Gettysburg PACU strives for great handoffs - WellSpan Health

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Gettysburg PACU strives for great handoffs


Tuesday, April 27, 2010

Editor’s note: This is the fourth article in a series about customer service improvement throughout WellSpan.

Nurse Marlene Crouse, left, of the outpatient services unit, discusses patient Karl Meadows Sr. with PACU nurse Carol Ritz during a face-to-face handoff at Gettysburg Hospital.

Nurse Marlene Crouse, left, of the outpatient services unit, discusses patient Karl Meadows Sr. with PACU nurse Carol Ritz during a face-to-face handoff at GettysburgHospital.

Anxiety, nausea and pain.  These are typical for anyone waking up in the post-anesthesia care unit (PACU) after surgery. 

Patients feel disoriented and vulnerable, so the quality of care they receive in the PACU leaves a lasting impression.    

“I reassure them that I am here to address their needs,” explained Mary Green, RN, a PACU nurse at GettysburgHospital.

Gettysburg's Surgical Services staff recently expanded their efforts to comfort and reassure recovering patients.  Upon viewing the Great Handoffs service education video by Wendy Leebov, they decided to implement face-to-face reporting when transferring a patient from the PACU.

Carol Smith, RN, director of surgical services, said that the hospital’s relatively small size is perfectly suited for face-to-face handoffs.

“You’re taking a nurse out of PACU staffing to go to the floor and the extra time required to give a report,” she acknowledged.  “Because we’re small, we’re not traveling a long distance to get up to our nursing units.  I do think it would be more difficult in a larger facility.”

Before leaving the PACU, the nurse inquires if the patient would like any food or drink to help with post-operative nausea.  Graham crackers and ginger ale are popular choices. 

The nurse then places the food or beverage order in advance, so that it will be present in the patient’s room upon arrival.

Once on the floor, the PACU nurse introduces the awaiting staff member, and provides a complete report on the patient’s condition.   

“A big fear of patients is that the hospital staff is not talking to each other,” Smith noted.  “During face-to-face reporting, the patients have the opportunity to hear what the PACU nurse is saying, and even add to it.

“The patient is more involved in their care because they are part of the report,” Green agreed.

The three-party reporting process does offer some challenges.  For example, staff discovered the need for tact when relaying potentially embarrassing information. 

One patient recently became upset when the PACU nurse reported that he smokes a pack and a half of cigarettes per day.  He calmed down upon understanding the significance of that fact in the report.        

“We’re learning how to communicate certain information in a way that’s not offensive to the patient,” Smith said.

Most often, she added, patients are grateful for the personalized nature of the handoff. 

“The benefits of face-to-face reporting and that one-on-one customer service are ideal.”


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