Nursing Journal Club: Bridging the Gap Between Practice and Research

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  • ported by BLS/ACLS certified non critical care trained

    OU nurses

    of systematic critiquing, critical appraisal and evaluative skills.

    The initial meeting discussed some of the guidelines and the ob-

    jectives. It was agreed that whoever was assigned to bring the

    pressure ulcer risk and methods of reducing the developmentarticle would have to send it out by e-mail and post copies at

    strategic areas of the unit so that the staff will have a chance

    to review it. An article review tool was developed that helps

    the staff in the appraisal of the article. Since its inception, the

    staff has developed a heightened awareness in the critiquing

    process. It is the intention of this club that it will generate

    new ideas in developing research projects that are focused on

    perianesthesia nursing.

    PURE SCALE: A VALIDATED TOOL FOR THEPREDICTION OF PERIOPERATIVE PRESSUREULCERSPrimary Investigator: Carol Nicoladis, BSN, RN, CPAN

    The Methodist Hospital, Houston, Texas

    Co-Investigators: Janet Gilmore, MSN, RN, Michelle Brents,Positive Outcomes Achieved:

    Improved efficiency in patient preparation for surgery Patient and staff satisfaction

    Implications for Perianesthesia Nurses:

    Enhanced patient safety Staff satisfaction with streamlined process

    NURSING JOURNAL CLUB: BRIDGING THE GAPBETWEEN PRACTICE AND RESEARCHTeam Leader: Sylva L. McClurkin, MSN, RN, CAPA

    St. Lukes Episcopal Hospital, Houston, Texas

    Lillian Bailey, BSN, RN, CAPA, Meggie Kwan, BSN, RN, CAPA

    With the constant changes in health care delivery and the de-

    mands of quality patient care, the professional nurse must con-

    tinue to stay abreast of the current evidence-based practices

    (EBP) in the provision of care. Keeping upwith new knowledge

    can be a difficult task, especially if the staff nurses feel that

    resources are limited or there is just no time to assess research

    evidence while meeting patient demands. The formation of

    a nursing unit journal club is one way of connecting research

    to practice.

    The journal club in our unit was first implemented at the start of

    this year. Among the objectives of the club are to improve nurs-

    ing knowledge of current research findings, foster the applica-

    tion of clinical research, and best practice models to nursing

    practice, and help the participants enhance the development Veins are preserved, less patient discomfort from numer-ous attempts

    Reduced incidence of lost patient belongings Use of pre op checklist ensures complete patient prepara-tion

    Improved safety of ICU patients who used to be trans-

    192MSN, RN, CNOR, Art Shumate, BSN, RN, Jocelyn Goffney, MSN,

    RN, WOCN, Terry Throckmorton, PhD, RN, David Metzof pressure ulcers.

    EXPANDING THE ROLE OF THE PRE-SURGICALNURSE IN CARING FOR PATIENTS UNDERGOINGEPIDURAL CATHETER PLACEMENTTeam Leader: Stephanie Nolan, RN, MSN, CPAN

    Memorial Sloan Kettering Cancer Center, New York, New York

    TeamMembers: Lori Gofter, RN, BSN, OCN, Anna Szul, RN, BSN,

    Brian Dunbar, RN, BSN, Danielle Silletti, RN,

    Inderani Walia, RN, MSN, Joan McKerrow, RN, BSN, MPH, OCN

    Background: Epidural catheters were being placed in the Pre-

    Surgical Center with limited RN involvement and monitored by

    anesthesia. Due to the nature of the oncologic patient, con-

    scious sedation was often administered for placement of the

    catheter. As the number of pre-op epidurals increased, stan-

    dards needed to be established for the care of these patients.

    Objective: A process improvement establishing standards and

    nursing competencies for the care of the patient receiving

    conscious sedation undergoing epidural catheter placement

    in PreeSurgical Center.

    Implementation: Amulti-disciplinary group including nurses,

    anesthesia, nursing assistants and nursing education discussed

    current process, conducted literature review and strategized

    on methods of improvement. Utilizing the American Society

    of Peri-Anesthesia Guidelines, an educational competency pro-

    gram was developed and standards were established for caring

    for patients undergoing conscious sedation in the pre-surgical

    area.

    Successful practice: By re-defining the role and competenciesPressure ulcers are a devastating complication of surgery aswell

    as a non-reimbursable expense for hospitals. Literature review

    revealed that there is a need for a pressure ulcer risk evaluation

    scale specific to perioperative patients.

    The objective was to create a tool that will predict pressure ul-

    cers in the perioperative population. The tool, Pressure Ulcer

    Risk Evaluation (PURE), was developedwith a multidisciplinary

    team including a wound care specialist and dietician.

    The scale incorporates two elements from the Braden scale: ac-

    tivity and nutrition. The PURE scale mirrors the scoring of the

    Braden scale: the lower the score, the higher the risk. The

    PURE scale is used preoperatively and intraoperatively to assess

    a patients risk for developing pressure ulcers during surgery.

    Preoperatively the scale evaluates age, activity, malnutrition

    risk, skin assessment, previous history of ulcers, diabetes, he-

    matocrit, cardiovascular surgery. Intraoperatively the scale eval-

    uates anesthesia risk score (ASA), use of a warming blanket

    under the patient, use of extracorporeal circulation, hypoten-

    sive episodes (diastolic less than 60mm Hg), operating room

    time, surgical position and hypothermic episodes (less than

    36C) during surgery.PURE scale was validated by comparing results of both the Bra-

    den and the PURE scales using 40 surgical patients. Results of

    the comparison indicated that the PURE tool predicted surgical

    patients at risk for pressure ulcer development.

    Using the PURE scale, The Methodist Hospital in Houston,

    Texas is conducting an Institutional Review Board (IRB) ap-

    proved research study of 100 cardiovascular patients to predict

    ASPAN NATIONAL CONFERENCE ABSTRACTSof the Pre-Surgical RN, we havemaintained ASPAN standards for

    themanagement andmonitoring of conscious sedation patients.

    Outline placeholder Positive Outcomes Achieved Implications for Perianesthesia Nurses

    Nursing Journal Club: Bridging the Gap Between Practice and Research Pure Scale: A Validated Tool for the Prediction of Perioperative Pressure Ulcers Expanding The Role of the Pre-Surgical Nurse in Caring for Patients Undergoing Epidural Catheter Placement Background Objective Implementation Successful practice

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