FAMILY-CENTERED CARE DURING OUTPATIENT SURGERY1 FAMILY-CENTERED CARE DURING OUTPATIENT SURGERY2 This sample paper gives students an idea of how to address the content of the CAP. Please be sure to focus on the content and not the formatting. This paper has not been updated to reflect the 7th edition APA rules! See Prof. Piccinini’s side notes in the margins. Family-Centered Communication in Day Surgery Three Quality of Care key drivers for Our Lady of the Resurrection (OLR) Medical Center’s Surgical Services department are measured quarterly. The Surgical Services Department has met or exceeded targets for two of the three key drivers. However, for the past six months, the department has not met the goal for a third key driver: explanations provided about progress following surgery. Meeting the goal for the third key driver is dependent on effective communication processes from staff and surgeons to patients and their families. A communication process exists, but by looking at areas in which the process is broken, relatively easy and effective fixes can be put into place. Comment by Carina Piccinini: Topic introduction, overview of issue, choice of topic. The charge nurse for preoperative and recovery care has identified difficulty in adhering to the current process due to difficulty in locating family members if they leave the waiting room and due to the volume and acuity of patients that enter the recovery area. The nurse manager has also identified meeting the third key driver as a priority for the institution and supports the project.Comment by Carina Piccinini: Pertinence of issue to the unit and preceptor and unit manager buy-in Increasing patient satisfaction—and thereby increasing the likelihood of returning to the facility for healthcare needs—can benefit the unit and the organization by increasing revenues. The profession of nursing can also benefit by increasing staff and improving technologies for patient care with additional revenues.Comment by Carina Piccinini: Benefit to the unit/organization Literature Review of Problem Much research on factors influencing patient satisfaction in perioperative care has been conducted. A driving factor identified is communication to patients and families during care. Yellen (2003) surveyed ambulatory surgery patients to determine the influence of the nurse-sensitive variables of age, gender, culture, previous hospital admissions, nurse communication, pain, and satisfaction with pain management on overall patient satisfaction. Results showed that nurse communication was the most significant indicator of patient satisfaction, and satisfaction with pain management was the second most significant indicator. Furthermore, patients who were satisfied with nurse communication also reported satisfaction with pain management. Fry and Warren (2005) conducted a qualitative study to determine the needs of family members in the waiting room of a critical care unit. Results showed that all pa ...

1. FAMILY-CENTERED CARE DURING OUTPATIENT
SURGERY1
FAMILY-CENTERED CARE DURING OUTPATIENT
SURGERY2
This sample paper gives students an idea of how to address the
content of the CAP. Please be sure to focus on the content and
not the formatting. This paper has not been updated to reflect
the 7th edition APA rules! See Prof. Piccinini’s side notes in
the margins.
Family-Centered Communication in Day Surgery
Three Quality of Care key drivers for Our Lady of the
Resurrection (OLR) Medical Center’s Surgical Services
department are measured quarterly. The Surgical Services
Department has met or exceeded targets for two of the three key
drivers. However, for the past six months, the department has
not met the goal for a third key driver: explanations pr ovided
about progress following surgery. Meeting the goal for the third
key driver is dependent on effective communication processes
from staff and surgeons to patients and their families. A
communication process exists, but by looking at areas in which
the process is broken, relatively easy and effective fixes can be
put into place. Comment by Carina Piccinini: Topic
introduction, overview of issue, choice of topic.
The charge nurse for preoperative and recovery care has
identified difficulty in adhering to the current process due to
difficulty in locating family members if they leave the waiting
room and due to the volume and acuity of patients that enter the
recovery area. The nurse manager has also identified meeting

2. the third key driver as a priority for the institution and supports
the project.Comment by Carina Piccinini: Pertinence of issue to
the unit and preceptor and unit manager buy-in
Increasing patient satisfaction—and thereby increasing the
likelihood of returning to the facility for healthcare needs—can
benefit the unit and the organization by increasing revenues.
The profession of nursing can also benefit by increasing staff
and improving technologies for patient care with additional
revenues.Comment by Carina Piccinini: Benefit to the
unit/organization
Literature Review of Problem
Much research on factors influencing patient satisfaction in
perioperative care has been conducted. A driving factor
identified is communication to patients and families during
care.
Yellen (2003) surveyed ambulatory surgery patients to
determine the influence of the nurse-sensitive variables of age,
gender, culture, previous hospital admissions, nurse
communication, pain, and satisfaction with pain management on
overall patient satisfaction. Results showed that nurse
communication was the most significant indicator of patient
satisfaction, and satisfaction with pain management was the
second most significant indicator. Furthermore, patients who
were satisfied with nurse communication also reported
satisfaction with pain management.
Fry and Warren (2005) conducted a qualitative study to
determine the needs of family members in the waiting room of a
critical care unit. Results showed that all participants sought
some information about the patient’s outcomes during the stay.
In addition, an element of trust was essential to a family
member’s sense of well-being, especially with nurses. The
study concluded that an environment that supports a nurse’s
interaction with patients and families enhances trust.
Conversely, a lack of information or trust of nurses can reduce a
sense of well-being and, ultimately, patient satisfaction.
Literature Review of

3. Solution
Implementing a family-centered communication process during
surgery can take many forms. The approach can be as formal as
a nurse liaison whose only job is to communicate with and to
families during surgery or as informal as periodic phone call
updates.
The Children’s Hospital of Philadelphia implemented a Family
Liaison Model that utilized current staff to communicate to
families during operative procedures with subsequent admission
to a cardiac intensive care unit (CICU). A CICU nurse was
designated family liaison during surgery. Duties included 1)
meeting the patient and family in the holding area, 2) escorting
the family to the waiting area, reviewing with the family what
they can expect, 3) obtaining updates from OR staff every 45-60
minutes, 4) relaying progress information to the families in the
waiting area, 5) admitting the child to the CICU, 6) ensuring the
family could be at bedside within 35-40 minutes post-op, and 7)
providing care until the end of shift. Patient satisfaction with
staff and nursing support increased over a two-year period.
However, 96% of nurses found time management with the
additional duties challenging (Madigan, Donaghue, &

4. Carpenter, 1999).
The University of Virginia Health System implemented phone
calls to families every two hours during surgery to provide
updates. A follow-up study on the program’s effectiveness
revealed that 95% of families who received the calls reported a
“good OR experience,” while only 84% of the families who
didn’t receive phone calls rated the experience favorably
(University of Virginia Health System, 2008).
The solution proposed for OLR will be a modified combination
of the two solutions reviewed. These modifications are
necessary because of cost limitations, OLR nurse workloads,
and OLR environmental restrictions that do not allow support
people to be with families in pre-op and recovery. Similarities
to the solution used at Children’s Hospital of Philadelphia will
be setting expectations of the patient’s family members through
a new brochure, using current nursing staff, and relaying
information in a timely manner. The primary mode of
communication to families will be through telephone contact,
similar to the solution implemented at the University of
Virginia Health System. Obtaining cell phone information from
families on a consistent basis is another significant
modification.
Implementation
The solution to the problem involves enhancing the current
process at four key communication opportunities.Comment by

5. Carina Piccinini: Description of intervention.
During outpatient registration, obtaining the family’s cell
number is inconsistent and expectations during surgery are set
verbally. The enhanced process involves developing a brochure
which informs families what to expect during the patient’s
perioperative experience, and it offers them an opportunity to
provide their contact information to the nurse in writing. The
contact information would be attached to the front of the chart.
In preoperative holding, delays sometimes take place, and the
current process does not include communication to families
about delays. The enhanced process requires the preoperative
nurse to make a phone call if delays longer than 45 minutes
occur.
If the family leaves the waiting room for any reason, surgeon
contact with the families following surgery may not take place.
With the family-provided cell phone contact information on the
front of the chart, the surgeon has the option of calling the
family to update them about the patient.
During recovery, the volume and acuity of patients sometimes
prevents recovery nurses from updating families. The enhanced
process will enable the surgical and recovery room nurses to
work collaboratively in deciding which nursing role should
complete the task for each patient.
Changes to the family communication process during the
perioperative period will start with development and approval

6. of the brochure. The roll-out schedule would be contingent on
completion of the brochure, but it should be done as soon as
possible. The unit manager and charge nurses in all phases of
care will schedule and conduct in-services about the new
process for all nurses in perioperative services. In addition, the
unit manager will document the new process and display
reminders of it prominently at the nurses’ stations and the
breakroom.Comment by Carina Piccinini: Rollout and timeline.
To measure the effectiveness of the new process, pre-
intervention, baseline data for the Quality of Care key drivers
will be compared to post-intervention data three months after
implementation. A small standing committee of nurses will
analyze data and patient comments every three months to
determine if refinements to the process are needed.Comment by
Carina Piccinini: Measurement of effectiveness.
Family-centered communication processes have been proven to
increase patient satisfaction and will improve the explanations
of progress during surgery, which is a Quality of Care key
driver. This new process allows for family mobility during
surgery while still maintaining contact with staff, which has
been a problem in the past. Enhancing current processes is
cost-effective, and it eliminates the need for retraining to
entirely new processes. Also, this process ensures that no one
nursing role is overburdened with communication
responsibilities to families.Comment by Carina Piccinini: How

7. the new process will improve the clinical issue
ECON 103 PROJECT GUIDELINES FOR STUDENTS
Introduction:
Students for ECON 103 course will conduct a project. This
project will be done individually by each student. The project
marks are 10 points. These marks will be distributed in
categories. The below rubrics will be used to grade the project.
Each student is required to read this rubric and do the project
where the marks are valid.
RUBRIC FOR EVALUATING THE PROJECT
Criteria
Points
Total points
Intellectual skills
· Inquiry and Analysis
1
10 points
· Critical thinking
1

8. · Creative thinking
1
· Written communication
1
· Data and its analysis
1
Applied Learning
1
Punctuality in submitting the project
.5
Content and Knowledge
1
Use of Research Methodology
1
Organization and format of the project

9. 1
Spelling and Grammar usage
.5
Project topics:
· Students can choose one topic from below to conduct the
project.
· Once the topics is chosen it is the responsibility of the student
to start the project, time the project and complete & submit the
project on time to the teacher
· The deadline to submit the project is 28 November 2013. late
projects submissions will not be graded by the teacher and the
project will earn a zero.
· Plagiarism within the project will be monitored and is
unacceptable and if 2 projects are similar in copy and paste than
both projects will earn a zero
TOPICS:

10. 1. Market and its impact on the business
2. Firms strategies to stay competitive in the market
3. Comparison of economic growth between any 2 countries.
4. Employment and its impact on the economic growth of the
country
5. Comparison of Industries and wealth of the economy
Project Organization:
The project is in 2 formats and each student is required to have
this format.
1. Project Report
1. Project Report
· The report should be 15 pages in total ( including cover page
and References page)
· Cover page: Student name, ID, Course name, Course Code,
Section ( if the section is not placed teacher will deduct .2
marks), Project Title, Instructor name and the be creative with
the cover page.
· Table of Content page: Place all the Title with page numbers

11. on this page
· Body of the paper: 13 pages.
· References: page 15
· Each page is to be numbered from Table of content till
References page
· The font should be only times new roman or Calibri with 12
size
· Sentences should be properly aligned with ZERO spelling and
grammar errors
Important information:
This project guideline is very clear and well explained. I highly
advice to all students to read this document very carefully and
follow the steps I have mentioned in this document to conduct a
successful project. Your hardwork and effort will always be
appreciated and graded. No Drafts will be reviewed