PACU to floor transfer protocol

1. PACU to floor transfer protocol Rapid Improvement Project Launching October 1, 2012

2. PACU to floor transfer protocol • PACU gets call out from procedure area 15 minutes prior to procedure ends. • PACU pages primary team resident to come to the PACU in 15 minutes for hand off. • If during rounds before 10 am, primary team should page night float senior resident to attend. • If during rounds after 10 am, primary team senior resident should attend.

3. PACU to floor transfer protocol • Resident goes to PACU for hand off from surgery/anesthesia.

4. PACU to floor transfer protocol • Resident goes to PACU for hand off from surgery/anesthesia. • Assesses patient.

5. PACU to floor transfer protocol • Resident goes to PACU for hand off from surgery/anesthesia. • Assesses patient. • Writes “Accept Patient” order.

6. Accept Patient order • Enter “accept” in the Search field • Click on the “Accept Patient” order • Enter free text comments: “OK to transfer pt once PACU d/c criteria met. Primary team will assume care once arrives on floor. Page primary team on arrival to floor.”

7. PACU to floor transfer protocol • Resident goes to PACU for hand off from surgery/anesthesia. • Assesses patient. • Writes “Accept Patient” order. • Marks Audit Board before leaving PACU.

8. Audit Board • Residents to track their process in PACU • If you met the standard and participated in hand off, put a green magnet in the column “Standard Met” • If you came and the patient hasn’t arrived, put a red magnet in the column “Resident arrived but patient not in PACU” • Please add comments for what worked and/or didn’t

9. PACU to floor transfer protocol • In PACU, patient under anesthesia/procedural team care. • Once patient meets PACU D/C criteria, patient will be transferred to floor and care assumed by primary team. • Primary team to be paged immediately once patient arrives on floor.

10. Troubleshooting • If there is a delay out of procedure area when the resident arrives, PACU will call into procedure area for update and send resident in to procedure area if ok with procedural team for hand off (intent is not to delay the resident). • If non-invasive procedure or SHC provider unavailable, then resident may get hand off from Anesthesia team in PACU.

11. Troubleshooting • If resident doesn’t arrive in time for hand off in PACU, then the PACU RN will initiate “andon” (or escalation) process • Escalation 1: RN to page primary team: “Pt A. ready to return to floor in 15”. Enter Accept orders and contact surgical team for sign out” • Escalation 2: PACU RSN to page primary team Fellow • Escalation 3: Nurse Manager to page primary team Attending

12. For questions/concerns, Contact stephanie.nguyen@stanford.edu Please complete the PACU to Floor transfer survey before Oct 10th for a chance to win a $5 Starbucks gift card. http://www.surveymonkey.com/s/9SP3LV3