Journal of Perianesthesia Nursing最新文献

{"title":"Implementation of a Preanesthetic Telehealth Visit to Reduce Day-of-Surgery Cancellations.","authors":"Elizabeth Wolgemuth, Jessica Glackin, Anh Bao Linquist, Jamie Dorman, Emily Somanath, Michelle Canale, Erik Rauch","doi":"10.1016/j.jopan.2024.05.022","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.05.022","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the telehealth preanesthesia clinic (PAC) is to reduce the number of day-of-surgery (DOS) cancellations through the implementation of an algorithm-based standardized protocol.</p><p><strong>Design: </strong>A prospective quality improvement project with pre and post assessment.</p><p><strong>Methods: </strong>One hundred and fifty preoperative and postoperative surgical chart reviews using the Focus, Analyze, Develop, Execute, and Evaluate model. Retrospective chart reviews were conducted via the electronic health record to collect DOS cancellation counts along with reason for cancellation for a 6-week period prior to implementation, and a 6-week period postimplementation based on inclusion and exclusion criteria.</p><p><strong>Findings: </strong>The implementation of a telehealth PAC using TEMPO (transition and action, evaluation and significant history, medications, procedure and condition, and overall plan) protocols resulted in a statistically significant reduction in DOS cancellations from 3.38% to 1.72%.</p><p><strong>Conclusions: </strong>Postimplementation findings support the use of a telehealth PAC to reduce DOS cancellations.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors Related to Postoperative Dizziness Among Patients Who Underwent General Anesthesia and Intraoperative Analgesics: A Prospective Cohort Study.","authors":"Yen-Fan Chin, Wei-Lin Wang, Hsing-Yi Yu","doi":"10.1016/j.jopan.2024.05.015","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.05.015","url":null,"abstract":"<p><strong>Purpose: </strong>To describe postoperative dizziness for patients who received analgesics during general anesthesia and to investigate the factors related to the trend of dizziness within 3 days after surgery.</p><p><strong>Design: </strong>A prospective cohort study.</p><p><strong>Methods: </strong>This is a longitudinal study. The severity of dizziness was assessed from the day of the surgery until the third day post surgery. Generalized estimation equation models were created to determine the predictive effect of each independent variable separately.</p><p><strong>Findings: </strong>After surgery, the incidence of dizziness was 42.1%. Approximately 10% of participants experienced severe dizziness. Participants with postoperative nausea and vomiting were more likely to experience postoperative dizziness. In addition, age, education level, history of motion sickness, surgical specialties, laparoscopic surgery, and long-acting analgesic use had an impact on the trend of postoperative dizziness. More than 25% of participants who used long-acting analgesics experienced dizziness on the third postoperative day.</p><p><strong>Conclusions: </strong>Postoperative dizziness was common among participants who received analgesics during general anesthesia. Monitoring for postoperative dizziness may need to be prolonged, especially in patients taking long-acting analgesics. For patients at high risk for postoperative dizziness, preventive measures such as adjusting analgesic and anesthetic medications may be necessary.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Prolonged Fasting Before Surgery on Pain and Anxiety.","authors":"Gülseren İster, Dilay Hacidursunoğlu Erbaş, Fatma Eti Aslan","doi":"10.1016/j.jopan.2024.05.020","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.05.020","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effect of prolonged fasting before surgery on pain and anxiety.</p><p><strong>Design: </strong>This was a descriptive study.</p><p><strong>Methods: </strong>This study was conducted in a plastic, reconstructive, and esthetic surgery clinic at a university hospital in Bursa, Turkey. A data collection tool was designed to collect data on the sociodemographic characteristics. The Beck Anxiety Scale was used to assess patients' anxiety in the preoperative period and the Visual Analog Scale was used to measure pain levels in the postoperative period. The Statistical Package for Social Sciences was used for data analysis.</p><p><strong>Findings: </strong>A total of 363 patients took part in the study. A majority (91.2%) of the patients who participated in the study were aware of why they were fasting before surgery, and 41.6% of them had been informed about preoperative fasting by the nurse. In addition, 60.9% of patients had thirst, 17.6% had headache, 40.5% were hungry, 62% had dry mouth, 79.6% were restless, and 83.7% were anxious. Most (82.6%) of the patients who participated in the study had a preoperative fasting period of more than 6 hours, 58.4% had a postoperative fasting period of 5 hours or less, and the mean fasting period was 6.82 ± 1.76. The mean score of the Visual Comparison Scale was 5.09 ± 0.31 and the mean score of the Beck Anxiety Scale was 21.86 ± 0.054, and patients with a fasting period of 6 hours or more experienced more pain and anxiety.</p><p><strong>Conclusions: </strong>This study shows that patients with longer fasting duration experience more pain and anxiety, and patients with more anxiety experience more pain. Based on the results of this study, it is recommended that studies should be done to emphasize the issue and to increase the awareness of health care professionals about pre- and postoperative fasting.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Emptive Acetaminophen for Postoperative Pain (PAPP): An Updated Meta-Analysis.","authors":"Brett Doleman, Síle Ann Johnson, Daniel Last, Nuriyah Ali, Zdenek Klezl, David Rogerson, Jonathan Lund, John Williams","doi":"10.1016/j.jopan.2024.04.005","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.04.005","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative pain is a common consequence of surgery. Pre-emptive analgesia involves the initiation of analgesics prior to surgical incision. This has been proposed as a simple method to help reduce postoperative pain, which may be more effective in higher-risk populations such as cervical spine surgery. A previous meta-analysis has demonstrated that pre-emptive acetaminophen may be effective in reducing postoperative pain although the certainty of evidence was limited. This present paper is an updated meta-analysis comparing pre-emptive acetaminophen versus postincision acetaminophen in adult patients undergoing surgery.</p><p><strong>Design: </strong>Systematic review and meta-analysis with the inclusion of an unpublished randomized, placebo-controlled, double-blind trial.</p><p><strong>Methods: </strong>An updated meta-analysis was conducted which searched electronic databases to identify randomized controlled trials with the same interventions.</p><p><strong>Findings: </strong>We included 845 participants and 12 studies in the updated meta-analysis. The meta-analysis (including our trial) found reduced 24-hour morphine consumption in the pre-emptive group (mean difference -2.42 mg; 95% confidence interval -4.26 to -0.59 mg), as well as reduced postoperative vomiting (risk ratio 0.56; 95% confidence interval 0.36 to 0.88). There was no difference between pre-emptive acetaminophen and control groups for time to analgesic request, pain scores at 6 and 24 hours or pruritis. For all outcomes assessed, there was very low certainty of evidence.</p><p><strong>Conclusions: </strong>This meta-analysis found pre-emptive acetaminophen reduced 24-hour opioid consumption and postoperative vomiting.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immersive Virtual Reality Versus Video Distraction for the Management of Emergence Delirium in Children: A Randomized Controlled Study.","authors":"Hong Chen, Le Chen, Chen Zhu, Sainan Li, Juan Zhou, Chengxiang Liu","doi":"10.1016/j.jopan.2024.05.006","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.05.006","url":null,"abstract":"<p><strong>Purpose: </strong>Emergence delirium (ED) presents challenges for both parents and health care providers in pediatric surgical settings. This study aims to evaluate the effectiveness of immersive virtual reality (VR) distraction and video distraction combined with parental presence in reducing ED in preschool-aged children undergoing elective surgery.</p><p><strong>Design: </strong>A prospective, randomized, controlled clinical trial was conducted with 90 children ages 4 to 7. Participants were randomly assigned to three groups: VR distraction (group V), tablet video distraction with parental presence (group T), and standard care (group C). The primary endpoints were the incidence of ED and Pediatric Anesthesia Emergence Delirium Scale scores, with secondary measures encompassing scores from the Parental Separation Anxiety Scale and the Faces, Legs, Activity, Cry, Consolability (FLACC) scale.</p><p><strong>Methods: </strong>Participants were assigned to one of the three intervention groups, and relevant scales were used to assess ED, parental separation anxiety, and postoperative pain. The immersive VR distraction and video distraction with parental presence interventions were compared against standard care.</p><p><strong>Findings: </strong>Immersive VR distraction significantly reduced the incidence of ED (6.67% in group V vs 40% in group T and 60% in group C), and the incidence of ED in group V was notably lower than in the other groups (P = .023 vs group T and P = .004 vs group C). Children in group V displayed significantly lower FLACC compared with the other groups as well (P < .05). However, no significant differences between the 3 groups were observed in perioperative anxiety as assessed by the Parental Separation Anxiety Scale scores (P = .27).</p><p><strong>Conclusions: </strong>This study underscores the potential of immersive VR distraction as an effective intervention for mitigating ED in pediatric surgical patients. The findings suggest that incorporating VR technology during the perioperative period can positively impact postoperative outcomes. Further research in diverse surgical contexts is recommended to validate these findings and explore the broader applicability of VR distraction in pediatric health care settings.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of Patients Undergoing Robot-assisted Cardiac Surgery: A Qualitative Study.","authors":"Berrin Pazar, Emine İyigün, Sevinç Taştan, Murat Kadan","doi":"10.1016/j.jopan.2024.05.010","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.05.010","url":null,"abstract":"<p><strong>Purpose: </strong>Over the last two decades, the use of robotic surgery in cardiac procedures has become increasingly prevalent. Typically, assessments of patient outcomes for robot-assisted surgery concentrate on patient morbidity and mortality, surgical complications, and length of hospital stay. However, there is limited research on patients' perceptions of robot-assisted surgery. Therefore, this study aims to determine the experiences of patients undergoing robot-assisted cardiac surgery.</p><p><strong>Design: </strong>The study used a qualitative design.</p><p><strong>Methods: </strong>The study was conducted with 12 patients who underwent robot-assisted heart surgery at an educational and research hospital. Ethical approval and written informed consent were obtained before the study.</p><p><strong>Findings: </strong>66.7% of the participants were male with an average age of 38.25 ± 16.06 years. The analysis of qualitative data identified three themes: Robotic surgery, Post-Surgical Experience, and Homecoming.</p><p><strong>Conclusions: </strong>Patients expressed satisfaction with robotic surgery and recommended it to others undergoing surgery. Based on the findings, we may suggest that nurses may conduct personalized education programs about robotic surgery and develop programs to follow up with patients at home.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of Postoperative Sore Throat in Patients After Day-case Surgery With General Anesthesia: A Retrospective Study.","authors":"Zijun Zhou, Linglin Gao, Zhu Lv, Linyao Chen, Kuan Lu, Jinxia Cai, Jiehao Sun, Xiaodan Chen","doi":"10.1016/j.jopan.2024.03.022","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.03.022","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative sore throat (POST) is a major complaint after day-case surgery. The objectives of this study were to investigate the risk factors for POST and develop a stratified nursing model for POST after day-case surgery.</p><p><strong>Design: </strong>This case-control study was conducted at Department of Anesthesiology of 1st Affiliated Hospital of Wenzhou Medical University in Wenzhou, Zhejiang, China.</p><p><strong>Methods: </strong>Anesthesia records and postanesthesia care files of adult patients undergoing day-case surgery with general anesthesia were reviewed. The primary outcome was the incidence of POST at 24 hours after day-case surgery or before discharge within 24 hours. Multivariate logistics regression was used to identify risk factors for POST. A nomogram was created to predict the probability of POST after day-case surgery.</p><p><strong>Findings: </strong>A total of 9,312 records were retrieved from June 1, 2021 to April 30, 2022, including 8,499 files in the training group and 813 files in the validation group. One thousand five hundred and twenty-five cases in the training group experienced POST. The independent risk factors for POST included: thyroid surgery (odds ratios [OR] = 22.42, 95% confidence intervals [CI]: 18.45 to 27.25), shorter thyromental distance (OR = 1.18, 95% CI: 1.06 to 1.30), smaller neck circumference (OR = 1.09, 95% CI: 1.06 to 1.11), duration of anesthesia (OR = 1.13, 95% CI: 1.04 to 1.22), female (OR = 1.66, 95% CI: 1.41 to 1.96), age (OR = 0.99, 95% CI: 0.99 to 1.00) and the presence of bloody sputum (OR = 8.33, 95% CI: 6.53 to 10.63). A nomogram that involved five factors was established to predict the probability of POST after day-case surgery. The area under the receiver operating characteristic curve in the training and validation groups was 0.77 and 0.81, respectively. The calibration curve demonstrated good consistency between the actual POST and the predicted probability.</p><p><strong>Conclusions: </strong>The following variables are independently associated with POST: thyroid surgery, age approaching to 40 years old, female, shorter thyromental distance and smaller neck circumference, longer duration of anesthesia, and the presence of bloody sputum. A novel stratified nursing model is feasible for predicting the probability of POST.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Research Trends in Postoperative Delirium and Its Risk Factors: A Bibliometric and Visual Analysis.","authors":"Xing Liu, Zhao Huangfu, Xiao Zhang, Taohong Ma","doi":"10.1016/j.jopan.2024.04.002","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.04.002","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative delirium (POD) is one of the most frequent complications after surgery which is closely associated with many adverse outcomes, including high mortality and low quality of life. This study aims to carry out a bibliometric analysis of POD and its risk factors from 2012 to 2022 to reveal the research status and hot spots.</p><p><strong>Design: </strong>This study is a bibliometric and visualized analysis.</p><p><strong>Methods: </strong>Relevant publications between 2012 and 2022 were extracted from the Web of Science Core Collection database. CiteSpace software (v6.1. R2, Drexel University), VOSviewer software (v1.6.18, Leiden University), and the Online Analysis Platform of Literature Metrology were used to analyze research attributes. These publications were used to analyze research attributes, including countries, journals, institutions, authors, keywords, and burst detection, to predict trends and hot spots.</p><p><strong>Findings: </strong>We included a total of 1,324 related documents from 2012 to 2022. The literature on POD has increased significantly since 2016. The United States and Harvard University were the leading literature publishing country (436/1324, 32.9%) and institution (112/1324, 8.5%). Anesthesia and Analgesia was the most frequently published journal. Keywords analysis with VOSviewer revealed that the keywords could be divided into five clusters, including anesthesia techniques, cardiac surgery, risk factors, intraoperative anesthesia monitoring, and postoperative cognitive dysfunction. We included a total of 198 POD risk factors documents, and the literature on POD risk factors increased. The People's Republic of China and Harvard University were the leading literature publishing country (53/198, 26.8%) and institution (12/198, 6.1%). Elderly, hip surgery, frailty, postoperative pain, cardiac surgery, dementia, and depression are keywords that are risk factors for POD.</p><p><strong>Conclusions: </strong>The number of literature on POD in the field of anesthesia has increased significantly. Risk factors and anesthesia techniques are still key areas of research. Encephalogram, the use of sedatives, and perioperative nursing may be the new research focus. Older adults, hip fractures, cardiac surgery, liver transplants, dementia, and depression are hot words in the field of POD risk factors.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Oral Carbohydrate-Containing Fluid Versus Plain Water in Elective Cesarean Deliveries: A Randomized Clinical Trial.","authors":"Sunil Thakur, Manjit Singh Kanwar, Anurag Sharma, Sushruti Kaushal, Poojan Dogra Marwaha, Nisha Sharma, Ravinder Kumar","doi":"10.1016/j.jopan.2024.05.007","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.05.007","url":null,"abstract":"<p><strong>Purpose: </strong>Traditional prolonged fasting regimens have recently been replaced with guidelines to take carbohydrate-rich clear fluids until 2 hours before surgery. With this study, we wanted to study if the addition of carbohydrates to preoperative oral fluids confers any advantage.</p><p><strong>Design: </strong>Randomized clinical trial.</p><p><strong>Methods: </strong>The study was conducted at a single center in North India among singleton pregnancies at term, scheduled for elective cesarean section under subarachnoid block. Participants were randomized into 2 groups of 50 participants each. The \"Carbohydrate group\" received 400 mL of fluid containing 50 g of glucose, while the \"plain water\" group received 400 mL of water 2 to 4 hours before surgery. A visual analog scale was used to assess hunger, thirst, anxiety, fatigue, and nausea before surgery. Intraoperative mean arterial pressure, hypotension, nausea, and vomiting were noted. On the first postoperative day, recovery from anesthesia was assessed using the Quality of recovery from anesthesia- 40 (QoR-40) questionnaire. Blood sugar levels were compared on the first postoperative day and in cord blood.</p><p><strong>Findings: </strong>Preoperative visual analog scale scores for hunger, thirst, anxiety, nausea, and fatigue were similar in both groups. The occurrence of hypotension (P = .688) and phenylephrine use (P = .39), recovery from anesthesia (P = .92), cord blood sugar levels (P = .24), and postoperative blood sugar levels were also not significantly different in both groups (P = .81).</p><p><strong>Conclusion: </strong>This study did not find any significant advantage of preoperative carbohydrate-containing fluid over preoperative plain water in women undergoing elective cesarean delivery under Subarachnoid block.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering Nurses to Increase Certification Rates in a Postanesthesia Care Unit: A Collaborative Team Approach.","authors":"Diala Epstein, Patricia Maria Lavin, Jennifer Withall, Diana Wong","doi":"10.1016/j.jopan.2024.05.004","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.05.004","url":null,"abstract":"<p><strong>Purpose: </strong>The number of postanesthesia care unit (PACU) registered nurses (RNs) with a specialty nursing certification at an orthopedic hospital in an academic health system was below the organizational benchmark. A clinical nurse-led process was developed to increase the percentage of PACU RNs with a specialty certification. This article will describe the strategies and interventions identified to support, reward, and recognize nurses who obtain or maintain their specialty certifications.</p><p><strong>Design: </strong>A performance improvement project using the Plan-Do-Study-Act cycle.</p><p><strong>Methods: </strong>A gap analysis identified barriers preventing PACU nurses from obtaining specialty certifications in an orthopedic acute care American Nurses Credentialing Center Magnet-designated hospital. An anonymous web-based survey was distributed to 18 nurses who, although eligible, were not certified. The survey assessed common barriers to certification (eg, cost of the examination, comfort level with the testing process, level of access to review courses and study materials, expense to maintain credentials, personal interest in certification, and awareness of qualification information to take the exam). The project team included PACU nurse leaders, certified clinical nurses, nursing professional development specialists, and other interdisciplinary team members (eg, content experts from different departments).</p><p><strong>Findings: </strong>Eighteen RNs completed the anonymous survey. The leading barrier was the expense of the certification exam (73%), while 66% of respondents reported discomfort with the test-taking process. Additionally, 61% of nurses reported that more access to review courses and study materials is needed, 44% responded that the expense of maintaining credentials is a barrier, 39% responded that the additional compensation pay for a specialty certification was considered to be insufficient, 39% agreed there is a lack of information on eligibility criteria, and 6% responded that they have no interest or desire to become certified. The survey results informed implementation strategies to increase certification rates, including initiating peer-to-peer exam groups and ongoing collaboration with nurse leaders on reward and recognition strategies. The removal of known barriers to obtaining specialty certification significantly increased certification rates in the PACU. Over the project period, the percentage of PACU-certified nurses increased to 60%, exceeding the project goal of 51%.</p><p><strong>Conclusions: </strong>Peer-to-peer education and collaboration with nursing leadership and other interdisciplinary team members helped increase PACU's certification rates in this orthopedic specialty hospital. The informational and recognition strategies were impactful, resulting in additional nurses interested in becoming certified. Newly certified nurses are now motivating others to seek certification. Based ","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}