Education for Registered Nurses Completing Preoperative Anesthesia Interviews: A Quality Improvement Project.

PURPOSE: This quality improvement project implemented job-related education for registered nurses (RNs) completing preoperative anesthesia interviews (PAIs) to increase their knowledge and confidence, improve completeness of documented preoperative interviews, and decrease day of surgery (DOS) cancellations. DESIGN: Pre/post implementation design and retrospective chart review. METHODS: An educational module on PAIs was created and RNs working in the pre-admission testing (PAT) clinic were asked to complete the module. Pre and post implementation data was collected on RN knowledge and confidence, assessment completeness, and DOS cancellations. FINDINGS: Knowledge and confidence increases were not statistically significant, although several interview components within PAI documentation improved with statistical significance. Overall DOS cancellations, although not statistically significant, were found to decrease, 1.3% to 1.2%. CONCLUSIONS: Registered nurses' knowledge, confidence and PAI completeness improved after completing the educational module with anesthetic considerations. Patients seen at the PAT clinic for PAIs before the DOS allowed for patient optimization and education leading to decreased preventable DOS cancellations.

Implementing a home-based exercise prescription for older patients with peripheral arterial disease and intermittent claudication: a quality improvement project.

A Nurse Practitioner-led quality improvement project was implemented in a vascular surgical care clinic to facilitate home-based exercise for patients diagnosed with peripheral arterial disease (PAD) and intermittent claudication (IC). The primary goal of the project was to develop an information brochure about PAD and the benefits of exercise, as well as, a written prescription for home-based exercise program. These materials are used in the care of patients with PAD and IC to augment verbal recommendations normally provided by the healthcare provider. The project's secondary goal was to determine the impact of these materials on the frequency of home-based exercises among participating patients. After implementation of the project, 70% of the patients who received the exercise brochure and prescription reported exercising at least four times per week. Prior to implementing the project, 7 (47%) of the patients in the project reported exercising at least four times a week. Additionally, on the follow-up survey 16 (94%) patients reported participating in some form of exercise and only 1 (6%) patient did not report exercising. Before the project was implemented, 7 (41%) patients reported no regular exercise, and 10 (59%) patients reported exercise. After the project, there was a 35% increase in reported exercise among the patient population. This was a statistically significant finding in the project. This suggests the prescription could have caused the change in the patient reports.

Perceived deprivation in active duty military nurse anesthetists.

There is a shortage of military Certified Registered Nurse Anesthetists (CRNAs). Relative deprivation is a perception of unfairness due to discrepancies between what one has and what one could or should have that is dependent on feelings (subjective data) and facts (objective data). Feelings of relative deprivation could contribute to the military CRNA shortage. The purposes of this study were to measure relative deprivation in active-duty military CRNAs and explore variables that correlate with relative deprivation. The descriptive, correlational study was conducted using a self-administered survey sent to 435 active-duty Army, Navy, and Air Force CRNAs. Surveys were distributed to subjects by mail and could be answered by mail or by secured website. Data were analyzed using descriptive and inferential statistics. Analysis of the data revealed a calculated response rate of 57.7%. There was no significant correlation (P < .05) between years as a CRNA, military pay, promotion opportunity, or scope of practice/autonomy and relative deprivation. Correlations of the psychological factors "wanting" and "deserving" with relative deprivation were significant (P < .001). Further research is indicated to identify definitive factors that can be modified to improve feelings of deprivation as they relate to retention and recruitment of military CRNAs.