192 ASPAN NATIONAL CONFERENCE ABSTRACTS

� 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-

ported by BLS/ACLS certified non critical care trained

OU nurses

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. Luke’s 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

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

article 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,

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

RN, WOCN, Terry Throckmorton, PhD, RN, David Metz

Pressure 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 patient’s 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

36�C) 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

pressure ulcer risk and methods of reducing the development

of 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 competencies

of the Pre-Surgical RN, we havemaintained ASPAN standards for

themanagement andmonitoring of conscious sedation patients.