Download or read book Utilizing Checklists to Improve Handoff in the Post Anesthesia Care Unit PACU written by Luis Tollinche and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: ImportanceMiscommunication from multiple care transfer has been shown to increase morbidity and mortality. To mitigate adverse events, use of checklists to standardize handoff communications in post anesthesia care unit (PACU) has been studied and shown to effectively reduce medical errors. ObjectiveThe goal is to establish measures to avoid miscommunication and improve patient safety through standardized PACU handoff protocol using a checklist.DesignA total of 120 handoffs were observed by two research assistants in real time for pre-implementation and post-implementation of a handoff checklist. 60 handoffs were observed for each pre- and post-implementation period. Using a 12-item checklist, each observer quantified items reported during every observed handoff. Additional data points, such as: duration of the report, training of the anesthesia staff giving report, and total number of questions asked by PACU staff were collected for further analysis.SettingM6 surgical floor post anesthesia care unit (PACU) at Memorial Sloan Kettering Cancer Center (MSKCC).Participants120 handoffs were observed between June 13, 2016 and July 15, 2016 from 10AM to 5PM., which included observation of interactions between RN, PACU midlevel providers (nurse practitioners, physician assistant), attending anesthesiologists, certified nursing anesthetists (CRNAs), anesthesiology residents, CRNA students, attending surgeons, surgical fellows, surgical residents, and surgical PA-C. Intervention(s) for clinical trials or exposure(s) for observational studiesDuring pre-implementation period, all staff were not informed of the research agenda. Post-implementation period, electronic and physical copy of the checklist were distributed to anesthesia staff only. At every observed handoff, anesthesia staff were reminded to follow the order of items on the checklist.Main outcome(s) and measure(s)u2022tOverall data transfer increased from 9 to 11 items during handoff with a checklist. u2022tMedian duration of handoff increased from 3 minutes to 4 minutes per handoff. u2022tNumber of follow up questions asked by PACU staff stayed consistent pre- and post-implementation period. u2022tImprovements in data transfer were independent of anesthesia training. Resultsu2022tImprovements in handoff were independent of duration of the report. The median number of 11 items stayed consistent through all lengths of reports.u2022tSurgical staff reported consistently a median of 6 items during pre- and post-implementation periods, whereas anesthesia staff improved from 5 reported items to 9. Overall handoff improvement is likely due to anesthesia staff report. u2022tData showed most improvement in anesthesia related items (ie. Allergies, Anesthesia Technique, and Airway) and least improvement in surgery related items (ie. Underlying diagnosis for the procedure, Procedure done, PACU plan, and Disposition).u2022t40 out of 60 staff were not compliant in following the order of the list. However, the 20 handoffs that adhered to the order reported a median of 12 items.Conclusions and RelevanceImplementation of a checklist for PACU handoff increased overall data transfer independent of duration of the report, improving patient safety. This result was noted across all trainings of anesthesia providers. For future directions, we recommend incorporating staff feedback into Plan-Do-Study-Act cycles for an improved checklist to ensure compliance and familiarize the staff with the use of a checklist through multimodal training modules.
Download or read book Identifying Delays in Care of Clinically Decompensating Patients in the Post Anesthesia Care Unit written by Kate Rohlf and published by . This book was released on 2019 with total page 37 pages. Available in PDF, EPUB and Kindle. Book excerpt: The post-anesthesia care unit (PACU) has an average Phase I length of stay goal of 60 minutes. The PACU has not met this goal. The purpose of this study is to identify a gap in care that could affect Phase I time. One gap identified was the time added for patients requiring a STAT order for a decompensating condition. These orders included a STAT chest x-ray, arterial blood gas, hemoglobin & hematocrit draw, or electrocardiogram. Direct observation revealed that up to ten minutes per patient was added by the current workflow. The study was a retrospective review of 74 patient charts of overall Phase I time and whether the patient had a STAT order placed during their PACU stay. The results concluded that the average Phase I time for patients without a STAT order was 74.4 minutes compared to 103.5 minutes for patients with a STAT order placed. This was an increase of 39%. A cost-savings analysis revealed that patients with STAT orders placed had an additional stay cost of $205 compared to hospital goal. A second cost-analysis reveals a staff productivity loss of $2,800 per month per RN, based on two patients per week required a STAT order. The recommendation from this study is for the organization to create a standing conditional order set for the PACU in the electronic medical record. There is a potential cost-savings of more than $3,000 per month. This could increase patient safety, expedite care, and improve patient throughput in the PACU.
Download or read book The Application of a Standardized Handoff Approach in a Community Hospital Setting written by Rebecca D. Hartley and published by . This book was released on 2018 with total page 98 pages. Available in PDF, EPUB and Kindle. Book excerpt: Handoffs are the transfer of care, involving communication of important clinical information, transfer of responsibility, and collaboration between clinicians, assuring safe transfer of care from one clinician or department to another. Inadequate handoffs may result in serious events that compromise patient outcomes and influence care provider's perceptions of handoff processes. Handoff communication stood as a critical patient safety issue and was identified as being an area of risk at the project organization. This risk was associated with inconsistent phone report processes and low scores concerning handoffs on the AHRQ Hospital Survey on Patient Safety Culture. Using the Plan, Do, Study, Act quality improvement cycle, this project focused on the implementation of an evidenced-based standardized handoff tool to provide consistency in information transfer from the Emergency Department to the Medical Unit or Surgical Unit; and the Post Anesthesia Care Unit to the Surgical Unit. The goal of this project was to streamline processes, reduce waste. and promote quality communication of essential care elements to improve nurse's perceptions of handoff transitions. As a part of this process, direct care nurses were involved in developing and implementing the handoff tool, with the goal of improving staff perceptions of handoff processes using the AHRQ Hospital Survey on Patient Safety Culture handoff and transition survey questions to evaluate the outcomes of quality improvement project. Results reflected no statistical change in any of the four handoff questions, although qualitative feedback did suggest positive implications associated with the implementation of the new handoff standard work. Keywords: patient handoff, clinical competence, quality of care, nurse perceptions
Download or read book Drain s PeriAnesthesia Nursing E Book written by Jan Odom-Forren and published by Elsevier Health Sciences. This book was released on 2022-12-27 with total page 770 pages. Available in PDF, EPUB and Kindle. Book excerpt: UPDATED! Revised content throughout provides the most up-to-date information for effective perianesthesia nursing practice. NEW! Full-color layout makes content more visually appealing and highlights important information. NEW! Information on SARS/COVID-19 is now included in the Pathogens chapter. NEW! Chapter on International Care of the Perianesthesia Patient offers complete coverage on this key topic. UPDATED! Coverage of pain management for the perianesthesia patient features the latest guidelines. UPDATED! Patient with Chronic Disorders chapter provides current information on caring for these patients. UPDATED! Evidence-Based Research boxes provide the latest standards of care.
Download or read book Overcoming knowledge gaps in use of capnography in a post anesthesia care unit written by Glen Meyer and published by . This book was released on with total page 132 pages. Available in PDF, EPUB and Kindle. Book excerpt: The use of capnography plays a significant role in patient safety while recovering from anesthesia and sedation. Capnography has been used for many years in emergency departments, operation suites, and procedural areas. However, in the post anesthesia care unit (PACU) capnography is rarely utilized. This proposed project explores the use of capnography in developing a project proposal and implementing an educational module to change this practice in a PACU. Dr. Watson’s Transpersonal Caring Theory is used as the theoretical foundation for developing the project proposal. Within this project proposal an educational module will be developed using Dr. Watson’s Theoretical concepts of mutuality, caring, and leadership will guide the development of the project. Implementation of the project will provide the necessary knowledge and skills for nurses in PACU to change their practice. Nursing leadership’s role in the development and maintenance of this practice will constantly change as education and resource allocation are constantly evolving factors in practice change.
Download or read book Miller s Anesthesia 2 Volume Set written by Michael A. Gropper and published by Elsevier Health Sciences. This book was released on 2024-07-18 with total page 7929 pages. Available in PDF, EPUB and Kindle. Book excerpt: Offering up-to-date coverage of everything from historical and international perspectives to basic science and today’s clinical practice, Miller's Anesthesia, 10th Edition, remains the #1 reference and trusted learning resource for practitioners and trainees in this complex field. Dr. Michael Gropper leads a team of expert editors and contributing authors who provide current information on the technical, scientific, and clinical issues you face each day—whether you’re managing a challenging patient care situation, preparing for the boards, or studying for recertification. Addresses timely topics alongside foundational basic science for an in-depth and comprehensive understanding of the field. Contains thoroughly up-to-date content, including two new chapters: The Immune System: Implications for Anesthetic Management and Emergency Preparedness in Healthcare. Provides new content in key areas such as sustainability, global health equity, the effect of anesthetics on immune function, anesthesia for special populations, coverage of infectious diseases including COVID-19, and occupational exposure and safety. Offers state-of-the-art coverage of anesthetic drugs, guidelines for anesthetic practice and patient safety, new techniques, step-by-step instructions for patient management, the unique needs of pediatric patients, and much more—all highlighted by more than 1,200 full-color illustrations (300 new to this edition) for enhanced visual clarity. Includes 40+ video clips demonstrating patient positioning, ultrasound, echocardiograms, and other imaging, and anesthetic procedures in real time.
Download or read book Alexander s Care of the Patient in Surgery E Book written by Jane C. Rothrock and published by Elsevier Health Sciences. This book was released on 2014-03-01 with total page 1309 pages. Available in PDF, EPUB and Kindle. Book excerpt: NEW and UNIQUE! Patient-Centered Care boxes feature simplified conversations that you can have with patients to help them better understand their surgical procedure. NEW! A Critical Thinking Question at the end of every chapter tests your understanding of chapter content. NEW! Key Points at the end of every chapter help you retain important concepts from the text. NEW! Laboratory Values appendix contains all laboratory value information in one convenient location.
Download or read book Clinical Anesthesia Procedures of the Massachusetts General Hospital written by Richard M. Pino and published by Lippincott Williams & Wilkins. This book was released on 2015-08-10 with total page 1053 pages. Available in PDF, EPUB and Kindle. Book excerpt: Apply today’s best practices in anesthesiology! Relied on for over 30 years by practicing anesthesiologists and residents as well as nurse anesthetists, Clinical Anesthesia Procedures of the Massachusetts General Hospital offers you current, comprehensive, concise, consistent, and clinically relevant guidelines on all facets of anesthesia, perioperative care, critical care, and pain management from a host of seasoned experts.
Download or read book Evidence Based Practice of Anesthesiology written by Lee A. Fleisher and published by Elsevier Health Sciences. This book was released on 2022-03-22 with total page 595 pages. Available in PDF, EPUB and Kindle. Book excerpt: Addressing both routine and complex situations with practical decision-making tools, Evidence-Based Practice of Anesthesiology, 4th Edition, helps anesthesiologists make sound decisions in everyday practice. World-renowned authority, Dr. Lee A. Fleisher, takes an evidence-based approach to a variety of high-impact topics related to effective perioperative patient management: preoperative assessment; monitoring and administration of anesthesia during surgery; postoperative intensive care management; and postoperative pain management. The 4th Edition has been updated from cover to cover, helping you make informed clinical decisions based on reliable, up-to-date guidance in every aspect of patient care. Explores important issues in perioperative management, discussing the available options, examining the relevant research, and presenting practical recommendations. Features concise, to-the-point chapters with numerous quick-reference tables for fast and effective decision making. Includes decision trees throughout to provide visual guidance and a logical flow of key decision points. Contains nine new chapters on how to identify patients at risk for postoperative neurocognitive disorder; the best strategy for perioperative ACE and ARB agents; emergency laparotomy; optimal postoperative analgesia and the opiate naïve patient; the best method for perioperative handoffs; myocardial injury after non-cardiac surgery (MINS); and more. Helps you master the current best practices you need to know for successful day-to-day practice and oral board review.
Download or read book Kaplan s Cardiac Anesthesia E Book written by Joel A. Kaplan and published by Elsevier Health Sciences. This book was released on 2016-10-20 with total page 1280 pages. Available in PDF, EPUB and Kindle. Book excerpt: Now in a revised and expanded 7th Edition, Kaplan’s Cardiac Anesthesia helps you optimize perioperative outcomes for patients undergoing both cardiac and noncardiac surgery. Dr. Joel L. Kaplan, along with associate editors, Drs. John G. T. Augoustides, David L. Reich, and Gerard R. Manecke, guide you through today’s clinical challenges, including the newest approaches to perioperative assessment and management, state-of-the art diagnostic techniques, and cardiovascular and coronary physiology. Complete coverage of echocardiography and current monitoring techniques. Guidance from today’s leaders in cardiac anesthesia, helping you avoid complications and ensure maximum patient safety. More than 800 full-color illustrations. A new section on anesthetic management of the cardiac patient undergoing noncardiac surgery. New availability as an eBook download for use the in OR. Online-only features, including quarterly updates, an ECG atlas...an increased number of videos, including 2-D and 3-D TEE techniques in real time...and an Annual Year End Highlight from the Journal of Cardiovascular Anesthesia that’s posted each February.
Download or read book Keeping Patients Safe written by Institute of Medicine and published by National Academies Press. This book was released on 2004-03-27 with total page 485 pages. Available in PDF, EPUB and Kindle. Book excerpt: Building on the revolutionary Institute of Medicine reports To Err is Human and Crossing the Quality Chasm, Keeping Patients Safe lays out guidelines for improving patient safety by changing nurses' working conditions and demands. Licensed nurses and unlicensed nursing assistants are critical participants in our national effort to protect patients from health care errors. The nature of the activities nurses typically perform â€" monitoring patients, educating home caretakers, performing treatments, and rescuing patients who are in crisis â€" provides an indispensable resource in detecting and remedying error-producing defects in the U.S. health care system. During the past two decades, substantial changes have been made in the organization and delivery of health care â€" and consequently in the job description and work environment of nurses. As patients are increasingly cared for as outpatients, nurses in hospitals and nursing homes deal with greater severity of illness. Problems in management practices, employee deployment, work and workspace design, and the basic safety culture of health care organizations place patients at further risk. This newest edition in the groundbreaking Institute of Medicine Quality Chasm series discusses the key aspects of the work environment for nurses and reviews the potential improvements in working conditions that are likely to have an impact on patient safety.
Download or read book Human Factors in Surgery written by Tara N. Cohen and published by Springer Nature. This book was released on 2020-09-28 with total page 246 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book delivers a comprehensive review of human factors principles as they relate to surgical care inside and outside of the operating theatre. It provides multi-dimensional human-centered insights from the viewpoint of academic surgeons and experts in human factors engineering to improve workflow, treatment time, and outcomes. To guide the reader, the book begins broadly with Human Factors Principles for Surgery then narrows to a discussion of surgical specialties and scenarios. Each chapter follows the following structure: (1) An overview of the topic at hand to provide a reference for readers; (2) a case study or story to illustrate the topic; (3) a discussion of the topic including human factors insights; (4) lessons learned, or personal “pearls” related to improving the specific system described. Written by experts in the field, Human Factors in Surgery: Enhancing Safety and Flow in Patient Care describes elements of the surgical system and highlights the lessons learned from systems engineering. It serves as a valuable resource for surgeons at any level in their training that wish to improve their practice.
Download or read book Transitions of Care for Patients with Neurological Diagnoses written by Sonja Stutzman and published by Elsevier Health Sciences. This book was released on 2019-08-02 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: In collaboration with Consulting Editor, Dr. Steve Krau, Dr. Sonja Stutzman has put together a state-of the-art issue of the Nursing Clinics of North America devoted to Transitions of Care for Patients with Neurological Diagnoses. Clinical review articles from expert authors are specifically devoted to the following topics: Transition from EMS to ED; Transition from ED to Hospital; Transition from OR to ICU; Transition from ICU to Floor; Transition from Hospital to Rehab (Nurse Navigator); Transition from Rehab to Home; Transition from Hospital to Home; Transition Trajectory: Stroke; Transition Trajectory: TBI; Transition Trajectory: Seizure Disorder; Transaction Trajectory: Neurodegenerative Disease; and International Perspectives of Transition. Readers will come away with the latest information they need to improve outcomes in patients with a neurologic diagnosis as they transition through various facilities as part of their care.
Download or read book Avoiding Common Anesthesia Error written by Catherine Marcucci and published by Lippincott Williams & Wilkins. This book was released on 2019-08-29 with total page 1777 pages. Available in PDF, EPUB and Kindle. Book excerpt: The full-color Avoiding Common Anesthesia Errors, significantly updated for this second edition, combines patient safety information and evidence-based guidance for over 300 commonly encountered clinical situations. With a format that suggests conversations between an attending and a trainee, the book helps you identify potential problems and develop a treatment plan to minimize the problem. Brief, easy-to-read chapters cover basic and advanced topics and help you digest information in minutes!
Download or read book Miller s Anesthesia Review E Book written by Lorraine M Sdrales and published by Elsevier Health Sciences. This book was released on 2017-08-31 with total page 544 pages. Available in PDF, EPUB and Kindle. Book excerpt: Encompassing all anesthesia topics from basic to advanced, Miller’s Anesthesia Review, 3rd Edition, by Drs. Lorraine M. Sdrales and Ronald D. Miller, is an ideal study guide to assess your knowledge and deepen your understanding. This easy-to-use resource is conveniently cross-referenced to the newest edition of Miller & Pardo: Basics of Anesthesia. Hundreds of questions cover everything from physiologic and pharmacologic principles through anesthetic machine systems, anesthetic delivery in a variety of settings, and anesthesia administration for a full range of disease states. Corresponds to Miller & Pardo’s Basics of Anesthesia to help you make the most of your study time and learn more efficiently. Provides immediate feedback with detailed answers to each question at the end of every chapter, cross-referenced to specific pages in Basics of Anesthesia. Includes new chapters on Neurotoxicity of Anesthesia, Palliative Care, Sleep Medicine, and Perioperative Surgical Home. Brings you fully up to date with revised questions throughout, progressing logically from basic to advanced topics. Covers hot topics such as Implantable Cardiac Pulse Generators, Anesthesia for Robotic Surgery, Perioperative Blindness, Human Performance and Patient Safety, and Civil, Chemical, and Biological Warfare.
Download or read book Perioperative Quality Improvement E Book written by Carol J. Peden and published by Elsevier Health Sciences. This book was released on 2022-07-30 with total page 451 pages. Available in PDF, EPUB and Kindle. Book excerpt: Quality improvement (QI) principles are increasingly important in every area of today’s healthcare, encompassing efforts to make healthcare delivery safer, more effective, patient-centered, timely, equitable, and efficient. Perioperative Quality Improvement provides up-to-date, easy-to-read guidance for perioperative clinicians on this critical topic. Each chapter covers a pertinent area of QI in the perioperative setting, focusing on both concepts and implementation. Written and edited by key international opinion leaders in the field, this text is a relevant, concise resource for anesthesiologists, surgeons, nurse anesthetists, and hospitalists—anyone involved in perioperative medicine regardless of specialty area. Explains concepts related to understanding the tools and techniques used in improving the quality of care, establishing a culture of quality, prioritizing areas of improvement, collecting and analyzing data, communicating, motivating people to change, and performing ongoing evaluations. Covers key topics such as patient-centered care, equity, shared decision making, process mapping, and sustainability. Addresses the critical areas of structure, process and outcome with a focus on perioperative care and relevant case studies.
Download or read book Clinical Anesthesia Fundamentals written by Sam R. Sharar and published by Lippincott Williams & Wilkins. This book was released on 2021-07-09 with total page 1171 pages. Available in PDF, EPUB and Kindle. Book excerpt: Part of the popular and well-regarded Clinical Anesthesia family of titles, and founded by Drs. Paul G. Barash, Bruce F. Cullen, and Robert K. Stoelting, Clinical Anesthesia Fundamentals, Second Edition, is a concise, highly visual resource covering the core concepts in anesthesiology. The editorial board comprised of Drs. Bruce F. Cullen, M. Christine Stock, Rafael Ortega, Sam R. Sharar, Natalie F. Holt, Christopher W. Connor, and Naveen Nathan, and their team of expert contributors clearly and simply present the information you need on key aspects of anesthesia for every specialty area and key organ systems. From physiology and pharmacology to anatomy and system-based anesthesia, it uses full-color graphics, easy-to-read tables, and clear, concise text to convey the essential principles of the field.
