Transition of Hospital Based Endoscopy Nurses to an Ambulatory Setting

Abstract

<h3>Background Information</h3> Our endoscopy services was adjacent to an Emergency Department (ED) and relied on it for support during medical emergencies. As the ED was transitioning to an Urgent Care, endoscopy realized a need to create plans for responding to emergencies without the support of the ED. <h3>Objectives of Project</h3> • Assess emergency preparedness of physicians and nursing staff • Identify knowledge gaps emergency situations • Provide Simulation activities responsiveness. • Build upon teamwork and closed loop communication skills through debriefing. Our goal was to improve staff comfort in identifying patient emergencies, increase knowledge of appropriate interventions and timely activation of community Emergency Response systems (911) in order to facilitate transport of patients to tertiary care. <h3>Process of Implementation</h3> • Pre/post assessment using a Likert scale to assess staff knowledge and comfort in identifying and treating emergency situations. • Nurse educators developed emergency simulations likely to occur in the endoscopy unit ○ cardiac arrest, bowel perforation, laryngospasm, allergic reaction and psychotic events • Endoscopy staff were divided into groups of four participants for three simulation activities and debriefed after each simulation • The exercise was repeated with on subsequent days in order to capture most of the staff. <h3>Statement of Successful Practice</h3> Nurses completed a post survey using Likert scale that was analyzed for improvement of comfort level. The pre/post assessment showed no increase in confidence: however, staff had rated themselves high on all elements in the pre-assessment. Anecdotally, they noted how much they learned an appreciated the opportunity to practice with the EMS provider. <h3>Implications for Advancing the Practice of Perianesthesia Nursing</h3> Teamwork and communication are essential in effectively intervening in emergency situations. Simulation was a valuable tool that provided an opportunity to practice and enhance confidence in a safe learning environment. Debriefing sessions provided an opportunity for discussion and reflection. Staff stated increased confidence in handling emergencies in endoscopy.