“Leading Perioperative Service Redesign: Evaluating and Enhancing Nurse Cross-Training”
Abstract for study:
Primary Investigators: Sandra Price, MS, RN, CAPA & Christine Deitrick, BS, RN, CAPA
Introduction: The purpose of the performance improvement project is to evaluate current cross-training efforts in the Ambulatory Surgical Center (ASC) and the 23 Hour Units (SD23). An effective cross-training program can alleviate the negative impact of variable patient census, nurse shortage, and unit workload imbalances to increase nurse competence to safely care for patients within a similar discipline. Within these two perioperative units one-third of the experienced nurses are approaching retirement age within the next few years. A projected nurse shortage drives the need to be creative in these areas with staffing to maximize skills, reduce costs, and increase productivity.
Method: During a three week period, both an electronic and paper needs assessment survey was distributed to nurses (n=23) in the ASC and SD23 units. Nurses voluntarily completed a survey consisting of seven Likert scale closed-questions and six open-questions to explore nurse perception of cross-training experience, barriers, and learning needs. Responses were kept anonymous.
Findings: Perioperative nurses (83%, n=19) completed the cross-training survey. Nurses understand the need for cross-training (100%, n=19), believe their unit will benefit from cross-training (79%, n=15), and would like a formal cross-training program (74%, n=14).
Discussion: A focus group of seven nurses formed a coalition, called “cross-training champions.” The champions are essential to lead change, review survey data, develop standardized tools, and precept nurses to a formal cross-training program. A formal cross-training program pilot was implemented to increase nurse knowledge and competence to cross-cover based on patient volume and acuity needs. The cross-training pilot program tested standardized tools, utilized a competency-based training, and performed ongoing evaluation to meet the needs of the learner.