Managing Through the Long Haul

• Do we have enough PPE?
• Are we communicating to ensure COVID-19 safety protocols are being followed?
• What questions are patients asking about safety?

It is questions like these that can keep perioperative nurses awake at night as they worry about what might be slipping off their radar.

Listen and Learn

Effective perioperative nursing care through the pandemic is requiring new behaviors and mindsets that will prevent perioperative nurses in all roles from “overreacting to yesterday’s developments and help them look ahead,” according to McKinsey’s May 2020 report on leadership in a crisis. The report suggests gathering information, devising solutions, putting them into practice, and refining solutions as you go. 

To achieve such goals, Deborah Ebert, MSN, RN, NEA-BC, CNOR, CCRN, CPAN, CAPA, vice president of Perioperative Services decided to take a “boots on the ground” approach to lead from the front through the pandemic at MemorialCare Health System in the Greater Los Angeles Area.

“Leaders should be highly visible in supporting their teams,” Ebert says. “I found that being in scrubs, ‘hands on’, was very important to frontline staff and managers.”

She also says this frontline presence has provided a chance to learn from the front because “listening to teams is how we maintain a pulse check on the health and concerns of staff.”

Shape Solutions

The COVID-19 pandemic has created a number of challenges for perioperative practice, but it has also taught Ebert and her fellow perioperative nurses valuable lessons that can improve perioperative care long term.

Here are three actions she and her teams on the frontline recommend to stay ahead of needs for providers and patients through the pandemic:

1. Leverage predictive analytics data
   Predictive analytics have become valuable tools with Ebert’s perioperative departments in recent years and, during the COVID-19 response, predictive tools have risen to the forefront of their tool chest as they respond to the ever-changing landscape in healthcare needs.
   
   Predictive analytics, for example, are facilitating planning for elective procedures, patient placement, and maintenance of an adequate supply inventory, Ebert says. “We owe it to our patients to provide the highest quality surgical care at all times—even as we address the COVID-19 pandemic.”
   
   
2. Maintain a close working relationship with supply chain/strategic sourcing
   Staying connected with supply chain is essential to maintain adequate supply and visibility to our leaders and teams, Ebert suggests. “We worked together with our frontline to calculate burn rate of PPE and critical supplies which we reported out regularly.”
   
   She worked with campus perioperative directors, staff nurses and supply chain leaders to plan for upcoming surgical procedures to assure necessary case supplies would be available. For example, she collaborated with her campus vice president of Strategic Sourcing to review analytics and leverage team huddles to communicate through the command centers to assure adequate supplies.
   
   
3. Practice frequent communications with surgeon and anesthesia partners
   “Maintaining frequent communication has reassured our teams during the stress of COVID-19,” Ebert notes. She says common concerns verbalized by surgeons centered around safety and the availability of PPE.  “We provided frequent updates on PPE inventory, safety protocols and updates on science via emails and medical staff meetings,” she explains.
   
   She and her team also coordinated with physicians to plan ahead for supply chain disruptions, especially for various surgical gowns and drapes. “As we learn of impending shortages, we discuss substitution options with our physicians and service line coordinators when possible.”