Doctor of nursing practice quality improvement project: Non-operating room anesthesia (NORA) process improvement for outpatient MRI at Oregon Health and Science University Public Deposited

BACKGROUND: Patients are referred to Oregon Health and Science University (OHSU) for MRI under anesthesia from a variety of care settings and geographic locations. Due to the unique nature of this service and care team, there is a gap in the existing peri-anesthesia systems at OHSU that results in patients more frequently arriving to their appointment improperly prepared to undergo general anesthesia than occurs in other non-operating room anesthesia (NORA) settings at OHSU. METHODS: A Human-Centered Design (HCD) approach will be applied to describe the current processes, identify the source(s) of miscommunication/gaps in workflow, and understand the needs of all stakeholders at various stages of this integrated care event. After system gaps are identified, recommendations will be formulated by incorporating the user needs (identified through HCD methods) with standards of care from the literature. INTERVENTION: Create evidence-based checklists and a scheduling protocol that will standardize the process of outside referrals to OHSU and patient preparation for MRI scans with anesthesia services. RESULTS: Collection of retrospective and prospective data on patients who receive anesthesia in MRI will include the presence versus absence of a current H&P, current medication list, and patient instructions in their record at the time of their appointment as well as the type of provider appointment conducted at the Perioperative Medicine Clinic. This data will de de-identified and will be IRB-exempt. CONCLUSIONS: These recommendations will be submitted for consideration to leadership in OHSU’s NORA, Perioperative Medicine Clinic (PMC), and Diagnostic Imaging (DI) Radiology departments.


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  • https://doi.org/10.6083/9k41zf25d
  • Staniels.Emma.2022.pdf
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  • 2022
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