Leadership Presentation: Volunteer Services and PACU Meg Tiongco December 2, 2008

Preceptors Manager Preceptor: R.C. ▫Director of Guest Services/Director of Volunteer Services/Planetree Coordinator Clinical Preceptor: M.B. ▫Charge Nurse in Post Anesthesia Care Unit (PACU)

Roles of Preceptors: R.C. Director of Guest Services ▫Logs and investigates guests compliments and complaints  Listens to each complaint and speaks with staff on the appropriate unit about each case.  Delegates to appropriate nurse manager, billing department, etc. as necessary to resolve the issue.  Follows up with patient and/or family about the complaint with a letter or phone call.  Arranges for free lodging, Kroger gift cards, meal vouchers and billing adjustments as needed.

Roles of Preceptors: R.C. Director of Volunteer Services ▫ Recruits Volunteers to various positions, including the information desks, gift shop, visiting patients, Emergency Room assistants and administrative support. ▫Coordinates volunteer training and appreciation activities.

Roles of Preceptors: R.C. Planetree Coordinator ▫Model of healthcare that focuses on healing and nurturing body, mind and spirit. ▫Patient-centered care: provide a more home-like environment with personalized, compassionate care ▫Other services include music and art therapy and complementary and alternative medical therapy such as therapeutic massage, meditation, and acupuncture ▫Goal is to increase patient and staff satisfaction

Roles of Preceptors: M.B. Post Anesthesia Care Unit ▫PACU is a 19 bed unit ▫Patient population is a variety of post operative patients including cardiovascular, orthopedic and neurological patients. ▫Nurse to patient ratio – 1:1 or 1:2 ▫Patients stay in the PACU an average of 1-2 hours before transferring up to the floors ▫Primary goal of unit is to make sure patient is stabilized and not experiencing complications from surgery

Roles of Preceptors: M.B. Charge Nurse of PACU ▫Assigns each patient to an RN as they are admitted to the PACU ▫Determine adequate staffing ratios to cover patient census ▫Acts as a mentor for other RNs in the PACU

Leadership Project: Volunteer Recruitment Brochure Volunteer Board meeting ▫Discussed how to recruit and retain quality volunteers ▫Each board member was asked how they came to be a volunteer at the hospital ▫Most board members said they had begun volunteering after a family member or friend had been a patient at the hospital and they had wanted to give something back to the hospital.

Create a brochure to be placed in the main family waiting room at the hospital to recruit new volunteers ▫Describe the volunteer tradition at the hospital ▫Communicate that there are a wide variety of opportunities for volunteers ▫Explain the requirements of the volunteer program and how to sign up for the program Leadership Project Objectives

Most Unique Aspect of Preceptor Experience Guest Services ▫Interesting to hear the variety of compliments and complaints patients and families had about the hospital ▫Learned a lot about how to deal with angry or upset patients

Strengths Guest Services ▫R.C. is very skilled at listening to patients concerns and resolving difficult situations ▫Provides needed assistance to patients and families, such as free lodging and free meals Volunteer Services ▫Volunteers provide added services to patients, such as visiting and reading books, that regular staff is not able to provide Planetree ▫Focuses on providing holistic care to patients ▫Improves patient and employee satisfaction

Strengths PACU ▫Nurses work very well together as a team ▫Nurses have many years of experience and are very knowledgeable about how to care for their patients

Areas for Improvement Guest Services/Volunteer Services/Planetree ▫R.C. is very busy and is often unable to respond to complaints as quickly as she would like  Required by JCAHO to respond to complaints within 7 days PACU ▫Often did not follow Contact Precautions for patients with MRSA  Did not always wear gowns when caring for contact isolation patients  Did not always use separate equipment for contact isolation patients

Recommendation for Improvement Add Staff to R.C.’s department ▫Create separate positions for Director of Guest Services, Director of Volunteer Services and Planetree Coordinator instead having it all handled by one person ▫Additional staff will be able to provide faster and more efficient service to patients and staff and increase patient and employee satisfaction and retention, which will save money in the long run

Recommendations for Improvement PACU ▫Review guidelines for contact precautions, droplet precautions and airborne precautions ▫Have separate equipment available for isolation patients

PICO Question In post-op total knee replacement patients, does the use of an autotranfuser for an autologous blood transfusion reduce the need for a homologous transfusion, compared with using a hemovac or other type of drain?