Track: Clinical Improvement/Innovation
Clinical Improvement/Innovation Poster Session (Posters #144-#153)
Background: Emergency bedside surgery is considered a rescue procedure for patients too critical to move to the operating room. With a low 28-day survival rate of 75.6% (Schreiber, 2014), surgical staff must prepare for emergency bedside cases appropriately. Studies have shown that the top indicators for emergency bedside surgery includes: Intra-abdominal bleeding (39%), Intestinal Ischemia (24.4%), Abdominal Compartment Syndrome (24.4%), and abdominal focus of sepsis (12.2%) (Schreiber, 2014). With a focus on reducing the environmental and organizational factors that affect surgical flow disruptions (SFD), we can provide better surgical outcomes for patients.
Objectives: The objective of this study is to improve efficiency and preparedness in emergency bedside surgery by incorporating the use of a standardized bedside emergency readiness checklist and cart. By having a bedside checklist and cart readily available, the goal is to minimize environmental and organizational stress factors on emergency bedside cases.
Method: Since research has shown that the majority of emergency bedside cases include intra-abdominal bleeding control, we focused our efforts in compiling a supply, equipment, and instrument checklist to meet these surgical needs. Not only was a checklist compiled, but a rolling and easily movable cart with the supplies and equipment listed was designed and made readily available in the event of an emergency. This test of change was implemented on our current surgical floor. Surveys will be distributed to all nurses involved in emergency bedside cases to provide measurable data on the effectiveness of our test of change.
Conclusions: With the data collected from the surveys collected, we can make a step in increasing efficiency and preparedness during trauma cases. By designing a ready-to-go emergency bedside checklist and cart, we hope to improve the procedural supply organization and increase staff preparedness before stepping into an emergency bedside case. This plan is aimed to support perioperative nurses in ensuring their patients have everything needed to undergo “rescue bedside laparotomy,” in a timely manner.
Co-Authors: Stephanie Bartkowicz, Gayane Erdoglian
Cedars-Sinai Medical Center
Valley village, California