OR Excellence Awards – Patient Satisfaction: Unforgettable Education

BLEEDING/BANDAGES: Depending on the surgery, some post-procedure bleeding can be normal. If you begin to have unexpected bleeding, call the physician. For uncontrolled bleeding, dial 911.

ACTIVITY: Go home and rest for the remainder of the day, no heavy lifting or strenuous activity.

NAUSEA: If nausea and vomiting develop after going home, stop eating and drinking for one hour and use over-the-counter anti-nausea medication. After one hour, start with clear liquids and only progress diet as tolerated. If nausea and vomiting does not stop after this, call the physician. 

DIET: The first meal after surgery should be light, non-greasy and not spicy. Advance to your pre-procedure diet as tolerated, unless otherwise specified by your physician.

ACCEPTABLE PAIN: Pain after surgery is expected. Our goal is to have your pain at an acceptable level, not pain-free. Your doctor may prescribe you pain medication to take at home. If pain medication is not prescribed, use over-the-counter pain medication if allowed by your physician. 

INFECTION PREVENTION: Notify the physician if you develop any signs of infection such as fever, severe nausea and vomiting, uncontrolled or abnormal bleeding, green or yellow drainage, or uncontrolled pain.

DO NOTS AFTER SURGERY: If you received anesthesia or procedural sedation, do not consume alcohol, operate heavy machinery, make any legal decisions, or drive for the next 24 hours. Do not do any of these things while taking prescribed narcotics. 

SCHEDULED FOLLOW-UP APPOINTMENT: Set up a time with your surgeon.

When patients take the time to send your staff thank you notes for the care they received at your facility, you know you are doing something right. But that does not mean there isn’t a little room for improvement. 

The Charles George VA Medical Center in Asheville, N.C., provides inpatient and outpatient surgical services for orthopedic, vascular, urology, general, ophthalmology, ENT, gynecology, podiatry and thoracic veteran patients. The busy facility houses seven ORs. “We have always had good patient satisfaction scores,” says Christie Anderson, MSN, RN, CNOR, nurse manager of the OR, PACU and day surgery. “But we had several instances where there was some confusion about who would be communicating with patients’ loved ones and keep them updated throughout the surgical process.”

With that in mind, surgical leaders decided to create a family liaison position. Fifteen different OR nurses rotate through the role, which is responsible for contacting designated family members when surgeries start, throughout procedures at established times and when cases are completed.

Having a dedicated team member serve as the go-between for families and surgeons has streamlined the surgical process. “Now, if the family liaison speaks to the family who has some concerns, they can go directly to the operating room and talk to the surgeon and the staff in the OR,” says Ms. Anderson.

The staff has also implemented a care card for each patient, which looks like a postcard and is personally signed by each staff member who cares for them. “This card allows staff to offer encouraging words for recovery and it gives the patients a personalized thank you for letting us care for them,” says Ms. Anderson. “We have received several thank you notes from patients with personalized messages for the staff who made their experience memorable and helped ease their anxiety during the perioperative process.”

The OR also gives out birthday cards embossed with an artistic rendering of the American flag to each veteran who comes in for surgery near their birthday. Every member of the surgical team signs the card.

The care cards and birthday cards that patients receive were designed by the surgery staff, making the patient-friendly gestures fun and creative. “It was an innovative project that got the staff excited about improving patient satisfaction,” says Ms. Anderson. 

— Danielle Bouchat-Friedman