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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


Changing Tides for Perioperative Nursing Students’ Observation Experiences

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

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


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

Erin Robertson BScN, MN, CPN(C), RN, is the Clinical Nurse Specialist (CNS) for Perioperative Services at Sinai Health System in Toronto. In February 2018 she was seconded to Information Services (IS) as the Business Lead/Subject Matter Expert to assist with the assessment, planning, development and implementation of the new Perioperative Clinical Information System.    Erin is an active member of the Operating Room Nurses of Greater Toronto (ORNGT) and she is currently the CoChair of the 2019 ORNAC Standards Committee.     Erin is passionate about education and standards, ensuring that perioperative Registered Nurses remain patient and family focused, and demonstrating why Registered Nurses must continue to practice in the operating room.

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

Aline Titizian, RN, BScN, CPN(c) is the Clinical Support Nurse (CSN) for General Surgery, Urology and Gynecology in the operating room at the Hospital for Sick Children, Toronto, Canada. She has been an OR nurse for over 20 years and has held various positions in the OR as a staff nurse, Practice Leader, and Advanced Nursing Practice Educator. Aline has been a leader in the implementation of the Surgical Safety Checklist across surgical services. She is passionate about reducing surgical site infections (SSIs), and has been involved in numerous SSI initiatives. Aline was a champion for hand hygiene (HH) in the OR, providing education, promoting compliance, and evaluating HH practices. Of recent, she has collaborated with NSQIP leaders to implement the clean closure protocol among high risk general surgery patients for SSIs.


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, Registered Nurse, Saskatoon Health Authority

I graduated with my Diploma Nursing from SIAST - Kelsey Campus in 1988. I started my career by working with post-operative patients on General, Cardiovascular and NeuroSurgery wards for 5 years. Having an interest in Surgery led me to complete the Perioperative Nursing Program in April 1993.  I began working in the Operating Room at Royal University Hospital in Saskatoon, SK in September of that year. Except for brief periods at St.Paul's Hospital and Saskatoon City Hospital, the majority of the last 25 years has been spent at RUH.  I am currently Resource Nurse for the ENT and Pediatric Ophthalmology surgery there. I completed my National Perioperative Certification on 2016. I've been married to my husband Tenny for 29 years.  We have 2 children - a son, Sidney and a daughter, Stephanie.  We are recent empty-nesters.

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

I graduated from the University of Alberta in 2003 with a BScN (my senior preceptorship had been in PACU at the Misercordia Hospital in Edmonton) - one of my first jobs after graduating was in the emergency department at the hospital in St. Albert. In early 2004 my husband and I relocated to Grande Prairie, Alberta where he had accepted a position with clinical engineering; I accepted a position in the PACU. I started along my perioperative training through BCIT until I was offered a position in the perioperative program through Grande Prairie Regional College, which I gratefully accepted. I started working in the operating room in 2005 and have never looked back; from the first glance that I had as a nursing student, I knew this was where I was meant to be.     Our family relocated once more, this time to Saskatoon in early 2008 where I was able to find work at the Royal University Hospital, the city's tertiary care centre. I was able to grow significantly in my role as a perioperative nurse, being exposed to new surgical specialties and gaining confidence as a leader and resource nurse. I was fortunate to be able to participate in the regions' electronic charting initiative for the operating room and this helped me to gain a more global perspective of the work that the department does; I was later approached to fill in as the interim manager for the department in the spring of 2015 and I am still here! I am currently working with several great teams in preparing for the opening of the Jim Pattison Children's Hospital in October 2019.    On a personal level, I have been married to Doug for 20 years and I am the very proud mom to Michael 12 and Jayne 9.


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, including the OR, would be unprepared to manage the 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. With the assistance of a project manager we developed a mass casualty plan and participated in a 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 elective 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. The simulation cases were booked into the system, and equipment, including anesthesia equipment, was brought to the OR’s and along with nursing staff, trauma physicians and anesthetists. Actual “patients” arrived in the OR, with a health history and a severe trauma, and the estimated time of surgery was recorded. My presentation will include what steps we took to prepare for the simulated mass casualty event, who was involved, how staff engagement, what the simulation day was like, what challenges we experienced and what we will do to sustain this project in the future.

About the speaker(s):

Kristen Webb, Clinical Educator, London Health Sciences Centre

Kristen graduated from the University of New Brunswick/Humber College Collaborative Nursing Program with a Bachelor of Nursing in 2007. After working in psychiatry for 5 years at London Health Sciences Centre Kristen completed the Perioperative Care course in 2010 from Humber College. In 2011 Kristen began working in the Operating Room. In  2015 Kristen became the Clinical Educator for the Operating Room. Kristen is currently working on her Master of Nursing from Athabasca University and is one course away from completion

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

Meredith Aziz graduated from the University of Western Ontario/Fanshawe in 2008 as an RN,BSCN.  She started her nursing career as an RN on the ortho\trauma unit.  After three years, she returned to where she enjoyed her time most as a student nurse in the PACU/recovery room; including a temporary position as the clinical educator.  Meredith accepted the position of accreditation specialist in 2018 for the perioperative department gaining exemplary status as an organization.  Most recently, Meredith completed the AORN OR nursing program to be an OR staff nurse


Educational Strategies for Teaching Non-technical Skills to Perioperative Nurses

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

Description:

Perioperative nursing education traditionally starts in college graduate certificate programs. Registered nurses gain surgical knowledge, procedural expertise and develop precise psychomotor skills, preparing them to function in scrub and circulating roles in operating rooms (OR). The OR, however, is a complex interprofessional environment that requires nurses to have advanced non-technical skills (NTS) such as task management and situational awareness, the ability to decipher cues in order to prioritize care. There is little research on educational strategies that teach nurses non-technical skills despite evidence that NTS directly impact patient safety and optimize surgical patient outcomes.

This Cardinal / ORNAC sponsored mixed methods research used convenience sampling to recruit nurses enrolled in a perioperative graduate certificate program. Data collection included pre and post-tests, case studies, semi-structured interviews, participant observation, and questionnaires. Data was coded and analyzed. Results demonstrate the learner preference and efficacy of using specific educational strategies to teach non-technical skills.

About the speaker(s):

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


Elective Foot & Ankle Surgery: What you need to know!

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

Description:

Having worked in Orthopaedics in the operating room for over 20 years, the least understood area of the body is elective foot and ankle surgery.  In Winnipeg we have fellowship trained foot and ankle surgeons that are doing procedures that are quite complex.  Without an understanding of the anatomy and physiology of the foot, it is hard to understand the procedures themselves.  In order to educate the nurses I developed a powerpoint presentation.  It contained over 120 slides and was taught over 5 one hour inservice sessions at our hospital.  I had it printed out for the staff to refer to and have had very positive feedback.  One of the surgeons stated that it was resident quality. In the spring of this year I was asked by the MORNA educator to present on this topic.  I condensed the information and gave a 50 minute oral presentation (with powerpoint slides to view).  The conference was well attended and my presentation was again well received. My approach in teaching on this subject was to talk about the anatomy and physiology of the foot as an intro and then go into details about the procedures.  I created this powerpoint completely on my own and used images and videos from the internet when applicable. I included the powerpoint presentation on the UPLOAD IMAGE tab.  If it did not come across please ask for it.  I would love to present this topic as I know it very well.  I am a great and fun presenter.

About the speaker(s):

Mr. Erich Boschmann, Registered Nurse for 27 yrs; Med/Surg/O.R.; presently Seven Oaks General Hospital O.R. CRN of Orthopaedics (Trauma/Elective) 40+slates/mnth; CNA perioperative certificate current, MORNA, Seven Oaks General Hospital


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,


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


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


Hybrid OR suites: The Future of Neurosurgery

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

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


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


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

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

Description:

Training of new incoming Post Grad Year 1 (PGY1) surgical residents has undergone profound changes within the past five years. In former years, PGY1 surgical residents would enter their training based on annual pre-determined timeframe achievements. Evaluation of competence through this method occurred via a variety of assessment modalities and documentation. As part of new educational visions at the University of Toronto, new entry surgical residents enter into a competency 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). The University of Toronto Surgical Skills Centre developed the 'Preparatory Camp' aka PREP Camp program, as one initiative to support this new methodology.This two week full-time program for all incoming PGY1 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 educaiton, 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 discuss 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 OSATS. The presentation will conclude with a review of how perioperative nursing groups can incorporate these modalities into perioperative teaching and assessment initiatives.

About the speaker(s):

Ms. Antoniette Labricciosa, RN, ORNAO, ORNAO


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

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

Description:

In the past year, the surgery leadership team at Oakville Trafalgar Memorial Hospital focused specific efforts on optimizing surgical team communication and improving the surgical patient experience.

This presentation will highlight the various strategies the OTMH surgical leadership team implemented to optimize communication, including the use of instant messaging and smart phones, web-based surveys and newsletters and websites.

The presentation will also outline the simultaneous and rapid-fire initiatives undertaken by the surgical team to improve and enhance the patient experience, including web-based patient surveys and telemedicine.

Useful and practical tools will be shared, including lessons learned.

About the speaker(s):

Ms. Julie McBrien, RN, MHSc, ORNAO, Halton Healthcare


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


Quality Improvement Iniatives That Work!

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

Description:

The MDRD at Hamilton Heath 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. Beverly Barbato, RN, ORNAO, Hamilton Health Sciences


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

Dr. Overcash has developed an in-depth national research program in two distinctive areas, life cycle inventory research and sustainability research.  Environmental Clarity has one of the largest chemical life cycle databases.  He received his Ph.D. from the University of Minnesota in Chemical Engineering.  He has served as the Sam Bloomfield Chair in Sustainable Engineered Systems at Wichita State University


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:

Description:

The perioperative world is exciting, fast-paced and constantly undergoing change with the introduction of new technologies and surgical procedures.  The nature of this environment can be challenging for new learners and can significantly affect the success of their orientation plan.  ESL learners also contend with the impacts of a language barrier and therefore require greater supports to be successful in the operating room.

This presentation will explore the current literature and shared lived experiences by internationally-trained perioperative nurses.  Participants will also learn various approaches and techniques on how to implement a successful orientation plan for internationally trained perioperative nurses.

About the speaker(s):

Mrs. Stephanie Depledge, RN, BScN, CPN(c), ORNAO, Guelph General Hospital


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

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

Description:

A 2018 study captured a one-week snapshot of surgical activity from 247 hospitals in 25 African countries and compared the results to a comparable global cohort. The results were startling - African surgical patients were twice as likely to die after planned surgery from their complications, despite being younger with a lower surgical risk profile and undergoing less complex surgery. One in ten African patients who developed a complication from surgery died.

Friends of African Nursing (Canada) has recently partnered with its U.K. counterpart to deliver programs in three African countries. 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. Further program delivery in Africa is anticipated early in 2019.

Reference:  Biccard, B.M. (2018). Perioperative patient outcomes in the African Surgical OUtcomes Study: a 7-day prospective observational cohort study. The Lancet. Published online January 3, 2018.

About the speaker(s):

Mrs. Mary Knight, BScN, MN, MORNA,


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

Peter B. Graves, BSN, RN, CNOR, serves as Director of clinical outcomes and education for the Irrimax Corporation. In his role, he serves as subject matter specialist for clinicians and for the Irrimax team. Peter graduated in 1989 from Northern Arizona University in Flagstaff, AZ with a BSN.  He is also a certified operating room nurse (CNOR). He has authored and collaborated on multiple papers in peer-reviewed journals such as Perioperative Clinics, the AORN Journal, Nursing Management, Infection Control Today, Advance for Nurses, and other journals. Peter has authored chapters on prevention of surgical site infections in Perioperative Safety by Donna Watson and hand off communication for the Competency & Credentialing Institute’s CNOR Study Guide. Peter was a chapter reviewer of Alexander’s Care of the Patient in Surgery, thirteenth edition on Infection control.  He has presented extensively to both nurses and surgeons on a variety of topics, such as infection control, latex allergy, and patient and staff safety.  He has presented internationally in Australia, Canada, Columbia, Ireland, Mexico, New Zealand, Singapore, South Korea, Spain, and Taiwan. In addition, he has been invited to speak at several AORN Congresses, general session speaker at the ANCC Magnet Hospital conference, the American Nurses Association, National Association of Orthopedic Nurses (NAON), Association of Women’s Health, Obstetrics, Neonatal Nurse (AWONN), and American Society of Ophthalmic Registered Nurses (ASORN).  An active professional with AORN. Peter chaired several national committees’ and is a past national board member of AORN. He recently held the clinical surgical services manager position at Baylor Medical Center in Carrollton, Texas and chaired the Baylor Scott & White healthcare system’s OR policy subcommittee. In addition, Peter was peer nominated and accepted into the Surgical Infection Society; is a member of the Association for Professionals in Infection Control and Epidemiology (APIC); is a clinical affiliate member of the American Academy of Hip and Knee Surgeons; and inducted into Sigma as a nurse leader - the Sigma Theta Tau International Honor Society of Nursing.


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

Jane A. Kusler-Jensen, BSN, RN, MBA, CNOR, is Specialist Leader with Deloitte Consulting.  Previously, she was executive director of the Orthopedic Hospital of Wisconsin; director of perioperative services for River Woods Outpatient Center and Ozaukee Campus, part of Columbia St. Mary's Healthcare System. Other prior positions were: director of surgical services for Aurora Bay Care, administrator of Physicians Plus Surgery Center, nurse manager at SurgiCenter of Greater Milwaukee, head nurse at Waukesha Memorial Hospital, patient care coordinator at St. Joseph's Hospital, and the OR head nurse at Children's Hospital of Wisconsin. Ms. Kusler-Jensen earned her diploma in nursing from Deaconess School of Nursing, her BSN from Carroll College, a BS in Management from Cardinal Stritch College and her MBA from the University of Wisconsin-Whitewater. She received an AORN writer's award and has presented at multiple Perioperative Conferences.  She has served on the AORN Board of Directors.


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

Patrice Currently works at North York General Hospital as the Clinical Nurse Educator for the Operating room, MDRD and Cataract Centre.  With 14 years of perioperative experience, Patrice brings a wealth of knowledge from a variety of leadership positions in both Canada and the United States.      She began her career in Calgary, Alberta and quickly discovered she had a passion for perioperative nursing practice.  While working in the US, Patrice honed her knowledge and skills as an OR nurse in all surgical specialties.  Patrice is dedicated in making positive changes that reflect best practices and standards in the OR


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