262 - The Role of Operating Room Nurses to Improve Quality of Life and Quality of Care
Description: Study question: Will a relationship based care approach to perioperative nursing increase patient outcomes and nurse satisfaction?BackgroundHead and neck cancer patients face an especially difficult course of treatment as they undergo extensive surgery occasionally requiring free flaps, chemotherapy, and radiation. Treatment often results in multiple complications, requiring speech, swallow, wound, and psychosocial rehabilitation. Perioperative care nurses may have a lack of knowledge on patients’ comprehensive treatment and care plans after surgery and desire more information on the diagnosis and disease process, treatment plans, and potential complications. Nursing staff participation in the formation of patient care plans will improve knowledge and involvement in care, leading to improved patient outcomes and increased job satisfaction. Multidisciplinary care teams including surgeons and nursing teams across the intraoperative, ambulatory, and inpatient care environments will be able to produce better clinical outcomes and increase nurse satisfaction.Design
Description: The overall purpose of the multidisciplinary head & neck free flap nursing team is to meet and coordinate treatment plans that are integrated with quality reviews and initiatives to close nursing practice gaps. A team consisting of one to two nurses from each of the following settings will be identified to represent their area of expertise: operating room/perioperative services, head and neck ambulatory clinic, and the surgical inpatient floor/ICU. In addition to nursing, the multidisciplinary team should include comprehensive supportive care experts from rehabilitation services, speech and language therapists, clinical social work, case management, and registered dietitian nutritionists. The multidisciplinary team will meet regularly to discuss specific patients who are at an increased risk for postoperative complications based on predictive factors (i.e. neoadjuvant treatments, comorbid conditions, etc.) and level of surgical case complexity. Expected outcomes and measures of success for the multidisciplinary head and neck cancer nursing team program will be defined and reviewed at each team meeting to ensure sustained focus, and to identify gaps and opportunities for improvements.Methodology: The City of Hope quality of life (QOL) model by Ferrell, Grant and colleagues is the guiding framework for all nursing care at our institution, and will be used to create the multidisciplinary head and neck nursing care team. QOL in head and neck cancer patients is increasingly important given the long-term sequelae of multimodality treatment. Attitude surveys are effective in revealing the current cultural environment of the department and readiness for team application. A comprehensive assessment tool will be developed and administered to assess nursing knowledge in the perioperative care of head and neck cancer patients to provide a baseline gap analysis.