Interprofessional Collaboration in the Perianesthesia Setting

Abstract

We are very fortunate in this issue of JoPAN to have a guest editorial that focuses on interprofessional collaborative practice, written by experts Dr. Jane Kirschling and Dr. Polly Bednash. Effective interprofessional collaboration (IPC) can positively affect how we deliver our perianesthesia care to patients. When we, as health care professionals, have problems with communication and interactions, our patients’ care can suffer.1Zwarenstein M, Goldman J, Reeves S. Interprofessional collaboration: Effects of practice-based interventions on professional practice and healthcare outcomes. Available at http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000072.pub2/abstract;jsessionid=02D907881B51194868FFCAB5D5518895.d03t02. Accessed October 16, 2012.Google Scholar The goal of interprofessional collaboration is a safer and better patient-centered US health care system.2Interprofessional Education Collaborative Expert PanelCore competencies for interprofessional collaborative practice: Report of an expert panel. Interprofessional Education Collaborative, Washington, DC2011http://www.aacn.nche.edu/education-resources/ipecreport.pdfGoogle Scholar Many health care facilities are putting IPC practice-based interventions into place to improve work communications between different types of health care professionals. Authors of one Cochrane review found that effects of practice-based IPC interventions in three out of five studies could result in improvements in patient care, such as drug use, length of hospital stay, and total hospital charges.1Zwarenstein M, Goldman J, Reeves S. Interprofessional collaboration: Effects of practice-based interventions on professional practice and healthcare outcomes. Available at http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000072.pub2/abstract;jsessionid=02D907881B51194868FFCAB5D5518895.d03t02. Accessed October 16, 2012.Google ScholarIn the perianesthesia setting, we are a model of collaboration in most health care settings. Our patients are under the care of a professional team that includes preoperative and perioperative nurses, perianesthesia nurses, surgeons, anesthesia providers, physical therapists, and pharmacists, just to name a few. An example of note is the collaboration between anesthesia providers and PACU nurses. A handoff with communication between the two key players is essential to quality patient care. Can you think of examples of good communication: the detailed report that allowed you to watch for noncardiac pulmonary edema because you were aware of a laryngospasm that occurred during extubation; or bad communication: the anesthesia provider who walked out before you agreed to take over the care for the patient?All throughout the hospital, there are examples of good communication that occurs and interfaces that are not so positive: the nurse who is afraid to call a physician who is known for a short temper; the pharmacist who doesn’t respond adequately to calls for information; or the nurse who does not adequately inform the physical therapist of his patient’s condition. The authors of the Cochrane review summarized by saying that further research is needed for a better understanding of effective interventions for interpersonal collaboration and how they affect IPC and lead to positive changes in health care.Also in this issue is an article that discusses evidence-based care for perioperative pain management for the patient with chronic pain, a focused preoperative review that results in increased quality of care, discharge delay from the PACU for nonclinical reasons, and a comparison study of normal saline and buffered saline when starting intravenous injections. All of these studies required IPC, teamwork, and communication. A thank you to our guest editors who give us food for thought and a way forward beginning with the education of our student nurses. We are very fortunate in this issue of JoPAN to have a guest editorial that focuses on interprofessional collaborative practice, written by experts Dr. Jane Kirschling and Dr. Polly Bednash. Effective interprofessional collaboration (IPC) can positively affect how we deliver our perianesthesia care to patients. When we, as health care professionals, have problems with communication and interactions, our patients’ care can suffer.1Zwarenstein M, Goldman J, Reeves S. Interprofessional collaboration: Effects of practice-based interventions on professional practice and healthcare outcomes. Available at http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000072.pub2/abstract;jsessionid=02D907881B51194868FFCAB5D5518895.d03t02. Accessed October 16, 2012.Google Scholar The goal of interprofessional collaboration is a safer and better patient-centered US health care system.2Interprofessional Education Collaborative Expert PanelCore competencies for interprofessional collaborative practice: Report of an expert panel. Interprofessional Education Collaborative, Washington, DC2011http://www.aacn.nche.edu/education-resources/ipecreport.pdfGoogle Scholar Many health care facilities are putting IPC practice-based interventions into place to improve work communications between different types of health care professionals. Authors of one Cochrane review found that effects of practice-based IPC interventions in three out of five studies could result in improvements in patient care, such as drug use, length of hospital stay, and total hospital charges.1Zwarenstein M, Goldman J, Reeves S. Interprofessional collaboration: Effects of practice-based interventions on professional practice and healthcare outcomes. Available at http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000072.pub2/abstract;jsessionid=02D907881B51194868FFCAB5D5518895.d03t02. Accessed October 16, 2012.Google Scholar In the perianesthesia setting, we are a model of collaboration in most health care settings. Our patients are under the care of a professional team that includes preoperative and perioperative nurses, perianesthesia nurses, surgeons, anesthesia providers, physical therapists, and pharmacists, just to name a few. An example of note is the collaboration between anesthesia providers and PACU nurses. A handoff with communication between the two key players is essential to quality patient care. Can you think of examples of good communication: the detailed report that allowed you to watch for noncardiac pulmonary edema because you were aware of a laryngospasm that occurred during extubation; or bad communication: the anesthesia provider who walked out before you agreed to take over the care for the patient? All throughout the hospital, there are examples of good communication that occurs and interfaces that are not so positive: the nurse who is afraid to call a physician who is known for a short temper; the pharmacist who doesn’t respond adequately to calls for information; or the nurse who does not adequately inform the physical therapist of his patient’s condition. The authors of the Cochrane review summarized by saying that further research is needed for a better understanding of effective interventions for interpersonal collaboration and how they affect IPC and lead to positive changes in health care. Also in this issue is an article that discusses evidence-based care for perioperative pain management for the patient with chronic pain, a focused preoperative review that results in increased quality of care, discharge delay from the PACU for nonclinical reasons, and a comparison study of normal saline and buffered saline when starting intravenous injections. All of these studies required IPC, teamwork, and communication. A thank you to our guest editors who give us food for thought and a way forward beginning with the education of our student nurses. Jan Odom-Forren, PhD, RN, CPAN, FAAN, is a Perianesthesia Nursing Consultant in Lousiville, KY, and is an Assistant Professor at the University of Kentucky, Lexington, KY.