229 - Stapling the Gap: Increasing Knowledge, Skills, and Practice Gaps for Perioperative Staff with Surgical Staplers
Description: Clinical IssueUNC Medical Center utilizes intraoperative specialty teams. On occasion, team members may have to work outside of their specialty which results in less familiarity with the use of surgical stapling devices. This educational project was initiated as a result of identified knowledge, skills, and practice gaps assessed through observations, staff surveys, and input from stakeholders.Description of TeamThe team for this project included an Education Specialist and a Senior Certified Scrub Technician (Sr. CST) with input from leadership.Preparation and Planning Management and staff identified that accessible reference materials were not available for staff who were off service and/or unfamiliar with surgical staplers. An education plan was developed to include creating illustrated posters to be displayed in the ORs, an illustrated reference book would be created and placed on the stapler cart for quick reference for the staff. A skills laboratory simulation event would be held as part of a skills fair for staff with hands on practice and pre/post testing and an educational presentation would be presented with pre/post tests and evaluation for metrics.Assessment Metrics were achieved through pre and post tests and evaluations showing an increase in knowledge, skills, and practice. Ongoing evaluation will be utilized to assess the efficacy of the education and its impact on staff competency, surgeon satisfaction, and patient safety.Implementation Instructional posters have been posted in the surgical suites consisting of step by step instructions with illustrations on assembly and use of the most commonly used surgical stapling devices. A copy of the illustrated reference book was placed on the stapler cart. A simulation laboratory was held that allowed for hands-on practice with surgical stapling devices for staff.. The scenarios included misfiring of a stapler so the staff could learn the skills to troubleshoot issues as well as assembly and handling techniques. An educational presentation was delivered to interoperative staff with an increase in knowledge as measured through pre/post testing and evaluation. Outcome The posted instructional materials have been well received by the staff and surgeons. A skills laboratory simulation was conducted in November, 2018 to provide hands on practice for staff. 164 staff members attended. Knowledge test scores increased 43% across all roles. Evaluations revealed positive feedback for reductions in practice gaps. An illustrated reference book has been developed and is being utilized by staff with positive feedback. An educational offering was presented in June, 2019 measuring a 25% increase in knowledge. Evaluations revealed an increase in skills and practice. Implications for Perioperative Nursing Surgical stapling devices are extremely overwhelming to staff who may not use them on a daily basis and it is important to patient safety for staff to be familiar with the use of these devices.