Oh Baby! There's a Pregger in My PACU…

Abstract

<h3>Background Information</h3> With a trending increase in patient volume and acuity in the Post-Anesthesia Care Unit (PACU)s in a large academic medical center, it was noted that one of the demographics fostering this growth is the Obstetric (OB) population. It is important to note that the OB patients presenting to the PACUs required post-anesthesia care for non-OB procedures and interventions with the exception of OB procedures requiring general anesthesia. Hospital leadership and nursing staff noticed that caring for the OB patient in a non-OB PACU setting offered some distinct challenges related to the special considerations unique to the OB population. Instead of viewing OB patients in the PACU as a quagmire, the PACUs viewed this as an opportunity to collaborate with the OB department, promulgating maternal care in the PACU. <h3>Objectives of Project</h3> The objective was to create a program increasing knowledge related to the care of the OB patient in the PACU. <h3>Process of Implementation</h3> Collaborative gap analyses by the PACU and OB educators revealed that fundamental knowledge, skills, and adherences to professional organization recommendations regarding standards of care were opportunities for improvement. "Special Population Considerations: The OB Patient" was created and added to the existing PACU Residency/ Transition to Practice and PACU Preceptor curriculums which offer didactic and simulation activities to facilitate learning. Topics addressed included OB assessment, fetal monitoring (FM) expectations, postpartum hemorrhage care, and OB emergencies and equipment guided by professional practice guidelines and recommendations. Further, the OB department committed to collaborative care for FM and additional resources as needed, easing the anxiety of PACU nurses. Knowledge assessment was performed pre and post offering to measure changes in knowledge and program evaluation. <h3>Statement of Successful Practice</h3> After completion of the program by five cohorts, the average preassessment score of 30.6% increased to 85.6% post assessment showing an increase in knowledge and program success. Further, 100% of participants found the program beneficial. <h3>Implications for Advancing the Practice of Perianesthesia Nursing</h3> In addition to the new OB curriculum being offered, OB learning enrichment opportunities should be added to unit in-services, yearly skills and drills, and/ or unit-based competencies to ensure that PACU nurses are retaining knowledge regarding the care of the OB patient in the PACU.