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Applying LEAN Principles to improve OR efficiency

At the end of the session, delegates will be able to:

Description:

Lean is a set of operating philosophies and methods that help create maximum value for patients by reducing waste and waits. An emphasis is placed on the customers’ needs, employee involvement and continuous improvement.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171573/

In April of 2017, the Adult Surgery Program at the IWK was involved in a comprehensive intitative to help improve OR efficiency in the Adult Surgery OR. Using LEAN principles, the patient’s surgical journey was examined closely by a multidisciplinary team.  Multiple initiatives were identified. One of the first initiatives that was focused on, was the turn over time between OR cases. By integrating LEAN methods in workflow, improvements in turn over times were recognized. This presentation will outline the incorporation of Standard Work, to decrease the turn over times between each case.

About the speaker(s):

Ms. Tanya Vandale, BScN RN CPN, ORNANS, IWK Health Centre

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Building a Perioperative Clinical Information System

At the end of the session, delegates will be able to:

  • Identify how documentation highlights perioperative nursing care provided and enhances perioperative nursing standards.
  • Recognize the power of documentation.
  • Define the importance of accurate documentation.
  • Describe how documentation supports the patient and family, your organization and the broader healthcare system.

Description:

Documentation is a task that Registered Nurses find onerous and often relegate to the lowest priority of their day-to-day activities in the operating room. This presentation will provide insight on how documentation can demonstrate perioperative nursing practice and enhance perioperative nursing standards. My two-year secondment in Information Services has broadened my appreciation of the power of documentation. While comparing my organization’s current nursing documentation to what it may look like in the future, I have examined and questioned the professional standards and guidelines that Registered Nurses use to frame their practice, sought out opportunities for development, and gained an appreciation for what the data informs on a larger scale. Registered Nurses are the catalyst to ensuring information best represents the patient and family during their perioperative journey, supports the organization and enhances the broader healthcare system. Throughout this presentation, I will reflect on my experience of building a new documentation system and provide insights for other Registered Nurses to consider when reviewing, revising or building their documentation.

About the speaker(s):

Erin Robertson RN, BScN, MN, CPN(C), Clinical Nurse Specialist (Perioperative Services)/Periop Subject Matter Expert (Information Services), Sinai Health System

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A Career Well Travelled :Journey of a Perioperative Nurse

At the end of the session, delegates will be able to:

  • Review their own personal professional goals
  • Recognize the value of professional development
  • Consider possibly getting involved in professional organizations
  • Reflect on their current practice
  • Reflect on their own professional "code" (as discussed in the presentation)

Description:

This presentation will focus on the experiences and journey of Cathleen Ferguson, a nurse with a passion to work in the field of perioperative nursing. Cathleen addresses the specific career decisions she made along the way and the lessons learned that will be of value to others. The presentation highlights the importance of ongoing education and professional development, the need to engage and network with others, and the value of actively participating in professional organizations. Surviving the tides of change and embracing the ocean of perioperative excellence.

About the speaker(s):

Cathleen Ferguson, Past President/ Governance Pillar, ORNAC

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Changing Tides for Perioperative Nursing Students’ Observation Experiences

At the end of the session, delegates will be able to:

  • Identifying and discussing the benefits of perioperative students' observation experiences
  • Bridging the gap between theory and clinical for perioperative students
  • Discussing faculty's role in assisting with perioperative student's success

Description:

Observing the specialized skills of the surgical team is valuable to perioperative students. However, time constraints, busy schedules, competing priorities, lack of clinical educators combined with an unfamiliar territory have all been challenges students have faced when trying to arrange an observation experience. This presentation will focus on streamlining the process through faculty facilitated observation experiences within the Saskatchewan Polytechnic Perioperative Program. Student survey results indicated learner satisfaction, enhancing knowledge by linking theory to practice, providing role clarity, defining career expectations, and increasing confidence in the perioperative environment. Changing the mindset of program and faculty has demonstrated our commitment to student success and strengthened partnerships with the health region.

About the speaker(s):

Ms. Leah McKerricher, RN, BN, SORNG, Saskatchewan Polytechnic
Barbara Omoth

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Clean Closure Protocol for Gastrointestinal Procedures

At the end of the session, delegates will be able to:

  • Define the key  principles of a Clean Closure Protocol
  • Discuss the Clean Closure Protocol within the inter professional  team setting
  • Apply the principles of the Clean Closure Protocol
  • Identify the implications of the Clean Closure Protocol and how it translates into practice

Description:

The presentation provides the following:

  1. Background information in relation to surgical site infection
  2. Description of the Clean Closure Protocol (CCP)
  3. Implications on practice
  4. Guideline on how to implement into practice
  5. Challenges to implementation of CCP
  6. Findings of CCP on surgical site infection
  7. Small - group sessions

About the speaker(s):

Aline Ttizian, Clinical Support Nurse for General Surgery, Urology and Gynecology, Hospital for Sick Children

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CODE ORANGE - The Operating room team’s experience responding to the mass causality event involving the Humboldt Broncos hockey team.

At the end of the session, delegates will be able to:

  • Understand the events of April 6, 2018
  • Appreciate the effect traumatic events have on our day to day lives
  • Learn more about coping techniques for dealing with the effects of traumatic work experiences.
  • Understand the changes made to hospital policy in relation to a Code Orange

Description:

On Friday April 6, 2018 a quiet highway intersection in northeastern Saskatchewan ignited global attention.  A horrific accident, involving the Humboldt Broncos Saskatchewan Junior Hockey League team became an event that is seared into out memories.  In response to this mass casualty event, a "Code Orange" was activated at the Royal University Hospital (RUH) in Saskatoon, Saskatchewan.    The activation of a Code Orange is more than following policy step-by-step. It required the collaboration of diverse team members to devise creative solutions that optimized the care being provided during this crisis.  This presentation will provide an overview of the presenters' (an on call charge nurse and a nursing manager) experiences during this event.  They will each share their perspective of this event, which will include a review of the health region protocol for a mass casualty incident, actions taken and policy changes.     This presentation will conclude with a discussion of the impact the Humboldt Broncos crash has had on the team. Due to the severity of the injuries and the resultant emotional toll, team members experienced varying degrees of post traumatic stress and have sought the emotional support of their team - as they too heal after this horrific accident.     Insight from this experience will be beneficial to others as they prepare to respond to what we all hope never happens.

Key Words: Mass causality, emergency preparedness,

About the speaker(s):

Alma Dirpaul, CPN (c), Saskatoon Health Authority

Anne-Marie DeWeert RN BScN, Manager, Royal University Hospital

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Code Orange - Are you Ready?

At the end of the session, delegates will be able to:

  • Identify the need for a Code Orange plan for Perioperative Care
  • Explain the steps the OR took to develop the plan
  • Describe the Code Orange plan through the simulated event
  • Discuss what went well and what did not
  • Discuss next steps for sustainability of the Code Orange Plan

Description:

LHSC recognized that should a mass casualty event occur in or around the City of London that most departments in the hospital would be unprepared to cope with this event. LHSC was told that in October of 2017, in collaboration with the City of London Emergency Services that a mass casualty event would occur and that “patients” would be coming to the hospital for treatment. The Perioperative Care department recognized that there was no mass casualty plan in place and should this occur we would be extremely unprepared. With the assistance of a project manager we developed a mass casualty plan and participated in the simulation exercise. A literature search revealed that no hospital in North America had ever conducted a simulation exercise which involved delaying or cancelling elective surgeries and simulating a mass casualty event. During the simulation exercise 82 surgeries were book for that day and while elective cases were underway 8 “emergency” cases arrived in the OR for treatment. Elective cases were put on hold, and those currently underway continued. The simulation cases were booked into the system, and equipment, including anesthesia equipment, was brought to the OR’s and nursing staff completed documentation along with the anesthetists and surgeons who were present in the room. Actual “patients” arrived in the OR, with a health history and a severe trauma, and the estimated time of surgery was recorded. Patient were then discharged to the critical care unit or PACU. My presentation will include what steps we took to prepare for the mass casualty event, who was involved, how we got staff engagement, what it was like the day we had the simulation, what challenges we experienced and what we will do to sustain this project in the future.

Kristen Webb, Clinical Educator, London Health Sciences Centre

Meredith Aziz London Health Sciences Centre, RN, BSCN, LHSC

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Educational Strategies for Teaching Non-technical Skills to Perioperative Nurses

At the end of the session, delegates will be able to:

  • Discuss Non-technical Skills and their applicability for perioperative nurses
  • Explain how non-technical skills relate to perioperative patient safety.
  • Explore specific educational strategies that enhance the learning of non-technical skills in perioperative educational programs
  • rovement in perioperative nursing practice, and by extension, surgical patient outcomes.

Description:

Education of perioperative nurses traditionally starts in college graduate certificate programs. Registered nurses gain surgical knowledge, procedural expertise and develop precise psychomotor skills that prepare them to function in both scrub and circulating roles in an operating room (OR). The OR, however, is a complex interprofessional environment that requires nurses to have advanced communication and teamwork skills and an awareness of cues and unraveling events in order to prioritize care. There is little research about specific educational strategies that teach nurses such soft skills as situation awareness, communication, teamwork and task management, all of which are identified requirements for effective perioperative nurses (Flin, Mitchell & McLeod, 2014). Many studies attribute team member soft skill effectiveness to patient safety and optimal surgical patient outcomes (Gordon, Darbyshire, Baker, 2012; Stanislaw et al., 2013).
The focus of this presentation is to describe a mixed-methods research that explores specific educational strategies used in a perioperative certificate program to help nurses learn non-technical skills that are essential to patient safety. Suggestions for embedding robust perioperative learning strategies are made based on qualitative and quantitative research results. The presenter makes recommendations for perioperative educational nursing programs.

About the speaker(s):

Dr. Debra Clendinneng, BScN, MEd, PhD, ORNAO, Algonquin College

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Energy in the Operating Room

At the end of the session, delegates will be able to:

Description:

Energy healing is a new phenomenon that is gathering popularity. An alternative therapy that has been around for hundreds of years, Reiki is making an impact on people's lives. Along with massage therapy and acupuncture, many are turning to Reiki as a non-medicinal way to deal with every day stressors, including surgery. There are even times when Reiki practitioners follow clients in to the operating room to provide treatment throughout the surgery.

The presentation will include a definition of Reiki, its history, how it is performed and how it helps, as well as what it can offer to patients going for surgery

About the speaker(s):

Mrs. Kelly Snook, RN, NBORN,

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Enhancing Perioperative Patient Safety: A Collective Responsibility

At the end of the session, delegates will be able to:

  • Identify barriers to interprofessional collaborative practice in the perioperative setting
  • Appraise the quality of the evidence supporting a positive relationship between perioperative team training and patient safety
  • Reflect upon the collective responsibility to enhance perioperative patient safety
  • List strategies for enhancing a collective perioperative safety culture

Description:

Although perioperative healthcare professionals endeavor to provide high quality and safe patient care, paradoxically, the prevalence of adverse events in the perioperative setting is remarkable. Whilst many adverse events are related to team dynamics, challenges to teamwork in the perioperative context are plentiful. A research question was formulated: what is the quality of the evidence supporting a positive relationship between perioperative team training and patient safety? A literature review identified articles associating a multidisciplinary perioperative team training intervention with patient safety outcomes of morbidity and mortality. With evidence of moderate strength, team training interventions support positive outcomes for patients. Safety checklists are practical for standardizing safety practices and contribute partially to solutions. Wenger's Communities of Practice and Gittell's Relational Coordination theories offer opportunity to understand team interdependency. Further considerations for enhancing a collective perioperative safety culture include team leadership, interprofessional education, and learning from adverse events.

About the speaker(s):

Lynne L. Laflamme, RN, BScN, MHS, RNFA, CNOR, Unit Manager, Operating Room

Carla Williams


Full Spectrum Success: Living & Leading in True Color

At the end of the session, delegates will be able to:

Description:

Have you ever considered how your personality plays a role in your ability to communicate in your everyday life, in your relationships with others and in your patient care?  What if, by discovering your Color Personality, you were able to gain a clearer understanding of where you excel in communication, what your limitations are, and how you can enhance your ability to communicate in “full spectrum."

In this presentation, we will discuss the secret to "inter-personality" communication by looking at the Four Color Personality profiles, as described by Personal Development Coach, Jacob Adamo. By discovering our Color Personality, we unlock our potential and are able to use it in our interactions with those around us.  Each Color Personality has a key question that helps guide the way people interact with those around them, thus, we are better able to reach these people, using their best received form of communication.

Application of the Color theory in the perioperative setting will be reviewed and findings will demonstrate the importance of utilizing the Color Theory. We will discuss why it is vital that all teams have a true color foundation, a balanced mix of staff that represent the Four Color Personalities.  Knowing your Color Personality can ensure the needed support from other colors on the team, when their own color gets the best of them. Yes, every interaction is an opportunity to either leave the patient you encounter unchanged, or change them for the better!  Just think, each interaction improves the perioperative team!

About the speaker(s):

Mrs. Meissa Swartzack, BScN, RN, CPN (c), ORNANS, NSHA

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How to get OR staff Engaged for Accreditation

At the end of the session, delegates will be able to:

Description:

This year London Health Sciences Centre is going through the Accreditation. Recognizing that the OR is a unique environment, preparing staff for Accreditation can be challenging. Along with using Point Points with a game attached at the end, such as Kahoot, I decided to use different activities to make learning about the Required Organizational Practices (ROPs) exciting and interactive. Over a span of 6 months, I used several different methods to teach Accreditation ROPs and concepts. The first activity was 5 interactive stations, such as a hand hygiene station, that focused on key ROPs, and staff moved through them at a fast pace. To emphasize some OR specific ROP's we conducted an Escape Room to help staff apply the ROP's in a real OR situation. An Accreditation Carnival occurred, in which staff were able to come by and spin a wheel and play carnival games that required answering a question about an ROP before getting a prize. A Halloween party is also planned in which staff will again move through 5 different stations, such as a costume party (which will be donning and doffing gowns), an OR graveyard, which will review the preventative maintenance program for broken equipment. My presentation will include how I was able to successfully plan these activities and how staff felt it helped them prepare for Accreditation in a non-traditional, interactive way. Since many hospitals, participate in Accreditation I would like to share my ideas for these activities with others so they can also use other methods to help teach Accreditation ROPs.

About the speaker(s):

Ms. Kristen Webb, RN, ORNAO, London Health Sciences Centre

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Hybrid OR suites: The Future of Neurosurgery

At the end of the session, delegates will be able to:

  • To identify the properties of what is a hybrid OR?
  • To recongnize the benefits of using a hybrid suite in Neurosurgery
  • To describe the significant safety risks to patients and staff working within a hybrid OR environment
  • To discuss the change management model of integrating the use of a Hybrid Suite into the current OR work flow

Description:

This presentation will share the lessons learned from a year's worth of new and or innovative neurosurgergical procedures performed in a Hybrid Suite at Sickkids.  Traditionally, the Hybrid Suite is part of the OR department, but at Sickkids, it is part of the Image Guided Department which posed different challenges for the entire team. The presentation will touch on themes : Different types of Hybrid OR designs (for neurosurgery), managing the change of patient flow, pre-op screening (for CT and MRI), configuration of restricted and semi-restricted areas, cross-training,  the pros and cons of specialized teams versus general OR staff.

About the speaker(s):

Mrs. Millie Markovich, Bachelor of Science in Nursing, ORNAO, Hospital for Sick Children

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Internationally Educated Nurses Journey to Global Perioperative Nursing Practice

At the end of the session, delegates will be able to:

Description:

Globally, the need for nurses will continuously skyrocket as the geriatric population and health care demands rise. The perioperative nursing workforce is not free of this dark fate as the majority of nurses today are over 40 years old. To meet this need, countries like Australia, Canada, New Zealand, UK, and USA are hiring internationally educated nurses (IENs). Although there are many benefits, importing this valuable resource can be a challenge. With the goal to pay forward through sharing, this presentation will take you on a unique journey with an internationally educated nurse as you explore the benefits, barriers and solutions that accompany hiring IENs. English proficiency, educational preparation, and licensure will be discussed along with recruitment, selection, and enculturation in the perioperative environment with the goal of retention and job satisfaction. When executed well, this can be a win-win solution to the global nursing manpower shortage.

About the speaker(s):

Ms. Daphny Grace Peneza, MSN, RN, CNOR, CSSM,  Memorial Hermann Hospital - Texas Medical Center

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Interprofessional Education and the Integration of Perioperative Nurses in a Surgical Resident PREP Camp

  • Differentiate between time-based and competency-based education in medical education
  • Recognize the need for change in the delivery and assessment of medical education in the 21st century
  • Recognize and discuss the interprofessional role of perioperative nurses in the PREP Camp program
  • Discuss ' Competence by Design (CBD)' (PREP Camp) assessment tools and concepts (OSATS) as applied to the training/evaluation of perioperative nursing students

Description:

Training of new incoming Post Grad Year 1 (PGY1) surgical residents has undergone profound changes within the past 5 years. In former years, PGY 1 surgical residents would enter their training based on annual pre-determined timeframe achievements. Evaluation of competence through this method occurred via a variety of variable assessment modalities and documentation. As part of evolving educational visions at the University of Toronto, new entry surgical residents now enter into a competency based rather than time-based training program. This new educational model has been endorsed by the Royal College of Physicians and Surgeons of Canada and is called ‘’Competence by Design” (CBD). To support this new methodology of training, the University of Toronto Surgical Skills Centre developed the “Preparatory Camp” aka PREP Camp program. This two-week full-time program for all incoming PGY 1 surgical residents (n = 67) meets the expectations of the Royal College’s CBD tier of “Transition to Discipline”. Paramount to the success of PREP Camp has been the inclusion of perioperative nurse educators who contribute to the education, training and assessment of residents in skills such as scrubbing, gowning, gloving, prepping, draping, instrument ID and handling, catheterization, cautery techniques, and suturing along with other core perioperative skills. This presentation will describe the interprofessional teaching and assessment integration of the perioperative nurse within PREP camp as related to syllabus development, teaching using simulation tools and final assessment using the Objective Structured Assessment of Technical Skills (OSATS) exam. The paper will conclude with a review of how perioperative nursing groups can use these valuable CBD training modalities to incorporate them into current shifts in perioperative teaching and assessment initiatives.

About the speaker(s):

Ms. Antoniette Labricciosa, RN, ORNAO, ORNAO

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Optimizing Surgical Team Communication and Improving the Patient Experience in Surgery at Oakville Trafalgar Memorial Hospital

  • Appreciate the value of communication to increasing team morale
  • Apply web based survey tool to assess state of communications within departments
  • Describe the value to encrypted instant messaging using the Signal App and monthly newsletters
  • Identify ways to measure and communicate patient experience data
  • Identify strategies to improve patient experience
  • Discuss the role of staff satisfaction in patient experience

Description:

A surgical program is comprised of many different essential parts including the operating room, post-anesthesia care unit, same day surgery unit, pre-admission clinic, inpatient floors, medical device reprocessing and numerous nursing staff, support staff, and medical staff. Poor communication at times can lead to poor patient care and suboptimal patient experience. This presentation will highlight the key communication strategies employed within the surgical program at Oakville Trafalgar Memorial Hospital in Oakville, Ontario to increase communication within the program and with patients and their families. These include: the use monthly newsletters, Websites, Instant Messaging, real time patient tracking, Telemedicine, and a patient online personal health manager. As highly trained healthcare providers in the practice of patient care, at times we may not emphasize the art of on the patient experience. Multiple studies have shown that patient attitudes and expectations have an effect on their outcomes after surgery. Patients’ perceptions of their care may be as important to them as the actual care received. This presentation will highlight the approach the Surgical Program took at Oakville Trafalgar Memorial Hospital in Oakville, Ontario to measure patient experience through patient-reported experience measures with mass surveying using an internet-based survey tool. The presentation will also how the patient experience data has been shared and communicated and patient experience strategies that have been deployed. The presentation will also highlight the important role of psychologically healthy staff in the patient experience, and strategies being deployed to address Caregiver Burnout and Compassion Fatigue in the Surgical Program.

About the speaker(s):

Ms. Julie D. McBrien, RN, MHSc, ORNAO, Program Director – Surgery, Halton Healthcare – Oakville Trafalgar Memorial Hospital
Elizabeth Pawlowski, Patient Care Manager - Operating Room, PACU, Ambulatory Procedures Unit, Endoscopy Suite, Ambulatory Clinics, Halton Healthcare – Oakville Trafalgar Memorial Hospital

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Polishing our Clinical Gems: Staff Orientation and Retention Strategies for Perioperative Leaders

At the end of the session, delegates will be able to:

Description:

Novice or expert, every perioperative nurse leader aims to contribute in building a strong perioperative team while also aiming for continuous professional development.  However, nursing staff retention issues and frequent turnover continuously challenge perioperative units today. With turnover costs ranging from $22,000 to $60,000 per RN, not only is frequent turnover a financial burden for clinical nurse leaders and educators, but it also contributes to low staff morale.  The greatest losers however are the patients. Habitual nursing turnover can pose a serious threat to patient safety.  This presentation will outline the unique journey of a novice nurse educator in developing the competencies of new perioperative nurses with the goals of improving staff retention rates while building key professional skills.

About the speaker(s):

Ms. Daphny Grace Peneza, MSN, RN, CNOR, CSSM,  Memorial Hermann Hospital - Texas Medical Center

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Quality Improvement Iniatives That Work!

At the end of the session, delegates will be able to:

  • Explain the lean methodology used in the initiatives
  • Apply web based survey tool to assess state of communications within departments
  • Discuss staff engagement and buy-in
  • List the principles of CQI (continuous quality improvement)

Description:

The MDRD at Hamilton Health Sciences - McMaster site amalgamated to one site over one and an half years ago.  It services 3 OR’s (2 are off site) and over 60 clinics and units throughout HHS.  Within Perioperative services, we have implemented Continuous Quality improvement (CQI) in the MDRD.  CQI uses a variety of tools to shift the way we think and problem solve.  It focuses on engaging and empowering all staff to identify and participate in problem solving.   Through our daily huddles, open communication and collaborative problem solving we have had the ability to understand and work on quality concerns within our department to improve patient care.  To date there have been over 60 improvements that have been completed. Some of these improvements include standardized work on; tray and basin assembly, tray write ups, new staff education/orientation, dispatching of equipment, and picking case carts.  Other major work has included; ‘5 S’ lean methodology to reorganize the MDRD, collaborating with the OR staff to develop quotas for the single wrapped common instruments, and the organization and creation of an inventory and resource binder of all the trays.  This presentation will outline the journey we have taken through CQI.  It will outline our successes, challenges as well as  how we have engaged staff across the MDRD and OR to assist in shared accountability to make improvements.

About the speaker(s):

Mrs. Beverley Barbato, RN, ORNAO, Hamilton Health Sciences

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Safe Perioperative Patient Care, But With Lower Environmental Impact

At the end of the session, delegates will be able to:

  • Explain the process used to evaluate the environmental impact of single use products and reusable products
  • summarize the actual hospital environmental benefit of choosing reusable products for the perioperative environment
  • discuss the impact of reusable choices on solid waste reductions, GHG emissions reductions, and water consumption reductions
  • utilize life cycle thinking to contribute to decision-making at ORNAC or their organization on position statements regarding product selection

Description:

The practices used in perioperative patient care can be complex and have evolved with evidence-based research and implementation.  Nurses are essential decision-makers for many of the devices, procedures, consumables, and requirements. We now have evidence-based information to support OR selections for quality patient outcomes, but now enhanced to select options that will also lead to lower environmental impact, thus contributing to public health (including the patient) improvement.  New evidence will be presented based on comparisons of reusable and single use surgical gowns, patient isolation gowns, the drape/tape systems for surgery, and other products (like central venous catheters, laryngeal mask airways, etc.).  These principles of quality patient care with lower environmental impact have also have been applied to other hospital services like radiology and dialysis.  This environmental improvement information may also support new position statements for ORNAC, as well as directly adding to a healthcare facility’s annual sustainability scoreboard.

About the speaker(s):

Dr. Michael Overcash, Professor, Sustainability Research Director, Environmental Clarity, Inc

Brendan O'Neill, Chief Operating Officer, London Hospital Linen Service Inc.

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Stand by Me: Improving Perioperative Nursing Orientation Plans to Support English as a Second Language (ESL) Adult Learners

At the end of the session, delegates will be able to:

  • List common challenges faced by internationally educated health care professionals entering the Canadian workforce
  • Summarize the recommended solutions for supporting learning needs of internationally educated health care professionals
  • Integrate the recommended solutions into existing orientation plans

Description:

This presentation will explore global literature findings related to the challenges faced by internationally educated health care professionals in order to understand their unique learning needs for successful integration into Canadian operating rooms.
Key focus areas will include a background review, method of data collection, literature findings, and recommendations for perioperative practice.
A case study will be reviewed after the presentation where participants can apply recommendations for an orientation plan.

About the speaker(s):

Mrs. Stephanie Depledge , RN, BScN, CPN(c), ORNAO, Clinical Educator, Professional Practice Lead- Perioperative Services,Guelph General Hospital

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Surgical Outcomes in Africa: Turning the Tide thru Perioperative Nursing Excellence

At the end of the session, delegates will be able to:

  • Describe the profile of patients undergoing surgery in Africa.
  • Identify surgical patient outcomes in Africa, including the most common postoperative complications.
  • Contrast above results from African countries with a comparable global cohort.
  • Describe the results of two educational programs provided by Friends of African Nursing in Zambia and Ghana.
  • Assess how educational programs can assist in the improvement in perioperative nursing practice, and by extension, surgical patient outcomes.

Description:

The presentation will review the current reality of surgical outcomes across 25 African countries, using the results of a 2018 study which captured a one-week snapshot of surgical activity from 247 hospitals in 25 African countries and compared the results to a comparable global cohort.
Friends of African Nursing (Canada) has partnered with its U.K. counterpart to deliver educational programs in Africa. The presentation will discuss the development of the first national perioperative nursing standards in Zambia (2017) and the delivery of programs on patient safety and a perioperative nursing update in Ghana (2018), demonstrating how FoAN can assist our colleagues to improve their perioperative nursing practice.

About the speaker(s):

Mary Knight BScN, MN, MORNA, Chairman, Friends of African Nursing (Canada)


Surgical Stewardship: The Perioperative Nurse’s Role in Preventing Surgical Site Infections

At the end of the session, delegates will be able to:

  • Review key infection control iniatives within the perioperative service line
  • Review evidenced based bundles that have proven impacts on surgical site infections
  • Discuss innovations that can reduce the risk of surgical site infections

Description:

Surgical stewardship is a new term that reflects the importance of the rigor that is necessary in the perioperative areas. Assessing, training, implementing, and measuring outcomes based upon evidenced based best practices and processes is the cornerstone of perioperative nurse’s role as well as the health care organizations.

This session will focus on key evidenced based initiatives and bundles that should occur in every perioperative care unit, every day and for every patient. From maintaining the environment of care, to the care of the surgical patient; the perioperative nurse must remain focused on our core mission in order to deliver the results our patients deserve and demand.

Evidenced based best practices will be presented that will provide the perioperative care providers with a robust, easy to understand practice initiatives that has proven results in clinical practice. Demonstrating that these evidenced based initiatives have published results is key to universal adoption.

About the speaker(s):

Peter B. Graves, BSN, RN, CNOR, Director, Clinical Outcomes Management and Educations, Irrimax Corporation

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Turning the Tide of Preference Card Management

At the end of the session, delegates will be able to:

  • Identify the process to standardize surgeon preference cards
  • List qualitative and quantitative benefits of having accurate preference cards
  • Discuss the importance of surgeon engagement when standardizing preference cards

Description:

The challenge with maintaining and updating preference cards is that many health systems have tens of thousands of preference cards in their electronic health record system. The number of preference cards is dependent on the number of surgeons who are actively practicing, the number of locations in which these procedures are performed and the various types of cases that are performed. Often, the labor time to maintain and update preference cards is not a priority. Over time, these tens of thousands of preference cards get filled with unnecessary, incorrect, outdated or wasted items that continue to be on the preference cards, especially due to the fast pace of an OR.     Implementing nurse manager and physician preference card working sessions every few months is an excellent way to stay on top of updates and facilitate discussion amongst the surgeons and OR staff. Keeping physicians engaged and aware of what instrument trays, soft goods, equipment with positioning devices they prefer, in comparison to their peers, is necessary for the health system to complete standardization as possible. Promoting and encouraging a culture that uses preference cards for their intended purpose is also a critical way to make sure the preference cards are kept current. The qualitative and quantitative benefits of having accurate preference cards must be taken seriously by all health system members to create a fully optimized and efficient operating room.

About the speaker(s):

Jane Kusler-Jensen, Specialist Leader, Deloitte Consulting

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What’s Bugging You? A multi-phased approach to reducing surgical site infections in a surgical colorectal population.

At the end of the session, delegates will be able to:

  • Summarize different components to reduce surgical site infection

Description:

“What’s bugging you? A multi-phase bundle approach to reducing surgical site infections in a surgical colorectal patient population”  Hannah Brooks, Patrice Clayton, Linda Jussaume  North York General Hospital     Surgical site infections (SSI) are an inadvertent repercussion of surgical procedures. Between July 2016 and June 2017, North York General Hospital noted a colorectal SSI odds ratio of 1.79 as collected by the National Surgical Quality Improvement Program. This metric clearly identified SSI as an opportunity for improvement. A multidisciplinary working group comprised of nursing, anesthesia, surgeons, surgical assists, pharmacy and management was formed to address the colorectal SSI rate. With the use of a project charter, the goal was set as an odds ratio of 1.0 by June 2019. To achieve this goal a two phase SSI bundle was prepared. The first phase was heavily focused on education and the reintroduction of ‘back to basics’. Components included: the standardization of intraoperative antibiotics, the introduction of preoperative antiseptic bathing for patients, implementation of a clean closing tray intraoperatively, the close monitoring of perioperative normothermia and normoglycemia, stricter adherence to hair removal practices, the usage of wound protectors in laparotomy cases, and the prescribing of oral antibiotics to accompany mechanical bowel preps. The first bundle phase is designed to address any controllable, low cost factors influencing the colorectal SSI rate. Should the odds ratio still be >1.0, a second bundle phase will be implemented: the introduction of antibacterial fascial sutures and topical skin adhesive. Current data collection of the first bundle phase is underway, with each bundle component having an associated metric. While complex we will share our experience of planning and implementation of this multi-phase bundle across the perioperative services.

About the speaker(s):

Ms. Patrice Clayton, RN, BSN, CNOR, Clinical Nurse Educator, North York General Hospital

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