A Proactive Nurse Driven Systematic Approach for Covid-19 Screening for Patients Undergoing Aerosol Generating Procedures

BACKGROUND INFORMATION: Our complex healthcare systems were dramatically disrupted by COVID-19, an emerging virus that swept the nation in early 2020. The nurses in the Perianesthesia unit took a proactive approach when confronted with this evolving pandemic. Our hospital offers highly specialized services that appeal to domestic and international patients. In, January of 2020, during the admission process we discovered patients who had recently traveled and returned from a quarantined area within China. It was also noted that we had an increase of patients that had symptoms that could be presumed as COVID-19 positive. These patients were arriving to our facility without standard practices in place for COVID-19 screening. We anticipated the need for a better process and took initiative to implement a nurse driven systematic approach for COVID-19 screening. OBJECTIVES OF PROJECT: • Promoting a safe work environment • Isolate and contain the further spread of COVID-19 • Creating an effective system to prescreen for COVID-19 • Alleviate anxiety regarding upcoming admissions and procedures with ongoing pandemic • To promote efficiency of the operating room schedule and to prevent day of surgery delays due to resulting COVID-19 tests PROCESS OF IMPLEMENTATION: • Utilizing Peri-operative float pool nurses to prescreen patients 24 hours prior to Surgery o Chart review performed to identify any concerns related to COVID-19 symptoms ○ Assessed patients for COVID-19 symptoms ○ Collaborated with the center of perioperative evaluation to ensure patients received the appropriate COVID-19 testing • Process evolved into the Peri-operative float pool nurses ordering COVID-19 test STATEMENT OF SUCCESSFUL PRACTICE: • Decreased day of surgery cancellations • Decreased patients arriving with COVID-19 symptoms • Decreased anxiety of patients and staff related to COVID-19 exposure • Successful practice of safe care commitment by striving for the safest possible environment in the perianesthesia setting IMPLICATION FOR ADVANCING THE PRACTICE OF PERIANESTHESIA NURSING: • We established a process that has evolved into a more sustainable practice to support the increase in OR procedures as the organization resumed to pre-COVID workflow and OR volume • Multi-disciplinary team collaboration allows for smooth process to ensure safety of patients and staff