Stacey Gilmore & Sharon Goodier
Topic: The Current Surgical Safety Checklist (SSCL)
The current Surgical Safety Checklist (SSCL) was implemented by the ministry without input from the user groups and as such was not well received by them. The purpose of the SSCL was to promote communication and patient safety thereby reducing adverse effects and eliminating ‘Never’ events. Over several years, this has not evolved and adverse effects and never events still occur across the province.
Our goal in RMH OR is to streamline the process while maintaining patient safety by incorporating user involvement and FHA audit tool for SSCL. This presentation will examine data, bridged gaps in communication between physicians, nursing and most importantly the patient as well as show the evolution the SSCL”.
Sandy Nichol - RN, CPN(C), Perioperative Care Leader Abbotsford Regional Hospital & Emily Mangum
Poster Presentation: Why Can’t RN's Run the Cell Saver
Why can't RN's run the cell saver was the question asked, when in 2014 Fraser Health found itself short of perfusionists.
This simple question had a huge impact on Abbotsford Regional Hospital and the patients undergoing surgery where a large blood loss is anticipated. Initially, our focus was on patients having and open AAA repair.
With the support of our OR manager, the Vascular Surgeons, our anesthesiologists, and the perfusion group from Royal Columbian Hospital, I was able to research the possibility and in collaboration with Professional Practice, and Don Trostheim, clinical Perfusion Educator at RCH, wrote policies and procedures to allow RN's to operate the Cell Saver.
We started with 5 RN's on the team. Don Trostheim provided both theory and hands on education, he taught us to operate the Autolog machine. Anesthesia also participated in these education sessions.
This now means, we at ARH can now provide surgical options to those groups who wish not to receive blood or blood products. We have also eased the burden of the blood bank - we no longer need to access blood banks solely for PRC's, although, this always remains an option for us. We can give back a unit of the patients own blood for about 25% of the cost of a unit from the blood bank This results in a significant saving to the Provincial Health Budget.
We started the program in 2014. We have expanded to orthopedics, specifically, hip revision surgery. We have increased our team to 7 members.
To date, we have re-infused more than 100,000 mls. of the patients own blood.
Azar Khodabandehloo - RN, BSN, CPN(C), Shannon Liu - RN, Heather Pottery - RN, Whitehead P - PhD
Poster Presentation: Understanding Nursing Shortages in the Operating Room
Aim: To identify the factors that newly trained Operating Room (OR) nurses identify as influencing their decision in leaving their positions and to gain further insight into the stressors affecting nurses in this specialty area.
Background: Nursing shortages in healthcare remain a global problem, particularly in areas requiring specialty education. The OR is no exception, and the failure to retain trained nurses comes with cost implications, increased nurse-sensitive outcomes and the potential cancellation of surgeries.
Methods: The study employed a qualitative approach grounded in Thorne’s (2008) interpretive description design, wherein analytic frameworks were created to provide direction for making preliminary decisions in sampling data collection and analysis.
The study was conducted at a tertiary hospital in Canada from 2016-2018. Eight candidates were found to meet the selective criteria and were thusly interviewed by study team members. Emergent themes were consolidated by the coded data garnered from interviews and formed the report analysis.
Results: Six themes were identified through the study data:
- Working hours (including short-notice schedule changes)
- OR Culture (nurse-to-nurse, nurse-to-physician and nurse-to-management relationships)
- The transition to staff member and related challenges
- The perception of the perioperative RN program
- The ability to provide patient-focused care
- Sick Time
Conclusion: Working hours imposed and/or short notice schedule changes (with an increased number of evening, night and weekend shifts), as well as the culture of the OR, were identified by the researchers as being the most significant reasons influencing new OR nurses’ decisions to leave their positions.
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