title: Improved pupil dilation with medication-soaked pledget sponges.
abstract: Use of multiple preoperative drops for pupil dilation has been shown to be inexact, to delay surgery, and to cause dissatisfaction among perioperative personnel. This article reports on an evidence-based, quality improvement project to locate and appraise research on improved effectiveness and efficiency of mydriasis (ie, pupillary dilation), and the subsequent implementation of a pledget-sponge procedure for pupil dilation at one ambulatory surgery center. Project leaders used an evidence-based practice model to assess the problem, research options for improvement, define goals, and implement a pilot project to test the new dilation technique. Outcomes from the pilot project showed a reduced number of delays caused by poor pupil dilation and a decrease in procedure turnover time. The project team solicited informal feedback from preoperative nurses, which reflected increased satisfaction in preparing patients for cataract procedures. After facility administrators and surgeons accepted the procedure change, it was adopted for preoperative use for all patients undergoing cataract surgery at the ambulatory surgery center.
authors.affiliation: Carolinas Medical Center University, Charlotte, NC, USA.
authors.forename: Celeste
authors.initials: C
authors.lastname: Weddle
authors.forename: Nikki
authors.initials: N
authors.lastname: Thomas
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Dienemann
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration / Q000592:standards; D002386:Cataract / Q000451:nursing*; D002387:Cataract Extraction / Q000451:nursing*; D055317:Evidence-Based Practice / Q000379:methods* / Q000592:standards; D006801:Humans; D009184:Mydriatics / Q000008:administration & dosage*; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D013527:Perioperative Nursing / Q000379:methods* / Q000458:organization & administration / Q000592:standards; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D011300:Preoperative Care / Q000379:methods / Q000451:nursing / Q000592:standards; D015397:Program Evaluation; D011680:Pupil / Q000187:drug effects*; D011785:Quality Assurance, Health Care / Q000379:methods / Q000458:organization & administration; D015503:Surgical Sponges
chemical_list: D009184:Mydriatics; D009883:Ophthalmic Solutions
keywords: cataract; evidence-based practice model; mydriasis; pledget; pupil dilation