188 ASPAN NATIONAL CONFERENCE ABSTRACTS

are often not capable of managing their device due to sedation or

anesthesia. To develop a process for safely transporting and caring

for stable LVAD patients who are admitted for procedures, a PACU

LVAD committee was formed to increase knowledge and safety.

Description: Educational needs for PACU staff prompted the

formation of a core group to become LVAD certified. Our car-

dio-thoracic intensive care unit (CTICU) provides education

and yearly certification regarding LVAD patients. PACU and

CTICU clinical nurse specialists collaborated to organize certifi-

cation of six PACU nurses. PACU nurses were selected based on

criteria: previous ICU experience and years of employment.

Outcome: All six nurses received certification. Written com-

mittee expectations and LVAD information were placed in the

unit newsletter and the website for reference. Future plans in-

clude inservices to staff regarding LVAD function, capabilities,

and management, utilizing staff committee members as content

experts to answer questions, maintain certification of core com-

mittee, and to send additional staff for certification.

PREPROCEDURE WARMING MAINTAINSNORMOTHERMIA THROUGHOUT THEPERIOPERATIVE PERIODKatie Hooven, BSN, RN, CAPA

St. Mary Medical Center, Langhorne, Pennsylvania

Research has been done that promotes the practice of preproce-

dure warming. The American Society of PeriAnesthesia Nurses

(ASPAN) defines hypothermia as a core temperature lower than

36�C. The purpose of this quality improvement project was to

support the idea that preprocedure warming maintains perioper-

ativenormothermia. Informationwasobtainedthrough retrospec-

tive chart reviewed (n5 148). Temperatures were compared for

patientswho receivedstandardpreprocedure care versuspatients

whowerewarmed by the Bair Paws gown for one hour preproce-

dure. Before the institution of warming about 50% of the patients

received in PACUwere hypothermic. After thewarmingwas insti-

tuted only 12% of the patients were received in a hypothermic

state in the PACU. Concepts discussed in this paper include pre-

procedure warming, post procedure hypothermia and complica-

tions associated with hypothermia.

POSTOPERATIVE PAIN MANAGEMENTFOR PERIPHERAL NERVE BLOCK PATIENTSPamela Windle, MS, RN, NE-BC, CPAN, CAPA, FAAN

St. Luke’s Episcopal Hospital, Houston, Texas

Agnes Hsu, BSN, RN, Thomas Prodan, RN, CPAN,

Videlyn Ilacio-Uy, BSN, RN, CPAN,

Herminia Robles, BSN, RN, CPAN

Painmanagement has been a major concern in the perianesthesia

setting. Since late spring 2010, a change of anesthesia practice for

preoperative peripheral nerve blockswas performed in two oper-

ating rooms instead of the Post Anesthesia Care Unit (PACU) de-

partment. By summer 2010, PACU nurses identified delays in

initiatingperipheral nerveblock infusionpumps, especially for or-

thopedic patients for immediate postoperative painmanagement.

A collaborative effort was initiated by the PACU staff to identify

and improve the delays for pain management through a PDSA

(Plan, Do, Study, Act) improvement process. The staff identified

key departments and unit champions; worked collaboratively

with the group in identifying specific issues and concerns and

identified improvement process for all departments involved.

The staff monitored all patients with peripheral nerve block in-

fusion and reported results to the group.

The overall goal was to initiate the patients’ continuous periph-

eral nerve block infusion pumps within one hour of the time of

PACU admission. An immediate improvement was noticed in

the first 2-3 months after the project started. The key success

of implementing this project was the driving force from the an-

esthesia provider and the constant communication among the

departments involved. The immediate attention and successful

initiation of each department’s roles to initiate postoperative

pain management helped improve patient satisfaction, success-

ful outcome and a positive surgical experience.

IMPROVING POSTOPERATIVE OUTCOMES FORPATIENTS WITH OBSTRUCTIVE SLEEP APNEAPamela Windle, MS, RN, NE-BC, CPAN, CAPA, FAAN

St. Luke’s Episcopal Hospital, Houston, Texas

Emilie Ramos, BSN, RN, CCRN, CPAN, Ann Fairchild, BSN, RN,

CPAN, CAPA, Tessie Santiago, BSN, RN, CPAN,

Lea Villadiego, RN

An increasing number of patients with obstructive sleep apnea

(OSA) patients developed post-operative complications in the

Post Anesthesia Care Unit (PACU). Evidence based practice

(EBP) recommendations showed the initiation of continuous

positive air pressure (CPAP), a device that provides positivepres-

sure in the upper airway overcoming potential tissue collapse,

maintaining a patent airway andpreventing subsequent obstruc-

tion, couldminimize the incidenceof respiratory complications,

especially in the PACU. The staff realized that having early initi-

ation of CPAP in the PACU can be beneficial for patients exhibit-

ing hypoxemia, apnea and frequent severe airway obstruction.

PACU staff collaborated with other departments in the prepara-

tion of these patients prior to their surgical experience. A new

innovative practice change was initiated for early identification

of diagnosed OSA patients prior to their surgery date and daily

communication to the departments provided an efficient and

timely process in the preparation of these OSA patients.

An algorithm of this intervention was developed to guide peri-

anesthesia nursing staff and in-service on the cautious use of opioid

analgesics, advocating the use of peripheral blocks, prompt initia-

tion of epidural medications, and multi-modal pharmacological in-

terventions. This successful practice showed an improvement of

the whole process implementation, staff’s increase in awareness

and knowledge-base and better outcomes of these patients.

THE PERIOPERATIVE HANDOFF PROTOCOL:APPLICATION OF A MULTIDISCIPLINARY MODELTO PROMOTE TEAMWORK AND REDUCEPERIOPERATIVE MISCOMMUNICATIONDina A. Krenzischek, PhD, RN, CPAN, FAAN, Yanjun Xie,

Michelle Petrovic, MD, Laura Kaiser, RN, Zahi Jurdi,

Hanan Aboumatar, MD, MPH, Marybeth Brady, MD

Johns Hopkins Hospital, Baltimore, Maryland

Clear and effective communication is an essential component of

safepatient care especially during transfers.However,miscommu-

nication frequently occurs when patient care is transferred from