The Post-Anesthesia Care Unit (PACU) iPad Project started in May 2012 as a very small idea that grew exponentially into a massive one for a group of recovery room nurses. Their primary goal has always focused on providing safe and efficient care to their patients recovering from anesthesia, especially those patients who have undergone head and neck surgery, unable to effectively communicate their needs post-surgery. They had an idea on how they could enhance the experience of these patients. The solution came with the support of MSK Librarians, Antonio DeRosa, Sarah Jewell, and Donna Gibson.
From left to right: Michael LeTang, Antonio DeRosa, Bonnie Monson, Jane Murphy, Kristyn DiFortuna, Sarah Jewell, Stephanie Nolan, Pam Ginex, Theresa Brunner.
How do patients after surgery communicate with their nurse if they are unable to speak? Many patients are faced with this obstacle during their recovery period. In addition, nurses are often faced with difficult challenges in trying to assist patients in this state while striving to ensure a positive care environment with a focus on achieving optimal recovery times. Communication difficulty is a frequently occurring and highly worrisome issue that has been associated with psychological distress, fear, and anger among patients with temporary speechlessness during their postoperative care. Could a mobile device like an iPad help in this context?
A review of the literature provides a handful of articles where augmentative and alternative communication (AAC) tools have provided a positive impact in pre-operative and post-operative care of patients in an intensive care unit but at the time of the search, no literature could be found mentioning the iPad. AAC is an umbrella term that encompasses the communication methods used to supplement or replace speech or writing for those with impairments in the production or comprehension of spoken or written language. By introducing an AAC application via the iPad in relation to pre-operative and post-operative care of patients who are momentarily unable to speak, this resource can help to reduce stress both prior to and after surgery. Using the iPad as a communication tool in a way to facilitate verbal interaction looked promising. What resulted was the protocol “Feasibility of a Computer Tablet to Facilitate Communication in Post-operative Patients with Head and Neck Cancer.”
The PACU nurses leading this initiative, Theresa Brunner, Michael Letang, Kristyn DiFortuna, Pamela Ginex, Bonnie Monson, Jane Murphy, and Stephanie Nolan — all wanted to pursue this idea and thought of the Library as a possible partner because “…to be honest….what made us think of the Library was the class that they offered for iPads.” What they soon discovered was that Sarah and Antonio had skill sets that would contribute to a successful project implementation. Support came in the form of training staff nurses how to effectively use the iPad as well as the selected AAC app, usability testing for key terms and symbols used in the app, designing and deploying targeted surveys to determine types of questions patients would ask in a post-op situation, developing patient feedback forms to rate their overall experience with the device and crafting/maintaining training documentation for both the nurses and patients.
Moving forward, all are interested in the outcome and monitoring the value of the iPad in the PACU. The partnership that has been established between the PACU Nurses and MSK Librarians will continue to grow as the results of the protocol unfold. All are eager to have our patients continue to experience the best post-op care and the future is open for other possible collaborations in an ongoing desire to continually improve on healthcare delivery.