innovative orientation strategies using simulation and self reflection
TRANSCRIPT
ASPAN NATIONAL CONFERENCE ABSTRACTS e27
hazardous material bins were the most accessible bins for dis-
posal. The UBC rearranged the bins and educated nurses that
only material saturated in blood should be disposed in the red
bins. This led to a dramatic decrease in the amount of waste
sent to the inappropriate area.
Nurses can identify even simple changes in front line practice
that can benefit the organization through reduced cost and
the environment through reduced waste. In the future, our
units will be looking at reducing energy usage to increase our
sustainability.
VERBAL COMPETENCIES IN PERIANESTHESIANURSINGTeam Leader: Sandy Hossman, RN, BS, CPAN
Cleveland Clinic, Cleveland, OH
Team Member: Carol Pehotsky, RN, MSN, CPAN, ACNS-BC
Theperianesthesia educational teamsought toassessnurses’ com-
prehensionboth inorientationand throughout their tenure.Utiliz-
ing Zickuhr and Atsberger’s (1995) competency text as a guide,
five levels of verbal competencies were developed by the educa-
tion and management team. The three phases of Beginning Peri-
anesthesia Nurse (BPAN) are completed at 45 days, 90 days and
sixmonths. Nurses at one year complete the PerianesthesiaNurse
(PAN). An optional Advanced Perianesthesia Nurse (APAN) can
be completed after the second year of perianesthesia practice.
The verbal competencies include management of patients
throughout the perianesthesia setting. This includes informa-
tion on anesthetics, post-operative complications, management
of co-morbidities and specific surgical procedures. Nurses are
given time out of staffing to prepare materials. The nurse then
meets individually with a member of the education or manage-
ment team to discuss. The meeting is designed to be an explo-
ration of each topic rather than a punitive environment.
Nurses report the preparation time is helpful, and that addi-
tional knowledge is gained through the one on one discussion
of content. The education team uses the results of these compe-
tencies to help guide performance evaluation of nurses in orien-
tation. The management team reports using these meetings to
gauge nurse readiness for leadership roles such as charge nurse
and preceptor.
Care of the patient in the perianesthesia setting is often complex
and requires deeper understanding than rote memorization.
Assessment of nursing knowledge through verbal competencies
prompts critical thinking skills and allows for additional learning
through discussion and sharing.
EMPOWERING STAFF THROUGH ENGAGEMENTDISCUSSIONSTeam Leader: Carol Pehotsky, RN, MSN, ACNS-BC, CPAN
Cleveland Clinic, OH
Lori DeWitt, RN, MSN, CPAN, CAPA, Katherine Zacharyasz, RN,
BSN, CPAN, Megan Anderson, RN, BSN, Catherine Prince, RN,
CPAN, Brian Rann, RN, BSN, Jillian Fetzner, RN, BSN, Kelly
Sadlik, RN, BSN, CPAN, Michelle Swancer, LPN
The leadership team and Unit Based shared governance Council
(UBC) of the Post Anesthesia Care Unit partnered to address items
from our annual Gallup� Employee Engagement survey. All em-
ployees ranked which of the twelve questions they most wanted
to discuss. Email discussion groupswere formed, accommodating
conversation among nurses from a variety of shifts. The groups
were asked to address what the selected question meant, as well
as how the groups thought the unit should address these areas.
UBC members served as facilitators of these groups to promote
openness. They encouraged participation and summarized the
discussions confidentially for sharing with all staff. Each em-
ployee participated, becoming more knowledgeable of the
questions and contributing to action plans. Results of the dis-
cussions were shared at staff meetings and through visual aids
during the 2011 survey timeframe.
Projects that resulted from these discussions include organization
of supplies and creation of a Suggestion Log. At the end of the pro-
gram, employees verbalized increased understanding of each
others’ perspectives and management reported appreciating
the increased employee input to the Engagement planning pro-
cess. Compared to the 2010 Gallup results, eight of the twelve
questions increased by a statistically significant amount (.0.1 in-
crease), ranking in the 50th percentile of the National Healthcare
database; while two questions ranked in the 75th percentile.
The Employee Engagement process should represent collabora-
tion between staff and management. Increased employee par-
ticipation in planning can lead to increased engagement and
unit cohesion. Ultimately, higher employee engagement results
in increased patient satisfaction.
INNOVATIVE ORIENTATION STRATEGIES USINGSIMULATION AND SELF REFLECTIONTeam Leader: Tracy Underwood, BSN, RN
WVU Healthcare Morgantown, WV
Raquel Evans, BSN, RN, Stacy Ross, BSN, RN
Self reflection is defined as careful thought about your own be-
haviors and beliefs. Self reflection is essential in teaching critical
thinking and fostering professional development. Self reflection
in a simulation setting allows nurses to examine their workwith
patients without fear of judgment or reprisal.
Simulation and learning space are innovative ways to use self re-
flection in a safe clinical setting. The objectives are to allow
nurses the opportunity to practice care in a safe setting and re-
view the simulation video to identify learning opportunities.
The nurses attend simulation lab where they complete a patient
care scenario. After completing the scenario, the nurse logs into
learning space to complete a self assessment based on previously
set criteria. The nurses watch the video of the experience and
scores themselves using a likert scale from poor to excellent.
The facilitator then completes the same assessment on the experi-
ence and a debriefing discussion is held to review the experience.
Adding the element of self reflection to simulation education
has many benefits. Allowing nurses to watch their simulation
and assess themselves provides them experience with self eval-
uation. The video provides a solid foundation to have positive
discussions with those nurses who have trouble identifying
their own learning needs. Self reflection also provides the nurse
with opportunities for professional development by highlight-
ing strengths and weaknesses.
Simulation using self reflection gives educators the tools neces-
sary to support perianesthesia nurses in becoming safe, confi-
dent care givers and foster professional development by
identifying learning needs.