1118 / Check-list for patients in the Postanesthesia Care Unit (PACU)

SPAIN
Classification of the PSP
Type of Patient Safety Practice Safe
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Communication
Handover situations / Transfer of patients There is no specified text here
Topic of the reported practice
Patient safety system
Aim and the benefit of the Patient Safety Practice
 
Errors in the information transfer are frequent. Almost 70% of patient safety incidents that risks patient safety are caused by communication errors. We believe that systematic screening at the bedside of the patient is a useful tool for efficient transmission of information
Description of the Patient Safety Practice
 
OBJETIVES • Creating a systematic checklist for patients in PACU to increase patient safety, both during the new ingress and in the check-out from the unit. • Improving communication between health workers in the operating room/pacu/hospitalization unit • Ensuring continuity of nursing care and improving the interrelationship of the units professionals involved.

METHODOLOGY Nurse and nurse assistant responsible for the patient will have to fill in the registration form at the ingress in the unit, stay and check-out from the unit. The project is seen as a need for exchange of communication between different professionals, with minimal items that guarantee patient's safety. The required minimum data from the patient will be available at bedside, thus avoiding misunderstandings or lack of communication. The checklist contains data in the following sections: • Patient Identification data • Check Pacu before reception of the patient • Patient data from the operating room • Check out from the pacu register the most relevant information to hand for the ingress in the hospitalization unit

RESULTS Once the pilot study completed to evaluate the implantation of this new ingress/check-out verification list for the reanimation patients, the results from February, 3rd to March, 3rd 2014, were: 219 records of patients audited, representing 100% of the population susceptible of study. From the information recorded: It is conclusive that 88,12% of the transfers have been correct. From the 11,88% presenting incidents the most significant and with the most incidence for patient safety were those with incorrect peripheral venous catheterization and lack of blue allergy sticker at bedside. As an improvement action PARU (although most of the catheterization is done pre-anesthesia) and pre-anesthesia personnel are informed of the existence of an standardized peripheral venous catheterization procedure in the hospital, and the personnel is reminded that all registry of the patient as well as the bed, must carry the allergy identification tag. In a second study during the next month, 104 records were audited, and the conclusion was: 92,31% of the transfers have been correct, achieving an improvement of 4,19% compared with the previous study, being the incidents that threaten the patient safety, just 0,96% , due to the lack of allergy sticker, and 0% the rest. Personnel is informed about the identification of the 0,96% record and about the 1,92% of cases of permeability and vacuum conservation on drainages, that were not shown in the previous study. CONCLUSIONS In our opinion the main advantages are: the visual perception of the patient at the bedside is not memorized, as it is printed; in situ check of the various clinical aspects of the patient to develop the plan for further care and set revision of these reviews at the appropriate interval; and the utility as a tool that encourages and facilitates the participation of individual members of the nursing team responsible for the patient. The conclusion as supervisors of the units is that this information record transfers benefits of the pacu to icu hospitalization, that is a safe tool that promotes patient safety in our hospital because it allowed us to identify errors and to establish improvement actions, this study was presented in the units and will again be held in the last quarter. Once the pilot study with the Department of Nursing is valued instituted the implementation of the new record was left in the patient´s consultation with the Committee on Medical Records. With the working group formed and with the nursing process supervisor, the procedure for implementing the registry for knowledge of all the staff of nursing center is performed.
Attachment of relevant written information and/or photos, as appropriate
2015020501441025511_WP4_check list urpa-pacu.pdf
There is no specified text here
There is no specified text here
There is no specified text here
Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Both/mixed (qualitative and quantitative)
Enclosure of a reference or attachment in case of published evaluation's results
A) 26th NATIONAL CONGRESS ASEEDAR-TD (Spanish association of nursing anesthesia - resuscitation and pain therapy).

B) 32th CONGRESS SPANISH SOCIETY OF QUALITY OF CARE.

C) 1st CONGRESS MADRID SOCIETY OF QUALITY OF CARE.

D) 1st DAY NURSE IN SANTA CRISTINA UNIVERSITY HOSPITAL IN MADRID. SPAIN.DECEMBER 2014.


2015020501460215511_WP4_CONTINUITY OF CARE PACU. ENTRY - GET OUT.jpg
Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
Not relevant
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Nurses
Technical support / technician
Clinical manager
Quality manager
Risk manager
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
Not relevant
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
No
List of sources where public information is accessible
There is no specified text here
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
No
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
There is no specified text here
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Other
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
Yes
Description of used incentives, if any.
A)MORE SECURITY PATIENTS.
B) MORE EMPORWEMENT TEAM. SATISFATION COLLEAGUES NURSES.
C)RECOGNITION OF MANAGEMENT HEALTH LEADERS.
D)BETTER COMUNICATION INTO COLLEAGUES AND PROFESSIONALS HEALTH.
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: GIMENO OLMO, JULIA
Country: SPAIN
Organisation: SANTA CRISTINA UNIVERSITY HOSPITAL. MADRID
E-mail: jgimeno.hscr@salud.madrid.org
Phone: +34670561879
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