Date of Graduation

Summer 8-5-2020

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

First Advisor

Dr. Nancy Taquino DNP RN

Second Advisor

Dave Ainsworth, MSN, RN, CNL

Third Advisor

Liesel Buchner, MSN, RN, CNL

Abstract

Problem: At a Northern California hospital (NCH), there is a current effort to ensure the perioperative patients are satisfied with their care. These patients receive the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey after surgery. The scores regarding discharge process and patient knowledge over the last five quarters have fluctuated between the 10th percentile and the 36th percentile. NCH relies on patient satisfaction scores to better serve their members.

Context: NCH understands the higher the scores, the more members they will retain and the higher the overall income. Based on the low OAS CAHPS scores, an evidenced-based educational program to increase these scores was devised. This quality improvement program uses an educational program to teach the nurses in the post-anesthesia care unit (PACU) to use a perioperative experience booklet to educate total joint home recovery patients when they arrive at the hospital.

Intervention: The first interventions for this project are to use an educational program that teaches the PACU RNs how to place a 24-hour post-operative call. The second intervention is to teach PACU RN’s how to use a perioperative experience booklet to educate patients during the preoperative phase of their care.

Measures: The goal of this quality improvement project is to increase the OAS CAHPS scores by the third phase of the project, which will start in December 2020. This quality improvement project will cover the first phase of the project. By educating the RNs to properly use the perioperative experiences booklet and place the 24-hour calls, patients should have an increase in their perceived care experience, which will impact the OAS CAHPS scores. By implementing this education with the nurses in the post-anesthesia unit, the leader hopes to see an increase in confidence in the RNs’ ability to perform these interventions. A survey was given to the RNs before and after the training. The survey was used to measure the difference in their confidence to perform this intervention. The results between the pre- and post-education surveys showed a marked difference in nurse confidence in delivering the post-operative call. The comments section displayed an increase in knowledge and understanding. RNs who took the post-education survey stated that they felt more comfortable in their abilities to implement the quality improvement.

Results: The RNs completed a survey before and after the training. The survey measured the difference in their confidence to perform this intervention. In the pre-education survey, 64% of the RNs felt they had little to no confidence in being able to teach total joint home recovery patients before surgery or place a 24-hour post-operative call. In the post-education survey, 57% of the nurses stated that they felt confident if using the perioperative experience booklet, and 100% of the nurses stated that they felt confident placing a 24-hour post-operative call. The results between the pre- and post-education surveys showed a marked difference in the nurse’s confidence in delivering the post-operative call. The comments displayed an understanding of the goal of using the perioperative experience booklet and how to make the 24-hour post-operative call.

Conclusion: The education session showed it to be a positive tool to use to increase the nurse’s knowledge of the interventions. Adequate nurse preparation to implement this intervention will increase the chance that this intervention achieves the goal of increasing the OAS CAHPS scores.

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