Creating the Perianesthesia Emergency Nurse Resource Role to Prevent Failure-to-Rescue: A Quality Improvement Project

Area of Science:

• Nursing
• Patient Safety
• Quality Improvement

Background:

• The postanesthesia care unit (PACU) faces challenges with patients experiencing hemodynamic instability.
• Failure-to-rescue events can occur in the PACU, necessitating rapid intervention.
• A specialized nursing role can enhance patient care and safety in critical settings.

Purpose of the Study:

• To implement and evaluate the role of a Perianesthesia Emergency Nurse (PEN) in the PACU.
• To reduce the incidence of failure-to-rescue events in the PACU.
• To provide real-time support and education to PACU staff.

Main Methods:

• A Quality Improvement Project was conducted using the Plan-Do-Study-Act methodology.
• The PEN role required specific qualifications including critical care experience and PACU tenure.
• Specialized education was provided on managing medical events like hypoxia and hypotension.

Main Results:

• Implementation of the PEN role led to a significant decrease in rapid response calls (4.8% vs. 11.1%).
• Staff overwhelmingly endorsed the PEN role, with 100% finding it beneficial.
• The PEN program identified practice gaps and fostered collaboration with anesthesia for improved patient care.

Conclusions:

• The Perianesthesia Emergency Nurse role was successfully piloted and integrated into PACU staffing.
• The PEN role effectively decreased perianesthesia failure-to-rescue events and enhanced staff support.
• Evaluation by the PEN in the PACU reduced subsequent rapid response calls after patient transfer to the ward.