S.P.A.N.C.

This blog is meant to be a place for Sunnybrook Peri-Anesthesia Nurses (Pre-Admission Centre, Same Day Surgery, Post Anesthetic Are Unit and Surgical Short Stay Unit) to stay in communication with each other and to be up-to-date with concerns regarding the Peri-Anesthesia Department. The Purpose of S.P.A.N.C is •To re-implement a unit based council •to identify the unique role of the Peri-anesthesia nurse and to help staff from other areas understand what it is that we do •to create a collegial atmosphere for sharing our professional experiences within the subgroups of Peri-anesthesia •to facilitate open discussion and priority of issues relating to professional practice, education and research that impact on the quality of our work life and thereby affect positive outcomes for our patients and their families.

Friday, July 4, 2008

Approved Minutes from May 30th

PACU STAFF MEETING
Friday May 30, 2008 – 0900

Present: Carol Deriet, Ramona Hackett, Delia Muresan, Eric Staines, Cathy Bendayan, Julie King, Clyde Vivares, Vicky Lloyd, Shelley Warwick, Dale Peterson, Hong Ling Wu
Recorder: Joan Munro

Team Leader Role Profile: Carol Deriet distributed copies of the Team Leader role profile to be reviewed by the staff. Carol will put a sheet on the window for everyone to sign after reading the role profile. The Team Leader position will be posted once the schedule has been voted on.

New Schedule: The new schedule will be in effect by September, 2008. According to NAPAN standards, there must be two nurses to recover a patient in PACU which means two nurses must be scheduled for weekends. The workload and acuity of patients has increased over the past year. Having two nurses will provide a safe environment for patients and staff. If PACU is quiet for a period of time, the second PACU nurse should be involved in other duties, i.e. stocking or committee work. Carol Deriet will support these activities, rather than having the second PACU nurse pulled to another area by the shift manager.
TWO MASTER SCHEDULES HAVE BEEN DISTRIBUTED. PLEASE VOTE FOR MASTER #1 OR #2 AND PLACE YOUR BALLOT IN BALLOT BOX AT NURSING STATION.
OPANA: Sunnybrook staff have not been involved with OPANA in recent years, and Carol Deriet encourages PACU staff to become involved. Carol has committed to a poster presentation at the OPANA conference in October. The focus will be development of a hand-over tool to improve communication between departments. Carol welcomes any suggestions or involvement in this SPANC project.

PACU Absenteeism Policy: Copies of the policy were distributed to the staff, and will also be emailed to all staff members, to serve as information for new staff, and a reminder to all staff.

Safety Walkabout: Carol discussed the focus issues of the safety walk-about that was recently conducted. The full report will be emailed to all staff.

Handover of patients from OR to PACU: Action - Carol and Ramona are working on a tool, including questions to ask anaesthesia. The draft will be sent to PACU staff for comments and suggestions.

OR Activity varies from day to day: Action – There are some engineering graduate students working on an OR Calming project, to adjust OR bookings to be more equal from day to day. This will take time to implement, as it will impact doctors’ office hours. Patient Flow staff are more involved with OR and PACU. There is a bed huddle every day at the OR desk at 1330hrs to discuss the following days OR activity and potential bed issues. If M-Ground ORs are not using the SSSU beds, they become available for appropriate M2 patients, but M2 cannot pre-book SSSU beds at this time. The PACU holding area will open next week, Monday to Friday, 1300 – 2100.

Inadequate labeling of narcotics: Action – The PACU nurse will no longer accept narcotics from anaesthesia. Anaesthesia can give the narcotic and document it should the patient require analgesic directly on admission to PACU. If the nurse is to give narcotics, (s)he must draw own medication.

Communication: Action – Ramona posts information on her blog. SPANC opens communication within peri-anesthesia services.

Physician care of critically ill patients in PACU: Action – Carol will be meeting with OR Executive, CrCU physicians and Dr. Keith Rose to establish a policy. In the meantime, CrCU and PACU are working together for the benefit of the patients. Please forward any suggestions to Carol. Meeting is set up for July 10 with OR Management and CrCU management.

Near Misses: Action – There is a new on-line safety report for incidences and near misses. The staff reaction is that the process is long and time consuming and discourages staff from completing reports. Carol will pass this information to Cynthia Bailey.
Intimidating behavior from physicians and other units: Action – All incidents of intimidation or disrespectful attitude should be reported to Carol, who will follow-up with the individuals involved.

Nurse Safety Concerns on M-Ground: The nurses can’t see the patients well, and suggested a change in the configuration of the beds. Julie King will send an email to all staff with proposed new lay-out and ask for feed-back. Carol will investigate implementation of a new bed lay-out.
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