3-Green
Evergreen Hospital Medical Center
PROFILE
The Surgical Pre-Anesthesia Clinic (PAC) department is comprised of a multidisciplinary team who focus on preparing patients for surgery. The PAC staff provide patients with the education and evaluation to meet their needs through the surgical continuum of care. PAC is often the first place our surgical patients encounter once they are scheduled for a procedure. Here patients begin to understand their surgical process by meeting a PAC nurse and possibly even a hospitalist and/or anesthesiologist if needed.
UNIT FOCUS
The professional perianesthesia nursing roles during the pre-operative phase focus on assessing the patient and developing a plan of care designed to meet the pre-procedural, physical, psychological, sociocultural and spiritual needs of the patient, family and/or significant other. The nursing roles also focus on preparing the patient, family and/or significant other for his or her experience throughout the surgical continuum. Interview and assessment techniques are used to identify potential or actual problems which may occur. Surgery can be one of the most difficult and stressful events in a patient’s life and our goal is to make this time as easy as possible for our patients.
PATIENT CARE DELIVERY MODEL
The patient care delivery model is highly collaborative and inclusive of all members of the pre- surgical team. A complete pre-surgical evaluation is an important part of the surgical process. Depending on the patient’s condition and type of surgery to be done, certain pre-operative tests and/or treatments may be indicated. PAC will facilitate the patient evaluation in partnership with the patient’s primary care provider. The patient may also be referred to the Surgical Pre-Anesthesia Clinic for a hospitalist evaluation. The hospitalist team is comprised of internists who provide medical consultations for surgical patients to support the community physician’s needs.
TEAM MEMBERS
The PAC team is comprised of surgical pre-admit nurses who are supported by health units coordinators (HUCs). 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 PAC unit. Prior perianesthesia/perioperative experience is preferred, 2 years of med-surg experience is required for nursing applicants.
SCHEDULING PRACTICES
Staff schedules are based on, but not limited to, the following criteria: number of patients, number of operating rooms, average time for patient preparation, and patient acuity. We enjoy a permanent day and mid-shift staff with 8-hour shifts. We try to be flexible with scheduling in order to accommodate personal and educational needs.
STAFF ORIENTATION
All hospital staff attend 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 PAC department 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 procedures performed, findings from performance measurement/improvement activities and areas identified in peer/management reviews.
The length of each new hire’s orientation is individually determined based upon past clinical experience in perioperative and/or perianesthesia nursing. A program is 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 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
In addition to the staff orientation, the Surgical Pre-Anesthesia Clinic leadership team is committed to continual education for staff. This education and development may occur at in-services, where new and upcoming procedures are discussed. The physicians, vendors and/or anesthesiologists generally provide these in-services to staff.
There is also opportunity for staff involvement in process/quality improvement within the unit. The leadership team collaborates to discuss practice and/or process concerns within the unit and development resolutions and process improvements to improve future outcomes. We support staff driven practice and unit improvement ideas. The nurse manager and staff promote the highest quality nursing care and optimal clinical practice based upon professional organizational standards. Staff RNs and HUCs have the opportunity to participate as preceptors to new staff members.
In addition, certification is encouraged in all areas, but is not considered mandatory.