patient safety & quality
By J . Hudson Garrett Jr ., PhD , MSN , MPH , MBA , FNP-BC , IP-BC , PLNC , CFER , AS-BC , VA-BC , MSL- BC , CPPS , CPHQ , NREMT , CADS , FACDONA , FAAPM , FNAP
Pandemics and Beyond : An Evidence-Based Approach to Resiliency in the Perioperative Environment
Over the past year and a half , perioperative clinicians and service lines have been challenged with addressing many challenges as a result of the ongoing COVID-19 pandemic . These challenges included cancelled surgical procedures , staffing shortages and furloughs , delays in care , and generalized fear of the unknown viral pathogen . This pandemic has served as a tremendous learning opportunity for both healthcare institutions and perioperative personnel . Impacts of the ongoing pandemic threat include :
● Fear and worry about your own health and the health of your loved ones
● Changes in sleep or eating patterns
● Difficulty sleeping or concentrating
● Worsening of chronic health problems
● Worsening of mental health conditions
● Increased use of alcohol , tobacco , or other drugs
● General Irritability due to chronic stress and anxiety
Currently , the Centers for Disease Control and Prevention ( CDC ) National Healthcare Safety Network ( NHSN ) COVID-19 Module tracks patient impatient and hospital capacity , healthcare worker staffing , and healthcare supply chain . There is an important element missing from this module , however , which is the impact to the actual healthcare personnel . Perioperative clinicians are continuously making efforts to catch up with previously postponed procedures , which can greatly stress existing perioperative staffing models .
To reduce the incidence of burnout , there are several key tips that can be followed to protect patients , perioperative clinicians , and healthcare institutions :
1Create a Culture of Resiliency : Build a culture that is focused on excellence , being part of something meaningful , and allow perioperative staff to have autonomy .
2Build a Personal Pandemic Plan : Perioperative clinicians must have a personal pandemic plan that is focused on how to address their family ’ s protection , living circumstances during a period of isolation or quarantine , access to personal medications and toiletry items .
3Prepare Your “ Go ” Bag : This bag should be always ready to grab at a moment ’ s notice and should include your personal favorite items such as snacks , lip balm , and other creature comforts .
4Maintain Your Normal Routine : Managing chronic stress such as that during long working shifts can be effectively managed with exercise , spending time with friends , family , and coworkers outside of the hospital , protective one ’ s sleep hygiene , and remaining engaged in personal activities such as hobbies or faith-based activities .
Accept a Culture of Learning and Focus on Failures : The
5 perioperative environment is a fast-paced and complex clinical care setting , which is bound to have periodic errors . With every error comes an opportunity to reduce a Surgical Site Infection or other adverse event in the perioperative setting .
6Implement a Hierarchy of Controls Approach to Preventing
Surgical Site Infection : Focusing on Elimination as the highest intervention will help substantially reduce risk . Next , risks can be substituted . A third option is utilizing Engineering Controls . Administrative controls are an additional option . Finally , the use of personal protective equipment ( PPE ) is the last line of defense in protecting both the perioperative clinician and the patient themselves .
Whether during a pandemic or simply in normal operating circumstances , the CDC recommends an intense focus on core infection control interventions which include :
● Hand hygiene
● Aseptic technique
● Safe injection practices
● Standard and transmission-based precautions
● Training and education of perioperative personnel
● Patient and family education
● Environmental hygiene
● Leadership support
● Monitoring of clinical practice
● Employee and occupational health
● Early removal of invasive devices
The impact of adverse events such as surgical site infections or wrong-site surgeries are widespread to the patient and healthcare facility . A vigilant focus on improving patient safety and infection control will yield substantial results for clinical outcomes . Perioperative clinicians are instrumental in not only improving patient safety , but also must ensure that they practice self-care . The impacts of reduced staffing , pandemics , high throughout , etc . can be detrimental to even the most seasoned perioperative clinicians . A team-based approach to resilience will improve the workplace culture , reduce errors , and improve staff morale .
J . Hudson Garrett Jr ., PhD , MSN , MPH , MBA , FNP-BC , IP-BC , PLNC , CFER , AS-BC , VA-BC , MSL-BC , CPPS , CPHQ , NREMT , CADS , FACDONA , FAAPM , FNAP , is president and CEO of Community Health Associates , LLC . He also serves as an adjunct assistant professor of medicine in the Division of Infectious Diseases at the University of Louisville School of Medicine . He may be reached at :
Hudson . garrett @ chaassociates . com www . healthcarehygienemagazine . com • august 2021
47