The Evolution of a Regional Post Anesthesia Care Course for the Obstetric Nurse

Purpose for the program:   The Central New Jersey Maternal and Child Health Consortium (CNJMCHC) is a non-profit organization, working to improve the health of women of childbearing age and infants through the collaborative efforts of member hospitals, healthcare providers, and consumers from 5 counties in New Jersey.  Approximately 10 years ago, maternal and child health directors from the member hospitals wanted a course that would afford OB nurses a standard level of competency when caring for the OB PACU patient.  This presentation discusses the evolution of the CNJMCHC Regional Post Anesthesia Care Course for the Obstetric Nurse (OB PACU Course).

Proposed change: The education provided sought to enhance the nurses’ knowledge of the standard of care required for women experiencing Cesarean birth in the immediate post-operative period.  Content includes: standards of care for patients recovering from anesthesia; anesthesia modalities, side effects and nursing implications; review of dynamic changes in pregnancy and post delivery; pharmacological agents; principles of cardio-respiratory monitoring and ECG rhythm interpretation; and communication skills. Providing a regional course was proposed to be cost effective, eliminate the need to provide a program specific to each hospital, maximize resources and ensure consistent educational experience. Furthermore, hospitals would benefit from knowing the minimal level of education most nurses possessed in the region, in light of a high turnover rate.

Implementation, outcomes and evaluation: The course utilizes peer reviewed standardized presentations and includes information from nationally recognized professional organizations, e.g. Association of Women’s Health, Obstetric and Neonatal Nurses, Association of Perioperative Registered Nurses, Malignant Hyperthermia Association of the United States, American College of Obstetrics and Gynecology, and NJ Department of Health and Senior Services Hospital Licensing Standards.  Clinical nurse specialists (APN’s) and educators, with expertise in obstetrical care and/or surgical PACUs from regional hospitals, served on the original and revision curriculum committees, as well as taught the course.  Overtime, as the curriculum was updated, test measurement strengthened, and the region began to embrace ACLS, this course evolved to be seen as an effective means to ensure that nurses working in the OB PACU practice a standard of care that is evidence-based and represents best practices.

Implications for nursing practice: Taking a regional approach to nursing education is cost effective and can facilitate the dissemination of evidence-based knowledge/best practice to a wider nursing audience, thus standardizing care that can improve outcomes.  This particular course curriculum can serve as model for other OB PACU programs.  

Keywords: post-anesthesia care unit, Obstetrical PACU course, regional course