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. AORN J 98 (August
2013) 131-143. AORN, Inc, 2013. http://dx.doi.org/10.1016/j.aorn.2013.06.005