Jillian Fetzner

Know the Flow: An Algorithm for Post Operative Urinary Retention

The group performed a literature search about POUR and decided to initially focus on patients who would be admitted to hospital. They developed a data collection sheet that tracked how much was voided, if the patient was bladder scanned including the amount, and the results after bladder scanning. The PACU staff was educated by the group and they have collaborated with the pre-op nurses and health unit coordinators as they also played a vital part in tracking this data. They also collaborated with the floor nurses to provide education about the quality improvement project.

Generation Z: Care of Adolescents in the Adult PACU

The physical layout and size of this institution allows for separate Pediatric and Adult PACUs. In many instances, however, adolescent patients may be cared for by surgeons and anesthesia providers from “adult” service lines based on specific disease processes, and ultimately are transferred to the Adult PACU for care. Although many adolescents are physically the size of adult patients, they have unique needs. Nurses in Adult PACU area reported low levels of confidence in meeting this patient population’s needs.

An Algorithm to Use as a Tool for the Bedside PACU Nurse to Manage Post-OP Pain

Rapid pain intervention is crucial in the immediate postanesthesia period to prevent further complications. Based on the Department of General Anesthesiology’s PACU/SDS Quality Indicators, a “Pain score > 5 for > 60 minutes” was recorded more often than any other patient event in PACU, even after various pain interventions were performed. Of all patient events noted between January and June 2012, 63% were related to delayed pain management. These interventions included Patient Controlled Anesthesia, Epidural, Peripheral Nerve Catheters, and as needed medications.

5s in Same Day Surgery: All the Stars Have Aligned

In order to continue to put our patients first, Same Day Surgery decided to implement a 5S project. The 5S methodology of Sort, Set in Order, Shine, Standardize, and Sustain was applied. This was done to organize and assure safety and efficiency in caring for our patients. Predominantly used items were prioritized and unnecessary items discarded. New bins and labeling were added to assist in identification of items. Each patient room was standardized and the main supply room reorganized. Supplies were categorized for reordering and restocking.