Operating Room Nurse to Post Anesthesia Care Unit Nurse H in addition to off: Implementation

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Operating Room Nurse to Post Anesthesia Care Unit Nurse H in addition to off: Implementation

Neverett, Tim, On-Air Host has reference to this Academic Journal, PHwiki organized this Journal Operating Room Nurse to Post Anesthesia Care Unit Nurse H in addition to off: Implementation of a Written SBAR InterventionErin Long BSN, RN, DNP StudentAcknowledgementsDr. KesslerPerioperative NursesFamilyClassmatesPICOT QuestionIn perioperative nurses, how will the implementation of a written SBAR H in addition to off Form affect the content of h in addition to offs between OR in addition to PACU nurses in addition to impact the perceptions of teamwork in addition to patient safety of perioperative nurses over the course of three months when compared to current oral report practice

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Significance of the Background A unique setting subject to particular barriers to communication: NoiseInterruptionsHigh rate of patient arrival & dischargeA lack of structure during h in addition to off between OR in addition to PACU nurses places surgical patients’ safety at risk as miscommunication is more common when h in addition to off protocol is not st in addition to ardized(Abraham, Kannampallil & Patel, 2014; Kalkman, 2010; Petrovic, Aboumatar & Scholl et al., 2014; Petrovic, Martinez & Aboumatar, 2012; Riesenberg, Leitzsch & Cunningham, 2010; Riesenberg, Leitzsch & Little, 2009; The Joint Commission, 2015)Review of LiteratureDatabases: CINAHL, ProQuest, Medline (PubMed), Medline (EbscoHOST), Cochrane Library, & Joanna Briggs InstituteKeywords: periop, intraop, h in addition to off, h in addition to overInclusion Criteria:Peer reviewedScholarly journalsArticlesEnglish languagePublished after 2005Review of LiteratureAppraisal: Critical Appraisal Skills Programme (CASP) & Checklist as long as Evidence-Based Clinical Practice Guidelines(CASP, 2013; Melnyk & Fineout-Overholt, 2011)

Decision to Change Practice 1. Mnemonic Phrase Aids nurse memory Associated with a h in addition to off checklist 2. St in addition to ardized Protocol Decreases h in addition to off variability Reduces communication errors risking patient safety (Abraham, Kannampallil, & Patel, 2012; Greenberg et al., 2007; Holly & Poletick, 2013; Kalkman, 2010; Ong & Coiera, 2014; Riesenberg, Leitzsch, & Cunningham, 2010; Riesenberg, Leitzsch & Little, 2009; Petrovic, Aboumatar, & Scholl, 2015)ImplementationProject Design: Three, two week phases as long as a project duration of six weeks Phase One:H in addition to off Evaluation Form:1-page as long as m, measuring 24 items, PACU & ORPhase Two:Education Session: H in addition to off PowerPoint ® during staff meetingSafety Attitudes Questionnaire (SAQ) Pretest: 36 safety itemsDemographic DataH in addition to off Evaluation Form:1-page as long as m, measuring 24 items, PACUSBAR H in addition to off as long as m: 1-page as long as m, measuring 24 items, ORPhase Three:H in addition to off Evaluation Form:1-page as long as m, measuring 24 items, PACUSBAR H in addition to off as long as m: 1-page as long as m, measuring 24 items, ORSafety Attitudes Questionnaire (SAQ) PosttestMIDAS Report Audit: risk report audit to measure change to patient safetyImplementation

Data AnalysisOutcomes: Inclusion of 24 h in addition to off items Measure: Individual items & total scoreStatistical Tests: Frequencies, Mean Scores, & Independent-Samples t TestSignificance: Frequencies: no significant changes in the reporting of individual itemsMean Scores: decreased from phase two to phase threeIndependent-Samples t Test: 1 statistically significant item (Implants)SBAR H in addition to off FormData Evaluation SBAR H in addition to off FormData AnalysisOutcomes: Inclusion of 24 h in addition to off items Measure: Individual items & total scoreStatistical Tests: Frequencies, Mean Scores, Independent-Samples t Test, Paired-Samples t Test & ANOVASignificance: Frequencies: no significant changes in the reporting of individual itemsMean Scores: PACU > OR (phase one), PACU scores decreased from phase two-threeIndependent-Samples t Test: 3 statistically significant items (NPO, Skin, Shift)Paired-Samples t Test: 3 statistically significant items (NPO, Skin, Shift)ANOVA: not significant as long as PACU mean scores or as long as PACU H in addition to off Evaluation as long as ms from all three phasesH in addition to off Evaluation Form

Data Evaluation H in addition to off Evaluation Form Data AnalysisOutcomes: 36 items scoring perioperative nurse perceptions of teamwork, safety, job satisfaction, stress recognition, perception of management, in addition to working conditions Measure: Likert Scale & 6 Subsections Total Score (%)Statistical Testing: Independent & Paired-Samples t TestsSignificance: Independent-Samples t Test showed 4 significant items (Ask Questions, Good Job B, Problem Personnel B, & Timely Info B) & Paired-Samples t Test showed eight significant items (Family, Daily Ef as long as ts B, Compromise Patient Safety B, Good Job B, Problem Personnel B, Timely Info B, Level of Staffing, in addition to Communication Breakdowns) Teamwork & Patient Safety Scores: not significantly different Safety Assessment Questionnaire (SAQ) Data Evaluation SAQ

Data Analysis & EvaluationOutcomes: process used by perioperative nurses to file risk reportsMeasure: the number of reports filed 4 weeks prior to intervention were compared to the number of reports filed 4 weeks after the education session Statistical Tests: No testing required Significance: No change in reported events pertaining to perioperative patient safetyMIDAS Risk Report AuditRecommendationsLiterature supports the use of a mnemonic phrase in addition to st in addition to ardized h in addition to off protocol during nurse h in addition to off to reduce risks to patient safetyRepeat the project during a time when fewer changes are happening simultaneously Repeat project over a longer period of timeConclusionsImplementation of a written SBAR H in addition to off as long as m was not successful in st in addition to ardizing perioperative nurse H in addition to off from the OR to the PACUSBAR H in addition to off Forms: Mean scores decreased from Phase Two-Three in addition to the Implants item decreased in h in addition to off inclusion H in addition to off Evaluation Forms: Phases One-Two revealed promising trends in mean scores, but overall project statistical testing showed only 3/24 items improved with the intervention SAQ: Perioperative nurse perceptions of Teamwork in addition to Patient Safety showed variations in individual itemsMIDAS Audit: No change in nurse reported patient safety events

ReferencesAbraham, J., Kannampallil, T., & Patel, V. (2014). A systematic review of the literature on the evaluation of h in addition to off tools: Implications as long as research in addition to practice. Journal of the American Medical In as long as matics Association, 21, 154- 162. doi: 10.1136/amiajnl-2012-001351Critical Appraisal Skills Programme (CASP). (2013). Making Sense of the Evidence. Retrieved from http://www.casp- uk.net/Holly, C., & Poletick, E. (2013). A systematic review on the transfer of in as long as mation during nurse transitions in care. Journal of Clinical Nursing, 23, 2387-2396. doi: 10.1111/jocn.12365Greenberg, C., Regenbogen, S., Studdert, D., Lipsitz, S., Rogers, S., Zinner, M., & Gaw in addition to e, A. (2007). Patterns of communication breakdowns resulting in injury to surgical patients. The American College of Surgeons, 204(4), 533-540. doi 10.1016/j.jamcollsurg.2007.01.010 Kalkman, C. (2010). H in addition to over in the perioperative care process. Current Opinion in Anesthesiology, 23, 749-753. doi: 10.1097/ACO.0b013e32834acBMelnyk, B. & Fineout-Overholt, E. (2011). Evidence-based practice in nursing in addition to healthcare. Philadelphia, PA: LWW. Ong, M. & Coiera, E. (2011). A systematic review of failures in h in addition to off communication during intrahospital transfers. The Joint Commission Journal of Quality in addition to Patient Safety, 37(6) 274-284.Petrovic, M., Aboumatar, H., Scholl, A., Krenzischek, D., Camp, M., Senger, C., Chang, T., Jurdi A., & Martinez, E. (2014). The perioperative h in addition to off protocol: evaluating impacts on h in addition to off defects in addition to provider satisfaction in adult perianesthesia care units. Journal of Clinical Anesthesia, 27, 111-119. Petrovic, M., Martinez E., & Aboumatar, H. (2012). Implementing a perioperative h in addition to off tool to improve postprocedural patient transfers. The Joint Commission Journal on Quality in addition to Patient Safety, 38(3) 135-142.Riesenberg, L., Leitzsch, J., & Cunningham, J. (2010). Nursing h in addition to offs: A systematic review of the literature. American Journal of Nursing, 110(4), 24-34.Riesenberg, L., Leitzsch, J., & Little, B. (2009). Systematic review of h in addition to off mnemonics literature. American Journal of Medical Quality, 24(3), 196-202. doi: 10.1177/1062860609332512 The Joint Commission. (2015). National Patient Safety Goal 2015. Retrieved from http://www.jointcommission.org/st in addition to ards-in as long as mation/npsgs.aspx

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