An innovative program was created to address the unique challenges faced within the Post Anesthesia Care Unit (PACU) environment in a large academic medical center. This program prepared Registered Nurses (RNs) to assess and intervene with a varying acuity of patients. PACU RNs typically specialize in the care of specific patient populations unique to their unit within the hospital. However, RNs are required to float to the other PACUs within the institution and it is expected that they can provide competent care for a variety of surgical procedures and patient acuities. At the time of the creation of this program, there were no educational offerings specifically for PACU RNs that addressed the management of patients in all of the PACUs.
Methods:
Competency in the care of PACU patients includes the care of Intensive Care Unit (ICU) level patients and being familiar with assessment of deteriorating patients, Critical Care (CC) device management, hemodynamics, interpretation of acid-base balance, ventilator management, and post-surgical complication management. The program addressed these fundamentals and advanced concepts of CC and perianesthesia nursing. Literature denotes that simulation can be used to enhance adult learning in a complex healthcare setting. A program was developed to enhance the RNs knowledge, skills, and confidence. The program was offered over a total of four days. All of the content was repeated in high fidelity simulation to enhance learning. Debriefing was also performed after each simulation and participants provided self-reflection regarding their experience. Rescuing A Patient In Deteriorating Situations (RAPIDS), CC knowledge test, and a confidence survey were used to measure program effectiveness.
Results:
The RAPIDS score increased by 59%. Knowledge tests showed an increase in CC knowledge by 29%. RN confidence increased by 22%. 100% of eligible nurses who took the Certified Post-Anesthesia Nurse (CPAN) exam in the next testing window passed.
Conclusion:
This revolutionary program focusing on the unique needs of PACU patients is beneficial as an educational offering to PACU nurses. This program can be use as a tool to increase certified nurses. Also, it can be used within nurse orientation and residencies to increase confidence and develop critical skills in the care of the post-surgical patients worldwide.