Keynote Address

Tides of Change: An Exciting Future for Perianaesthesia Nursing, Let’s make it happen! - Dr Paula Foran

Perianaesthesia nursing is a wonderful and privileged profession. Patients entrust themselves into our care when they are at their most vulnerable and dependant . Caring for these patients during anaesthesia and post-anaesthesia requires a specific skill set encompassing compassion, planning, knowledge, and critical thinking. All perianaesthesia nurses possess these skills but often do not appreciate their level of expertise and scope of their ability and workplace talents. 

The Australian population is aging which, in turn, will lead to an increased demand for surgical health services. So too the perioperative nurse matures making it essential for us to provide an environment of support and education to encourage replacement nurses for our retiring workforce and enough qualified perianaesthesia nurses to meet future projections.  

This presentation will present the credentialing process for perianaesthesia nurses in Australia including anaesthetic nurses (as defined by PS08) and Post Anaesthetic Care Unit (PACU) nurses, as defined by ACPAN. It will also outline future initiatives by ACPAN to provide the education support at all levels of perianaesthesia education and training.

Discussion will also surround future challenges for perianaesthesia nurses including, the decreasing numbers of perioperative nurses with post-graduate qualification, replacing experienced perianaesthesia nurses in an aging workforce and caring for patients with greater co-morbidities. This will require passion and commitment by our workforce which I know we all possess.  As we watch our second group of Australian College of Perianaesthesia Nurses (ACPAN) Fellows graduate at the ICPAN conference, it is time to embrace our profession, appreciate our special skills and celebrate them together. 

Dr Paula Foran

Fellow Australian College of Perianaesthesia Nurses (ACPAN –  Chief Examiner), Fellow Australian College of Perioperative Nurses (ACORN – Education Officer) University of Tasmania – Unit Co-ordinator 

Dr Paula Foran RN, has an Anaesthesia & Post Anaesthesia Nursing certificate, Graduate Diploma in Adult Education and Training; Certificate 4 in Workplace Assessment and Training; Master of Education (research) and is a Doctor of Philosophy (Workplace Education and Training). She has held positions of Associate Charge Nurse, Charge Nurse, Clinical Nurse Educator and Clinical Facilitator for Perioperative Education. Paula has a number of publications to her credit (AORN August 2015, Nurse Education in Practice 2016), has recently completed two book chapters on Post-Anaesthesia Care & has been a guest speaker at National & International Conferences.

Paula is a Fellow of the Australian College of Perianaesthesia Nurses (ACPAN) and is their Chief Examiner. She is also a Fellow for the Australian College of Operating Room Nurses (ACORN) and is their national Education Officer. She also holds a senior lecturing position with Critical Care Education Service, Unit co-ordinator for University of Tasmania, a casual appointment with the Deakin University Medical School and sits on the Victorian Consultative Council for Anaesthetic Morbidity and Mortality.  Just to keep her hand in clinically, Paula works 2 days per week as a grade 2 registered nurse in perianaesthesia nursing.

Home Recovery of Ambulatory Surgery Patients: What Perianesthesia Nurses Need to Know- Jan Odom-Forren

Approximately 60-70% of surgeries today are conducted in the ambulatory surgery setting.  However, it has only recently have we determined what patients and their caregivers experience at home after ambulatory surgery.  Patients and caregivers have identified important gaps in care that need to be disseminated to nurses at the bedside. This session describes the home recovery of the ambulatory surgery patient and experiences of the caregiver based on new evidence.  Gaps in care identified by patients and their caregivers will allow perianesthesia nurses to add vital information to their care of patients.  It will also describe a pilot study conducted with ambulatory orthopaedic patients using an innovative approach to deliver information about self-management.  After this session, you should be able to:  (1) List symptoms and consequences of surgery that are experienced by patients and their caregivers during home recovery. (2) Identify self-management techniques used by patients at home after ambulatory surgery. (3) Discuss implications for the perianesthesia nurse in the education of patients and caregivers for home recovery. (4). Discuss feasibility of an innovative approach to assist with patient self-management of care.

Jan Odom-Forren, PhD, RN, CPAN, FAAN

Associate Professor, College of Nursing; University of Kentucky, Lexington, KY, USA; Perianaesthesia Nursing Consultant, Louisville, KY, USA

Jan Odom-Forren has been a staff nurse in PACU; clinical nurse specialist, perioperative services; nurse manager, PACU; and Director, Surgical Services.  She is currently an associate professor at the University of Kentucky, College of Nursing and a perianesthesia nursing consultant.  She is an international lecturer on perianesthesia and sedation issues and has published extensively in journals and books.   Her research area of interest is postoperative symptom management with a focus on patients after ambulatory surgery.  Dr. Odom-Forren is a past president of the American Society of PeriAnesthesia Nurses and has served that organization in many capacities.  She is a Fellow in the American Academy of Nursing where she serves on the Acute and Critical Care Expert Panel.  She is currently a Co-Editor of the Journal of PeriAnesthesia Nursing and editor of Drain’s Perianesthesia Nursing: A Critical Care Approach.

Videolaryngoscopy: A Master Piece for Total Airway Management-Professor André Van Zundert

Professor André Van Zundert, MD, PhD, FRCA, EDRA, FANZCA

Professor & Chairman, Discipline of Anesthesiology, The University of Queensland, Chair, The University of Queensland ‘Burns, Trauma, Critical Care Research Centre’, Chair, RBWH & The University of Queensland ‘Centre of Excellence & Innovation in Anesthesia’, Royal Brisbane & Women’s Hospital, Department of Anesthesia & Perioperative Medicine, Brisbane, Qld, Australia

Qualifications in anesthesia, intensive care and trauma care, graduating as a medical doctor cum laude, at the University of Leuven (Belgium) in 1978, and with a PhD in obstetric anesthesia from the University of Leyden (Netherlands) in 1985. Has worked for 30 years as an anesthesiologist in the Netherlands, and has obtained numerous diplomas and certifications in anesthesia-related courses, often at instructor level. Received 13 international awards. Founding member of European Societies of Anaesthesiology and Pain. Presents nationally and internationally on airway management and regional anesthesia, annually. Prior to relocation to Australia in 2013, Director of Anesthesia at the Catharina Hospital Brabant Medical School in Eindhoven – a major teaching institution in the Netherlands. Currently holds the position of Professor and Chairman, Discipline of Anesthesiology at the University of Queensland Medical School, and the Royal Brisbane and Women’s Hospital. He has ongoing professorial appointments in anesthesiology at the Universities of Ghent (Belgium), Maastricht (Netherlands), Udayana (Indonesia), Queensland University of Technology and Victoria University Melbourne (Faculty of Engineering & Sciences).

Plenary Address

Experience of Teaching a Recovery Room Course to Nurses in Cameroon, Africa- Owen Ashwell and Harriet Zych

An opportunity arose via ICPAN to teach nurses the principles of recovery room nursing for 6 weeks in Cameroon. This presentation will outline the differences encountered, experiences and reflections of the 6 week volunteer mission at the Mbingo Baptist Hospital, Cameroon.

Owen Ashwell

Owen Ashwell is the lead specialist for the Perioperative Mortality Review Committee at the Health Quality & Safety Commission in New Zealand. Owen’s previous experience in the perioperative care area has been as a charge nurse manager, clinical nurse educator and registered nurse at Wellington Hospital. He has been involved with national and international perioperative societies and has a masters in nursing. 

Harriet Zych

Harriet Zych trained at Guy’s and St Thomas’ hospitals in London and has worked there since 2012, specialising in post anaesthetic care. In addition to teaching in Cameroon, she worked in Greece with Doctors of the World in response to the refugee crises in Europe. She also has a diploma in tropical nursing from the London School of Hygiene and Tropical Medicine. Harriet is a member of the British Anaesthetic and Recovery Nurses Association.

The Gathering of the Nations - Dr Ellen Poole, Dr Joni Brady, Mette Ring, Bente Buch

Continuing the work started at the Copephagen Conference, this interactive networking session provides a unique opportunity for delegates from different countries to meet in smaller groups to discuss various perianesthesia clinical practice and management issues as discovered at the Copehagen Conference. Groups will be led by a facilitator to enable  sharing of the findings with all delegates fostering opportunities to meet and discuss possibilities for future collaboration specific to perianesthesia nursing interests (e.g. staff development, education, management, research and evidence-based practice).

Dr Ellen L. Poole, PhD, RN, CPAN, CNE

Professor, Chamberlain College of Nursing, Phoenix, AZ, USA

Ellen Poole has been a staff nurse, head nurse of PACU and ambulatory surgery, and clinical nurse III in PACU. She is currently a professor at Chamberlain College of Nursing teaching baccalaureate, masters and doctoral students, with a primary focus on nurse educators along with advanced research courses. Dually certified as perianesthesia nurse and a nurse educator, Dr. Poole has been actively engaged in both the Research and EBP committees of ASPAN serving as a mentor to many colleagues along the way. In addition to her published studies on family visitation in PACU and ambulatory surgery, she was the first to publish on working along in PACU. She has been co-investigator on several ASPAN studies such as the two Delphi studies and an evaluation of ASPAN’s preoperative videos.

Joni M. Brady

Joni M. Brady

DNP, RN-BC, CAPA, Chair, ICPAN

Born to a Canadian mom, American dad, and family life that crossed national borders, Joni now serves as Chair for the International Collaboration of PeriAnaesthesia Nurses, Inc. (ICPAN www.icpan.org) Transitional Board of Directors. She earned a nursing diploma in New York (USA) and began professional life in the intensive care unit. An affinity for critically ill postoperative surgical patient care led to recovery room specialization, with a subsequent focus on perianaesthesia and perioperative pain management practice for most of her career. In 2015, she received a Doctor of Nursing Practice Degree in Nursing Administration from George Mason University in Fairfax, Virginia (USA). This published work explored the role of formal education with mentorship in the promotion of clinical nurses’ evidence-based practice adoption across a multi hospital health care system. Joni holds board certification in pain management and ambulatory perianaesthesia nursing. Being in a military service family, she moved about Asia, North America and Europe over three decades; ICPAN involvement began in Europe in 2009. Dr. Brady advocates for expansion of clinical nurse education and mentorship and interprofessional perioperative care team collaboration to improve knowledge and partnership that positively contributes to local and global surgical quality and patient safety.

Mette Ring

Registered Nurse, Klinik Akut, Aalborg University Hospital, Denmark

Mette Ring has worked as a Registered Nurse since 1980. After a few years of experience in clinicaI practice, Mette specialized as an intensive care nurse and a Nurse anesthetist.

Mette currently works as a nurse anesthetist at Aalborg University Hospital in Denmark.

Mette has a masters degree in Learning processes and for several years has been working with different education programs in clinical practice.

Mette was part of the organizing group for the ICPAN Conference in 2015, which was held in Copenhagen Denmark.

Bente Buch

Bente Buch is the former conference Chair at ICPAN 2015, Copenhagen Denmark. She was part of the Delegates forum, an interactive session where 400 delegates from 21 countries discussed different perianesthesia topics. Bente has worked as

Bente has worked as clinical nurse for the past 26 years at University hospital Rigshospitalet, Copenhagen. For the last ten years, bente has also worked as an educator and mentor, whilst working part time in recovery and part time educating nurses.Bente is

Bente is board member of the Danish Association of Nurse anesthetist, Intensive care- and Recovery nurses. Here her main fokus is a national education for Recovery nurses in Denmark and of course ICPAN, where she is a member of Global Advisory Council (GAC).

Global Outreach to Promote Patient Safety: The Checklist Effect. Lifebox: Australia and New Zealand-Dr Rob McDougall

Dr Rob McDougall

Lifebox Volunteer; Deputy Director Anaesthesia and Pain Management, The Royal Children’s Hospital, Melbourne

Dr Rob McDougall MBBS, FANZCA, Grad. Cert Health Prof. Education is a specialist paediatric anaesthetist and Deputy Director of the Department of Paediatric Anaesthesia and Pain Management at the Royal Children’s Hospital, Melbourne. He is a Clinical Associate Professor in the Department of Paediatrics, University of Melbourne. He has recently completed an 8 year term on the Council of the World Federation of Societies of Anaesthesiologists (WFSA). Rob has extensive experience in education in anaesthesia and resuscitation in Asia and Australasia. His clinical interests include anaesthesia for burns, craniofacial and general paediatric surgery. Rob has Lifebox volunteer since 2011 and assisted with the development of the Lifebox educational materials. He is a leader on the Lifebox Australia and new Zealand project.

 

Enhanced Recovery after Surgery (ERAS)-Dr Hans Donald de Boer, Brenda Zoer and Hanneke van Kooten

ERAS is a multimodal, multidisciplinary approach to the care of surgical patients and based on evidence based protocols. These ERAS protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining preoperative organ function and reducing the profound stress response following surgery. The key elements of ERAS protocols include preoperative counselling, optimization of nutrition, standardized analgesic and anesthetic regimens and early mobilization. Despite the significant body of evidence indicating that ERAS protocols lead to shorter length of hospital stay by 30-50%, a reduction of complications by 40% and improved outcomes, they challenge traditional surgical doctrine, and as a result their implementation has been slow. Moreover, after implementation of the ERAS program a reduction of healthcare costs is achieved and therefore ERAS is a good example of valued based healthcare. As initial implemented in colorectal surgery, ERAS has been shown to improve outcomes in almost all major surgical specialities. Many surgeons and anesthesiologists state that they have “never heard of ERAS,” while others cite inadequate multidisciplinary and community support as an impediment to implementation. In terms of barriers to introducing ERAS, even the simple measures are discussed and still represent fundamental changes in practice, and can therefore be difficult to achieve. One of the most important aspects is the ERAS team, which includes pre-ari4rdmission staff, dieticians, nurses, physiotherapists, social workers, occupational therapists and doctors. All team members must be familiar ERAS principles and be motivated to carry out the program; they must be able to overcome traditional concepts, teaching and attitudes towards perioperative care. The ERAS principles, the strategies how to implement a complete ERAS program in a hospital, the healthcare improvement and reduction of healthcare costs will be discussed.

Dr Hans Donald de Boer

Dr. de Boer (PhD anesthesiologist/pain specialist) is scientifically active in neuromuscular management (sugammadex), perioperative patient safety, innovations and legal issues in perioperative patient care and ERAS® Society committee member implementing opioid free/opioid sparing anesthesia techniques programs. In all these fields he is involved in educational and scientific programs.

Brenda Zoer

Brenda Zoer is a trained nurse anaesthetist and is now working at the department of perioperative care in the Martini General Hospital Groningen. Originally she has a master in science (Biology) and subspecialized in behavioral and neuroscience and internationally active as a clinical study manager at PRA International. After her training as a nurse anaesthetist she focused on postoperative cognitive dysfunction. Furthermore, she is a member of the ERAS committee in the ERAS Centre of Excellence in the Martini General Hospital Groningen. She is also a teacher at the Wenckebach Institute where she is participating in the education of nurse anaesthetist with special interest in evidence based medicine.

Hanneke van Kooten

Hanneke van Kooten is a trained general nurse and is now working on the PACU as a certified PACU nurse in the Martini General Hospital Groningen. She is involved in several quality committees and participating in innovative projects. She is EBP (Evidence Based Practice) and Good Clinical Practice (GCP) certified.  Furthermore, she is a member of the ERAS committee in the ERAS Centre of Excellence in the Martini General Hospital Groningen. She is also specialized in nursing patients with chronic respiratory insufficiency/failure. Nationally and internationally she is involved in conference committees in her profession (Member of National Conference Committee (BRV) and Global Advisory Council, ICPAN), with special interest in evidence based medicine. 

Nursing Advocacy/ Global Implications - Susan Fossum

The diversity of the nursing profession and its unique relationship with the public can provide opportunities for influence and change.  Challenging times in healthcare create opportunities for nurses to have a greater voice for healthcare changes and patient safety.

Every nurse has the opportunity to make a positive impact on the nursing profession whether in their workplace, their community or for the nursing profession itself.  Every nurse can learn and use specific skills that will allow them to advocate for safe, healthy work environments and for the patients they care for.  

Nurses historically struggle to influence change on an individual basis within care delivery systems, or on the broader healthcare policy level where legislative decisions negatively impact the profession. Nursing knowledge, influence, and health and public policy contributions frequently go unrecognized. In reality, the collective “Voice of Nursing” is much too often silent, and in need of a unified approach by nurses to inform issues affecting patient care and nursing practice.

ICPAN provides nurses a unique opportunity to meet and explore shared practices. Using our collective global nursing voice we can provide a forum for nurses and nursing organizations to influence standards of care and clinical guidelines, and promote implementation of health policies and actions aimed at improving global patient care.

This session will discuss professional nursing advocacy and related implications for delegates.  Essential advocacy skills will be presented.  Through global connections and shared experiences, perianaesthesia nurses can advocate for our practice, improve patient care delivery and advance the profession.

Susan Fossum, BSN, RN, CPAN

President, ICPAN; University of California Medical Center, Davis, CA, USA.

Susan has been a staff nurse for over 43 years, practicing in PACU for 35 of those years.  She has held positions of clinical nurse, assistant nurse manager, and clinical educator for OR and PACU.  She currently travels worldwide with teams of plastic surgeons providing free reconstructive surgery for children, practices as an ACLS and CPR, and teaches CPR/First Aid in the community.  Susan is a past president of the American Society of PeriAnesthesia Nurses and currently is the president of ICPAN.  She has conducted and published clinical nursing research and has currently co-authored a chapter in Global Reconstructive Surgery titled Perioperative Management: PACU Requirements and Set-up.