Outpatient Surgery Magazine

Year of the Nurse - November 2020 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 53 of 83

The facility replaced its temperature monitor- ing strips with temporal scanning thermometers and clinical educators conducted in-services to train staff on the proper use of the devices. Nurses record and document temperatures when patients arrive in pre-op, at regular intervals dur- ing surgery and upon their arrival in PACU. All temperatures are taken and recorded in Celsius to avoid confusion. Temperatures are retaken after a warming intervention is applied if the initial meas- urement was outside the normal range — 36°C to 38°C — and the reading is documented on a new line added to the flow sheet. The new policy ensures that the temperature taken within the first 15 minutes of a patient's arrival in the PACU was properly documented. It also helps to ensure staff actively warm patients who are hypothermic, check their temperatures again and document a normothermic reading. The goal is to prepare patients for surgery in a warm environment in order to prevent hypothermia. To ensure members of the surgical team don't turn down the temperature in the ORs, one staff member now holds the key to a small plastic lock- box that covers the thermostat. The staffer is the only one who can adjust the temperature upon request, but ensures the room temperature always remains with- in the AORN-recommended 68°F to 73°F. "We had conducted a lot of staff education to make sure they understand the patient's needs come before their own," says Ms. Dowling-Schmitt. • Control. The staff at the ASC remain vigilant in efforts to main- tain normothermic readings in patients. They continue to moni- tor outcomes on a monthly basis, and respond immediately if they see a cooling trend in recorded temperatures. Ms. Dowling-Schmitt says it's important to focus on the impor- tance of consistent and accurate charting. "It provides data for quality metrics, and nurses need to document the wonderful clinical care they provide," says Ms. Dowling-Schmitt. "That documentation needs to reflect everything they do to improve outcomes. If patients came out of the OR hypothermic, and nurses took steps to ensure they were normothermic before discharge, those steps must be recorded. "What really surprised me is 'if it wasn't docu- mented, it wasn't done' still needs to be reinforced," she continues. "I think some nurses still don't fully understand that concept." Getting warmer After implementation of the quality improvement project, 94.1% of the surgery center's patients were normothermic within 15 minutes of arriving in the PACU. Ms. Dowling-Schmitt says emphasizing evi- dence-based practices can help achieve such posi- tive results. "When staff realize patient warming impacts outcomes, a light goes on," she explains. "It's gratifying to conduct research and complete quality improvement practices that truly impact patient care." OSM 5 4 • O U T P A T I E N T S U R G E R Y M A G A Z I N E • N O V E M B E R 2 0 2 0 LOCK AND KEY Giving one staff member complete control over the OR thermostat can better ensure the room's ambient temperature remains within the recommended range. Miriam Dowling-Schmitt

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