ANNUAL ASPAN CONFERENCE ABSTRACTS 191

IMPROVING PERIOPERATIVE GLYCEMIC CONTROLPresenter: Nancy Michaelian, BSN, RN, CPAN

SDI Perianesthesia, Pinnacle Health System, Harrisburg, PA

Background: Studies supporting tighter glucose control show that hy-

perglycemia, especially . 200 mg/dl, increases the risk of developing

postoperative infections. Controlling blood glucose may decrease perio-

perative morbidity and mortality in certain patient populations such as

cardiac surgery, but little is known about implementation of a hospital-

wide program.

Objectives: To determine the effectiveness of a perioperative glycemic

control program for diabetic patients admitted on the day of surgery.

Process: Protocols for perioperative education and blood glucose man-

agement were developed. Prior to admission, patients received standard-

ized education about oral medications and insulin. On arrival, patients

with BG levels . 180 mg/dl received insulin based on a sliding scale pro-

tocol, were monitored intra- and post-operatively and received addi-

tional insulin if needed.

Statement of successful practice: Mean blood glucose on arrival im-

proved from 191 to 155 mg/dL (p 5 0.016). Patients with blood glucose

. 180 mg/dL preoperatively improved from 51% to 26%. Mean postop-

erative blood glucose level improved from 189 mg/dL to 168 mg/dL, and

percentage . 180 mg/dL decreased from 59% to 37%. Hypoglycemia

rates remained low.

Implications for Advancing the Practice of Perianesthesia Nurs-

ing: Perianesthesia nurses play an important role in glycemic control

for diabetic patients undergoing surgery. A nursing led protocol which

standardized preoperative education, testing and treatment of elevated

blood glucose safely improves perioperative glycemic control.

IMPROVING SCIP COMPLIANCE THROUGH FLIGHTCHECKEmily Mickelwait, RN, BSN, CPAN, CAPA

Inova Fair Oaks Hospital, Fairfax, VA

The Surgical Care Improvement Project (SCIP) has become an integral

part of Surgical Services across the Nation. At Inova Fair Oaks Hospital,

our initial compliance with SCIP recommendations for almost all mea-

sures was around 70% for over a year. Our objective was to provide ‘per-

fect care’ to our patients on a consistent basis. A multi-disciplinary team

was assembled in 2008 to improve our compliance with these measures

and gain a sustained improvement. We developed a ‘Flight Check’ to go

along with our ‘Boarding Pass’ to make sure every surgical patient gets

perfect care. A lot of education and improved processes have us report-

ing 95-100% compliance in all measures for 2009.

Care of the PeriAnestheisa patient is a multidisciplinary team approach.

Providing ‘perfect care’ is a lofty but achievable goal when all who touch

the patient are in tune with the evidenced based practice of SCIP.

IMPROVING PATIENT FLOW: A HANDOFF SYSTEM FROMTHE PACU TO INPATIENT AREA MEMORIAL SLOANKETTERING CANCER CENTERStephanie Nolan, MSN, RN, CPAN, Jacquelyn Burns, MSN, RN,

Debra Rodrigue, BA, RN, CNS, Glendacy Thom, RN,

Elizabeth Larson, BSN, RN, Colleen Germaine, UA, Eileen Rooney, BSN,

RN, CPAN, Mary Yanolatos, BSN, RN, Wanda Rodriguez, MA, RN, CNS,

CCRN, CPAN

Background: Current telephone handoff report process between PACU

RN and Inpatient RN was frustrating and inefficient. It required multiple

phone calls, taking nurses away from patient care and causing delays in

transfers.

Objective: Handoff report to be given on first phone call attempt

Implementation: Nursing representation from both inpatient unit and

PACU discussed current process, conducted literature review and strat-

egized on methods of improvement. Building on a model developed by

our ASPAN colleagues at Bringham and Woman’s Hospital PACU, a system

was implemented to alert staff in advance via telephone call that the in-

patient RN would be receiving report from the PACU RN in twenty min-

utes.

Successful practice: Data showed enhanced reporting times, de-

creased phone call attempts and improvement in patient flow. Advanced

notification of patient transfer, allowed the inpatient nurse to prepare for

report and the patients arrival, ultimately improving patient safety.

Nurses in both areas reported decreased telephone time led to increased

available time for direct patient care and strengthened relationships be-

tween units.

Implications for advancing practice: The system assists in maintain-

ing an efficient PACU patient flow, facilitating OR efficiency, cost contain-

ment, patient safety, staff job satisfaction and patient and family

satisfaction

PRE-SURGICAL PATIENTS ARE ‘‘IN TUNE’’ WITH MUSICPROGRAMStephanie Nolan, MSN, RN, CPAN, Memorial Sloan Kettering Cancer

Center, New York, NY

Leonore DeLince, RN, BA, BS, Shirley Thevenin, BS, MPH,Unit Assistant,

Betty Kane, RN, Anne Walsh, MS, RN, OCN, Lori Gofter, BSN, RN, OCN,

Frank Morales, III Unit Assistant

Background: Anxiety is common in the Pre-Surgical patient, affecting

both their emotional and physical well being. This can result in increased

vital signs, hypothermia and nausea. Traditional treatments such as med-

ications, warm blankets and soft lighting aren’t always successful. If

these symptoms are not controlled, surgeries can be delayed or even can-

celled.

Objective: To provide comfort and reduce anxiety of the pre-surgical pa-

tient through a music alternative.

Implementation: A music program was introduced in the

Pre –Surgical Center. Patients are offered a Music Menu that lists a variety

CD’s to listen to during their peri-operative experience. The menu’s

choices range from Classical, Relaxation and Subliminal to Popular,

Jazz and R&B.

Successful Practice: Patients have verbalized their pleasure at having

the music available. Nurses report the music program has had a positive

effect on patient’s vital signs and mood. The Peri-Operative Music Pro-

gram not only provides patients with a sense of calm but also a sense

of control since they choose the music they want to listen to.

Implications for the Peri-Anesthesia Nurse: Music is a non-pharma-

cological, non-invasive and inexpensive way to aide patient’s pre-op anx-

iety.