e28 ASPAN NATIONAL CONFERENCE ABSTRACTS

PATIENT CARE TECHNICIAN CRITICAL THINKINGSKILL ASSESSMENTTeam Leader: Sandra Filla, BSN, RN, CCRN, CPAN

Barnes-Jewish Hospital, St. Louis, MO

Janelle Holthaus, BSN, RN, Kelli Thaman, BSN, RN, CPAN,

Elizabeth Cox, MSN, CMSRN

Purpose: Our patient care technicians (PCTs) assist the nurse

at the bedside. Yearly skills days would show that PCTs were

competent in these tasks. However, performance at the bedside

varied widely between PCTs. Nurses expected consistent ac-

tions from all PCTs. The leadership team questioned whether

PCTs should have two separate groups: transport only or bed-

side care and transport. To make this distinction, an assessment

of critical thinking skills was suggested.

Description: The Post Anesthesia Care Unit (PACU) clinical ed-

ucator and lead charge nurse devised an evaluation tool that

placed the PCT in a simulation bay with props to evaluate their

critical thinking skills. A model was placed on a stretcher in

a bay to represent a patient with an intravenous, arterial line,

and urinary catheter. One PCT at a time was asked to the bay,

given a scenario, and asked to perform PCT admission tasks.

The evaluation started with placing the ‘patient’ on the moni-

tor. They also were expected to connect, level, and zero the ar-

terial line, and attach the intermittent compression stockings to

a pump. The evaluators watched while these tasks were per-

formed. The PCTs would be prompted with information such

as a temperature of 35.5 and a urine output of 15. Expected ac-

tions were: suggesting hypothermia blanket and making sure

data hand off occurred to nurse.

Outcome: All PCTs passed the critical thinking test. All PCTs

continue to perform transport and bedside duties. The PCTs

were pleased with their performance in the scenarios.

PROFESSIONAL DEVELOPMENT OPEN HOUSE

Team Leader: Sandra Filla, BSN, RN, CCRN, CPAN

Barnes-Jewish Hospital, St. Louis, MO

Lucy Pfyl, BSN, RN, Elizabeth Cox, MSN, RN, CMSRN

Purpose:Our hospital provides nurses with the opportunity to

be recognized and rewarded for professional achievements in

the Professional Nurse Development Program (PNDP). Obtain-

ing certification, making posters, and giving presentations are

examples of the activities recognized. The nurses accepted to

the program are compensated financially. The program is, at

times, perceived as confusing and daunting for first time appli-

cants, as they must create a plan and a portfolio. The post-anes-

thesia care unit (PACU) leadership team wanted to increase the

number of participants in the program and encourage staff to

apply for promotion to higher levels.

Description: The clinical educator held an open house for

PNDP promotion. Staff was notified by email that the educator

would be available from 7:30 a.m. to 6:30 p.m. in the office on

two particular days for nurses interested in applying or promot-

ing. The educator was available to mentor nurses in creating

unit based projects, encouraging them to sign up for certifica-

tions, and helping them put their portfolios together. The

nurses could drop in at anytime, which accommodated their

busy, unpredictable schedules. If needed, further timewas allot-

ted. Prior to the deadline, the clinical educator announced a day

of ‘House calls for PNDP.’ The educator, when called would

come to the nurse and assist with any questions or concerns

to finalize the portfolio.

Outcome: Five new nurses applied to the program in Septem-

ber 2011, and were accepted. Sixteen nurses reapplied, and of

these, three applied for and were promoted to a higher level.

HIP AND KNEE JOINT REPLACEMENTCERTIFICATION SURVEY: COLLABORATION FORCENTER OF EXCELLENCETeam Leader: Sandra Filla, BSN, CCRN, CPAN

Barnes-Jewish Hospital, St. Louis, MO

Janelle Holthaus, BSN, RN, Betsy L’Hommedieu, BSN, CPAN,

Elizabeth Cox, MSN, CMSRN

Purpose: Our hospital is a level one trauma center performing

over 100 surgical cases daily. Our PACUwas asked to proactively

participate on a multidisciplinary teamwithin the hospital with

the goal of establishing Certification by Joint Commission for

Hip and Knee Joint Replacements.

Implementation: Monthly interdisciplinary meetings were

initiated with staff, division leadership, surgeons and hospital

safety members participating. The team followed an action

plan to identify work flow, completion dates, and identification

of responsible parties. PACU specifics were detailed to before

and after surgical care. Opportunities to streamline nuances

specific to this patient population such as DVT prophylaxis

and timing of antibiotic administration were identified early.

Although orientation and yearly competencies were already in-

corporated into the care of joint patients, additional modules for

education such as hip precautions and Post-operative complica-

tions were added. PACU staff participated in “mock survey” re-

views to increase awareness of potential questions asked.

Outcome: Strong collaborative relationships were built be-

tween all divisions as preparation of survey readiness occurred.

Unified by a common goal and vision, multiple disciplines par-

ticipated to maximum capacity. Our hospital embraced the suc-

cess of passing the Joint Commission review. Strong, lean

processes placed prior to the review have been sustained.

SKIN ASSESSMENT RE-EDUCATION

Team Leader: Sandra Filla, BSN, CCRN, CPAN

Barnes-Jewish Hospital, St. Louis, MO

Team Member: Colleen Miller, BSN

Purpose: Skin breakdown during the hospital course is an on-

going issue. Reimbursements for skin breakdown treatments

are decreasing, especially if it is found that the breakdown oc-

curred during the hospital stay. Pre/Postoperative assessment

is key to tracking the origins of the breakdown and initiating

treatment as early as possible.

Description: After reviewing hospital policies regarding skin

breakdown, staff performed roving in-services to all nursing

personnel reviewing minimum documentation requirements.

These requirements include: 1) full body assessment docu-

mented pre and post operatively on all patients. The post-op