Post Anesthesia Care Unit (PACU)
(Holding, Phase I, Phase II)
3-Blue
Evergreen Hospital Medical Center
PROFILE
The Post Anesthesia Care Unit (PACU) is comprised of 16 beds to care for patients following their surgery. Included in the unit are 10 phase I recovery spaces and six day surgery rooms. A variety of surgical specialties are performed on a daily basis in the main operating room and then recovered in PACU. Some of these include general surgery, peripheral vascular, neurosurgery, plastic/reconstructive, orthopedics, obstetric-gynecological, advanced spine, urological and bariatrics. Care is provided to patients from all age groups, except neonates.
Included in the unit is a seven bed Holding area (Immediate Preop Care Unit), where patients have their final check before surgery, confirming critical information such as consent, NPO status and surgical site marking.
UNIT FOCUS
The Department of Surgical Services is a vital component of Evergreen Hospital Medical Center, supportive of the mission, beliefs and practices of the institution, and dedicated to the provision of holistic, comprehensive and visionary care. The focus of the PACU unit is to collaborate and cooperate with other members of the health care team in meeting the emergency, restorative, and preventative health needs of the community.
PATIENT CARE DELIVERY MODEL
It is the belief of the Department of Surgical Services that the patient and his/her family are the central focus of all care activities. The nurses of the PACU deliver patient care at the highest level of proficiency and efficiency, individualizing the care given to each patient from their pre-operative preparation until their recovery. This begins when the perianesthesia nurse greets the patient in the pre-surgical holding area, develops a nurse-patient relationship and explains how the perioperative process will work from beginning to completion. It ends when the patient is recovered and discharged either home with family/friends or to their inpatient bed.
The patient care delivery model is highly collaborative and inclusive of all members of the perianesthesia team, including the anesthesiologist, surgical pre-admit nurse, Holding/PACU nurse, perioperative nurse, surgeon and patient. Practices at all time are guided by principles of human, ethical and moral care of the patient and respect of his/her rights as expressed by the American Hospital Association, medical and nursing associations and Evergreen Healthcare bylaws.
TEAM MEMBERS
The PACU team is comprised of PACU nurses who are supported by Surgical Services Assistants (SSA’s). The Surgical Services Director and Director of the Department of Anesthesia are the administrative team for the department. The manager and assistant manager are accountable for the nursing practice and daily operations of the PACU unit. Prior experience in PACU is preferred, ICU experience is required, ACLS and PALS are also mandatory requirements.
SCHEDULING PRACTICES
Staff schedules are driven by the need to support patients 24/7. We enjoy a permanent day and evening staff with 8, 10 and 12 hour shifts. Staffing follows ASPAN guidelines. Call is posted each month and staff voluntarily sign up for a minimum of 2 weeknights and 24 hours of weekend call per month. We try to be flexible with scheduling in order to accommodate personal and educational needs.
STAFF ORIENTATION
All hospital staff attends the Evergreen Healthcare orientation for two days at new hire. The nursing staff also attend a skills lab at the time of hire and again yearly to keep up to date. The PACU provides education and training designed to maintain the knowledge and skill of all personnel in the department. Education is based on staff needs, patient population, type of surgical procedures performed, findings from performance measurement/improvement activities and areas identified in peer/management reviews.
Each new hire’s educational needs are assessed and a program designed to meet their individual learning needs/objectives is designed based on the performance expectations, skills and behaviors appropriate to the individual’s job functions and responsibilities. The education and training provided utilizes cognitive, psychomotor, and other methods of teaching to accomplish the learning objectives identified. The staff’s learning is then assessed using preceptor/peer and self-performance appraisal tools both at new hire and upon yearly evaluation.
EDUCATIONAL AND DEVELOPMENT OPPORTUNITIES
The PACU leadership team is committed to continual education for staff. This education and development may occur when new procedures, products or services are introduced for patient care in the department. The anesthesiologists, physicians, vendors and/or manager usually provide these in-services to staff.
The PACU leadership team collaborates with staff to discuss practice and/or process concerns within the unit and works toward developing resolutions and process improvements for future outcomes. We encourage and support staff driven improvement ideas.
In addition, certification is encouraged in all areas, but is not considered mandatory with the exception of our SSA’s required certified nursing assistant licensure.