Independent Assessment Committee Summary - Orillia Soldiers

Recommendation 35: The lAC supports the Hospital's intention to revise andupdate the documentation form used by the PACU RNs.Recommendation 36: The lAC supports the Hospital's intention to revise andupdate the documentation form used by the DSU nurses.Recommendation 37: The lAC strongly recommends that the documentation formused by the anaesthesiologists revise and updated.Recommendations 38-41:38. In the absence of a clear and consistent transfer of care communication thelAC does not support the current practice of fast tracking of patients to DSU39. The Fast Track - Bypassing PACU Phase I - II policy makes reference to theOPANA position statement 7. The lAC strongly feels that the policy not be limitedto the position statement but also be inclusive of the OPANA guidelines ascontained on pages 220-221 6th edition immediately. In the absence of this thelAC does not support the current practice of fast tracking of patients to DSU40. Ensure all nurses in Phase II (Day Surgery) are competent to handle anyunexpected outcomes (Cardio/Respiratory) that may be a direct result of fasttrackinga patient41. The lAC encourages the Hospital and Association to collaboratively exploreways of encouraging and promoting RNs to enhance their professionaldevelopment and undertake further educational opportunities such as CNAcertification. The lAC also strongly encourages the Hospital to explore jointprofessional development opportunities with other healthcareproviders/organizations within their LHINThe lAC believes that the RNs in perioperative program should move forward toobtaining their Canadian Nurses Association Certification.Day Surgery (Phase II Recovery) Schedule / Staffing Supportive of Patient FlowRecommendation 42: Change the 0830 start time to a 0800 start time to ensure aRN is available when patient(s) are being fast tracked to arrive in DSU prior to0830, otherwise the patient should remain under the care of a RN from PACU untilthe 0830 RN arrives.Recommendation 43: The Hospital undertake a review with active participation bythe staff to identify the profile (i.e. nature and characteristics) of the patientpopulation in DSU between 1630 – 1900 hours by day of week to identify andmatch the appropriate RN:The review may include the following:a. Volume of patientsb. Average and median LOS post 1630 hoursc. Nature of surgeryd. Reasons for delayed discharge up to and beyond 1900 hourse. Admissions to DSU from the 'Emergency List'f. Decisions to admitThere are times in day where one RN is staffed in Day Surgery, this is unsafe. A secondindividual should be staffed between 1730-1900 in the absence of a review of the patientpopulation in DSU between 1630 - 1900 hours.9