Improvement of Perioperative Efficiency via Pediatric Preanesthesia Respiratory Risk Training.

This process improvement to the registered nurse (RN) preanesthesia telephone call interview applied an evidence-based bundle of interventions to improve perioperative efficiency. The overarching aim was to decrease RN subjectivity regarding pediatric upper respiratory tract infection (URI) symptoms...

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Publicado en:Journal of PeriAnesthesia Nursing Vol. 40; no. 2; pp. 254 - 260
Autores principales: Reddinger, Jamie L., Dickman, Jennifer, Martyn, Slava
Formato: research Journal Article
Publicado: W B Saunders Apr2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2025
      vid: 40
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      pid: 1351
      pub: W B Saunders
      place: Philadelphia, Pennsylvania
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        10.1016/j.jopan.2024.04.001
        184012033
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        atl: Improvement of Perioperative Efficiency via Pediatric Preanesthesia Respiratory Risk Training.
      aug:
        au:
          Reddinger, Jamie L.
          Dickman, Jennifer
          Martyn, Slava
        affil: Department of Anesthesiology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA
      sug:
        subj:
          Perioperative Nursing
          Quality Improvement
          Registered Nurses Education
          Anesthesia, General
          Preoperative Care
          Pediatric Nursing
          Early Diagnosis
          Respiratory Tract Infections In Infancy and Childhood
          Surgery Cancellations
          Online Education
          Outcomes of Education
          Human
          Child
          Telephone
          Interviews
          Nursing Practice, Evidence-Based
          Pretest-Posttest Design
          Anesthesiology Service
          Referral and Consultation
          Confidence
          Risk Assessment
          Patient Satisfaction
          Patient Safety
          Child: 6-12 years
      ab: This process improvement to the registered nurse (RN) preanesthesia telephone call interview applied an evidence-based bundle of interventions to improve perioperative efficiency. The overarching aim was to decrease RN subjectivity regarding pediatric upper respiratory tract infection (URI) symptoms during the preoperative telephone call family outreach interview to allow for early identification of respiratory illness that could lead to a day of surgery (DOS) cancellation. The design was an evidence-based process improvement with a pretest post-test design. An E-learning module, on pediatric preanesthesia respiratory risk training, was delivered to the RN telephone call staff. An anesthesiology-created pediatric URI algorithm with use of the Current signs and symptoms, Onset, Lung disease, airway Device, Surgery (COLDS) score, a preanesthetic risk score for children with URI symptoms, were used to trigger consultation with anesthesiology for URI symptoms. Anesthesiology consultation cards following situation-background-assessment-recommendation were used to streamline consultation with an anesthesiology attending physician. Predata were obtained from the Quality Report Card on patient illness cancellations made both on the preoperative telephone call and DOS from the previous 24 months. A plan-do-study-act cycle was completed over 10 weeks. RNs' confidence in their ability to recognize the need for anesthesiology consultation was 92% after completion of the E-learning module. The rate of DOS cancellations for patient illness decreased by 10% from 2021 and 7% from 2022. The rate of preoperative telephone call-identified patient illness cancellations increased by 10% from 2021 and 7% from 2022. Decreasing DOS cancellations by early identification of illness on the preoperative telephone call is preferred to avoid loss of operating room time, patient and family dissatisfaction with a DOS cancellation, and provide a safer time frame for surgery and anesthesia. RNs' confidence in anesthesiology consultation protocol was high after completion of the E-learning module. The process improvement to the RN workflow resulted in improved perioperative efficiency as evidenced by comparison of pretest post-test data indicating a reduction in DOS patient illness cancellations and an increase in preoperative telephone call patient illness cancellations.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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