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e24 ASPAN NATIONAL CONFERENCE ABSTRACTS

PEER REVIEW PANEL PILOTTeam Leader: Joyce Burke, RN, BSN, CPAN

The Christ Hospital, Cincinnati, OH

Barbara Ackerman, RN, BSN, Kimberly Latham, RN, BSN, CCRN,

CLIII, Dianne Stapp, RN, CLIII

Thepurposeof thePEERPanelPilotwas to assess staff satisfaction

with the peer review as a part of the overall performance evalua-

tionprocess.ThePACUstaff had elected apanel of staff toprovide

meaningful, constructive, consistent, positive peer review feed-

back for all staff. Anonymous surveys were given to all staff.

The Peer Panelmethod is congruentwith shared governance en-

hancing professional performance through collegial exchange

with a mutual respect andmutual goal of developing each other

personally and professionally. An additional goal is to create

a more holistic picture of capabilities, strengths, and areas for

growth through a professional partnership. Furthermore, the

desired result is to provide a blended method of an annual eval-

uation that truly means something and effect change to assure

quality outcomes. In addition, to grasp and adhere to improved

innovated process that could result in unity of the unit,

strengthen peer relationships and comfort level with effective

and healthy communication to identify areas of improvement

as well as enhance areas of excellence.

The evaluation of the project provided feedback to improve the

process. Other units were interviewed on their processes and

outcomes. Brainstorm sessions were held with the Peer Panel

as well as a six month follow-up self-review from staff, in addi-

tion the PACU Professional Development Council were con-

sulted for suggestions and revisions of the PACU peer panel

review. The long-term plan is to continue this new process

and to re- evaluate and improve the peer panel review process

on a continual basis.

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EMERGENCE AGITATION: WHAT IT IS AND WHATCAN WE DO?Team Leader: Katherine Tembelopoulos, RN, BSN, CPAN, CPN

Children’s Hospital, Boston, MA

John Carr, BSN, RN, CPN, Catee Tressy-Murphy, RN, CPAN,

CAPA

Emergence agitation is a disordered state that can negatively ef-

fect the PACU environment and family dynamics in a clinical set-

ting. Eckenhoff1 first described it in 1961 as a state of confusion

postanesthetic. In our facility, most cases coincidewith the orig-

inal findings of Eckenhoff, our patients are less then 9 years old,

have procedures with short duration of anesthetics, and are

generally preoperatively anxious.

We hope to gain insight on emergence agitation, to seek out pre-

ventions for patients recognized as predisposed to it, and pre-

pare staff and families how to cope when patients are agitated.

Our process of implementation included decreasing the stress

in a preoperative setting, utilizing calm environments and

play therapy to distract and decrease anxiety in patients and

families. Another step included parents during the induction

phase of anesthesia and upon arrival to the recovery room to

be reunited with their child. Important to decreasing emer-

gence agitationwas the use of adequate intraoperative pain con-

trol, and increase use of caudal and spinal anesthetics.

Our staff currently is well-versed in the care of the child in emer-

gence agitation and continues to maintain a calm environment

throughout. We use distraction techniques preoperatively and

have a high standard for adequatelymedicating the child for pain.

As emergence agitation can be dangerous to patient and staff, it

is imperative that all nurses know to differentiate it from other

potential causes of agitation. Careful teaching of staff alongwith

techniques for decreasing anxiety can be important aspects of

reducing emergence agitation.

Reference: Houck, Constance S. Wild Child in the PACU:

Update on Emergence Agitation. 2005. Available at: http://www

.pedsanesthesia.org/meetings/2005winter/man/RC1.pdf

LENDING A HAND TO IMPROVE HAND HYGIENE(HH)Nancy Strzyzewski, MSN, RN, CPAN, CAPA, Toni Szpara, BSN,

RN, CCRN, CPAN, CAPA, Denise O’Brien, DNP(c), RN,

ACNS-BC, CPAN, CAPA, FAAN

University of Michigan Hospitals and Health Centers, Ann

Arbor, Michigan

� Background:

� PACU educators tasked to improve compliance re-

garding institutional HH requirement

� Audits not valued/ not performed on consistent basis

� Staff unaware of the HH data/ issues because only two

people conducted audits

� Educators identified knowledge deficit

bjectives of project:

� Improve awareness and compliance with policy, and

submit data consistently

� Identify barriers and successful process to ensure data

reporting

rocess of implementation:

� Process of implementation

� PACU educators assessed problem and received com-

mitment from management for resources

� Report out data to PACU staff by posting data graphs

� Posted/emailed evidence based articles

� Staff completed on-line learning module

� PACU educators taught auditors daily

� Charge nurses assigned auditor daily, reports submit-

ted before deadline, exceeded requirement

� Posted blank audit forms for easy access, deposit enve-

lope for completed audits

� Reminder signs posted

� PACU educators monitored audits to insure comple-

tion and submitted monthly

� Reward 3 months of 100% compliance with pizza

party

tatement of the successful practice:

� Audits consistently/ completely submitted and indi-

cate improved staff behaviors

� Increased number of monthly HH observations

mplications for advancing the practice of perianesthesia

nursing:

� Since hospital guidelines for HH typically reflect

in-patient nursing, PACU nurses can now translate

guidelines into their environment