The Johns Hopkins Evidence-Based Practice (EBP) Model: Weinberg Perianesthesia Interventions for a Healing Environment

Abstract

<h3>Introduction</h3> Weinberg Perianesthesia Unit has 28 Prep/PACU bays divided by curtains. In this unit, diverse surgical patients are prepared/recovered from anesthesia and surgery. Patients/families described the unit as congested, cluttered, dim, noisy, and unfriendly. This Prep/PACU is the busiest adult unit in this Mid-Atlantic academic medical center and has been compared to "Grand Central Station." <h3>Identification of the problem</h3> After participating in the Weinberg EBP Competency Program in 2017, the staff identified the need to conduct EBP Healing Environment Project that focused on therapeutic nursing interventions. <h3>EBP Question/Purpose: PICO question. Databases utilized</h3> What are the best therapeutic nursing interventions to create a safe, caring, healing environment for perianesthesia patients being prepared and recovered from their surgeries? P = Prep/PACU patients having surgery; I – Therapeutic healing nursing interventions; C = Compared to standard Prep/PACU nursing care; and O = Safe, caring, and healing environment. PubMed, CINAHL, and Scopus databases identified 43 key articles relating to complementary techniques to promote relaxation, music therapy, guided imagery, massage therapy, noise reduction, light therapy, aromatherapy, and clean, uncluttered environment. <h3>Methods/Evidence</h3> Nineteen articles were appraised and leveled using Johns Hopkins Nursing EBP Model that revealed: 8 Level I's, 6 Level III's, and 5 Level IVs with a 19 Quality "A" rating for strength of the evidence. <h3>Significance of Findings/Outcomes</h3> Evidence revealed: Promoting filtering light correlates with higher satisfaction, decreased opioid use; decreasing noise during agitated emergence reduces anxiety; providing music listening reduces anxiety, improves pain management and easy to administer; offering relaxation therapy with guided imagery decreases anxiety and reduces pain; providing massage therapy and therapeutic touch are beneficial for relieving pain and anxiety. <h3>Implications for perianesthesia nurses and future research</h3> Increased lighting, decreased noise, relaxation techniques, guided imagery and music therapy improved the perianesthesia healing environment as well as patient care outcomes. The project raised staff awareness of the importance of using EBP to change practice by motivating staff to use complimentary techniques to improve the healing environment of the PACU. Currently, the PACU nurses are conducting randomized comparative clinical research study with music listening interventions to determine if patients' anxiety and pain are alleviated.