processes.