Improving the paediatric day surgery patient experience

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In January of 2012, Registered Nurse Halona Scott of London Health Science Centre was challenged with finding a way to give teary-eyed children waiting for day surgery in the hallways outside operating rooms the confidence they needed to be brave.

“In the past, a porter or a SSW would bring our paediatric patients to us,” says Scott, chair of the CQI Council for Victoria Hospital’s OR unit. “We’d do our pre-op prep work with them outside the OR; check arm bands, look at consent, check NPO status and anything else we need to know.”

But the process wasn’t always conducive to courageous children – or parents. Young patients from Children’s Hospital, Scott explains, were often separated from their mother, father or guardian for up to 20 minutes before meeting their nurse for the first time and going into surgery.

“Children are taught not to talk to strangers, and what parent wouldn’t want to meet the nurse that’s going to be caring for their child?” Scott asks rhetorically. “We wanted to improve the experience for everyone involved.”

The solution, she says, was to start checking paediatric patients with the parents present in Day Surgery Prep before accompanying the child and SSW to the OR.

“We went to the College of Nurses of Ontario for guidance and after looking at the five components of the nurse-client therapeutic relationship and examining the best practices in place at other hospitals, we decided to start going to the patient instead of relying on the patient to come to us,” Scott says of the new procedure that went live in May of last year.

“The parents get to meet you, and in doing so the child gets to see that their parents trust you.”

Not only does the new process raise everyone’s comfort level, it reduces the possibility of errors occurring. Scott says by meeting with parents and/or guardians, nurses are able to do things like go over the procedure with parents and confirm consent – and by accompanying their patients to the OR, they are able to ensure the right patient is in the right place at the right time.

“It eliminates the possibility of the wrong patient ending up in the wrong operating room,” says Charge Nurse Belinda Keating-McLeod, noting the unit handled 3,432 patients last year alone.  “From my perspective, this new process has been excellent and has been a positive experience for parents and children alike.”

LHSC’s CQI councils were established by Professional Scholarly Practice to enable staff at the point of care, who have the specific knowledge of the issues and the solutions, to implement the changes necessary to increase the quality and safety of care delivery.

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