ANNUAL ASPAN CONFERENCE ABSTRACTS 193

A PREOPERATIVE FORCED-AIR WARMING PROTOCOL TOMAINTAIN POSTOPERATIVE NORMOTHERMIAJoanne Sedei, MSN, RN

The Medical Center of Plano, Plano, TX 75075

Introduction: Studies have shown that actively prewarming a surgery

patient helps maintain normothermia postoperatively and potentially de-

crease incidence of surgical site infections.

Identification: Surgical site infections (SSIs) account for about 40% of

all hospital-associated infections. Nearly 3% of postoperative patients de-

velop a SSI and are twice as likely to die as other postoperative patients.

Purpose: To determine if the use of a preoperative forced-air warming

device maintained postoperative normothermia.

Methods: After approval from the IRB and associated surgeons, a proto-

col was initiated by the nursing staff to prewarm patients. Patients under-

going colorectal surgery were warmed with a forced-air warming device

for 30 minutes in the preoperative holding area to promote postopera-

tive normothermia (.96.8�F).

Results: In the first six months after implementation, 72 patients were

reviewed. 66.2% of patients were normothermic immediately postop.

During the following 20 months, 98.3 % of the 385 patients entered

PACU normothermic.

Discussion: Preoperative warming had a significant impact on immedi-

ate postoperative temperatures in colorectal surgery patients.

Conclusion: The implementation of this forced-air warming protocol

has shown significant improvement in temperatures postoperatively.

Implications: Surgical outcomes can be improved through adherence

to evidence-based practices. The next step will be to determine the im-

pact of postoperative normothermia on reduction of surgical site infec-

tions and to potentially extend this protocol to all surgical patients.

Forren, J. (2006). Preventing surgical site infections. Nursing 2006,

36(6), 59-63.

Institute For Healthcare Improvement. (2008). 5 million lives cam-

paign. Retrieved from http://www.ihi.org/IHI/Programs/Campaign/

Campaign.htm?TabId51

Kurz, A., Sessler, D. I., & Lenhardt, R. (1996). Perioperative normothermia

to reduce the incidence of surgical-wound infection and shorten hospital-

ization. The New England Journal of Medicine, 334(19), 1209-1215.

KEEPING IT AT THE BEDSIDEAllison Smith, RN, Marlene Reyes, BSN RN CPAN CAPA CCRN,

Ann White, BSN RN

University of Michigan Health System, Ann Arbor, MI

Background Information: Pacu nurses expressed dissatisfaction with

frequent need to leave bedside due to:

� Limited computers

� The three phones in unit were not conveniently located

� Limited, scattered supplies

� Resource reference guides not located at bedside

� Handwashing sinks not near bedside

Objective: Improve patient care and safety by keeping nurse at bedside

Process of Implementation: Access to supplies improved with

� Beepers issued to each nurse

� Phones installed at bedside

� Hand sanitizer mounted on each bedside table

� Portable laptops for each nurse

� Fanny packs given to each nurse

� Thermometers mounted at each bedside

� Sharps container installed at each bedside

� Pacu algorithms mounted at each bedside

� Pocket reference guides given to each nurse

Statement of Successful Practice: Increased nursing presence at bed-

side led to improved patient safety and satisfaction while efficiently uti-

lizing nursing time and resources

Implication for Perianesthesia Nurses: Nursing presence at the bed-

side increases:

� Nurse and patient satisfaction

� Patient safety

� Communication between caregivers

� Nurse retention

� Cost effectiveness

� Efficient use of time

SURPRISE! I’M HERE TO PICK UP THE PATIENT.STANDARDIZING THE ON-CALL PROCESSBeverly Smith, BSN RN CPAN CAPA, Denise O’Brien, MSN RN ACNS-BC

CPAN CAPA FAAN

University of Michigan Health System, Ann Arbor, MI

Background: Operating Rooms and Procedure Areas through out the

hospital system experienced delays when putting patient’s on-call be-

cause inpatient units did not have pertinent patient information readily

available.

Objectives of Project:

- Standardize information requested by all receiving units

- Standardize preoperative/pre-procedure intra-hospital hand off form

- Standardize paging scripts

- Standardize time allotted from on-call to patient pick up

Process of Implementation:

- Define receiving units and agreement to participate

- Receiving units met to determine standard information needed from

sending units when putting patients on-call

- Selected pilot units and contacted to participate

- Receiving units and pilot sending units met to develop process and

agree on the patient hand off form content

- Pilot completed and changes to process and form made

- Final process and preoperative/pre-procedure intra-hospital hand off

form to Integrated Clinical Council and Nursing Leadership Forum for

approval

- Contacted Educational Services for Nursing to assist with education

and implementation

Statement of Successful Practice: Nurses and clerical staff report sat-

isfaction with the standardized process. Nurses on sending units have

fewer interruptions to provide information to receiving units. Receiving

units have fewer delays picking up patients.

Implications for Advancing the Practice of Perianesthesia Nurs-

ing: Standardized process improves compliance by sending units to pro-

vide pertinent patient information, improves efficiency of on-call

process and enhances patient safety.