Congress Abstracts 2005

9

OUTCOMES OF A NURSE PRACTITIONER MANAGED PRE-ADMISSION TESTING CENTER AT A MAJOR METROPOLITAN CANCER CENTER. Martha Rodriguez, MS, ANP, Megan Abate, RN, MA, ANP, MaryAnn Carousso, RN, MS, FNP, Joanne Falletta Cregg, RN, MS, MPH, ANP, and Evlyn Hinds, RN, MS, FNP, Memorial Sloan-Kettering Cancer Center, New York, NY.

The pressure to deliver cost conscious, patient-focused, evidence based care has played a key role in the reconstruction of effective systems to manage elective surgical patients. In a cancer center where surgical interventions are the primary therapy for treatment and cure, a preoperative program that meets the needs of the patient, surgeon and anesthesiologist is crucial. The preoperative multi-modality therapies cancer patients receive in addition to co-morbidities contribute to the cancer patient’s increased surgical risk. This comprehensive cancer center developed a model utilizing nurse practitioners as the designated staff to evaluate all patients preparing for surgery. The goals of this project are to identify and reduce the impact of co-morbidities, to improve surgical outcomes and increase patient satisfaction

The goals of the Pre-Admission Testing process are to evaluate patient’s medical condition, to provide accurate airway evaluations, to assess preoperative risk, and to promote homeostasis in operating room and recovery room. A review of the literature identifies nurse practitioners playing a central role in the assessment of patients preparing to undergo elective surgery. The nurse practitioner’s expertise in eliciting accurate health histories paired with sharp physical assessment skills is critical to determining a patient’s suitability for anesthesia and surgery.

In Pre-Admission Testing, five nurse practitioners trained by committed anesthesiologists are responsible for the assessment of adult surgical patients. All levels of acuity are evaluated by the nurse practitioners including co-morbidities, airway classification and risk/status. A review of systems and physical examination is performed. Some patients are referred for cardiac or medical consultation. Discussions regarding risks, benefits, the recovery room and pain management are individualized to the patient.

Data analyses from the first six months of implementation of the model indicate a reduction in surgical delays and cancelations, and improved documentation. Second quarter patient satisfaction measured by Press Ganey Associates, Inc. indicate increased patient satisfaction with overall surgical experience.

This model of presurgical testing evolved through the collaboration and cooperation of interdepartmental teamwork. A nurse practitioner managed presurgical testing center can provide accurate assessments contributing to operating room efficiency and positive patient outcomes