Defense Date

7-20-2026

Graduation Date

Summer 8-7-2026

Submission Type

Dissertation/Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Doctor of Nursing Practice (DNP) Program

School

School of Nursing

Faculty Mentor

Dr. Mary Loughran

Keywords

PACU education, PACU nursing, PACU training program, and PACU residency program

Abstract

Post-anesthesia care unit (PACU) nurses are responsible for managing complex postoperative patients requiring advanced clinical judgment, airway management, hemodynamic monitoring, and rapid recognition of complications. Many nurses transition into the PACU without formal perianesthesia education, resulting in variability in orientation practices, competency validation, and preparedness for independent practice. At a military treatment facility (MTF) in Mississippi, 78% of newly assigned PACU nurses had only one to two years of medical-surgical experience, and a standardized orientation program was not available.

This quality improvement project aimed to implement and evaluate a standardized, evidence-based PACU orientation program designed to improve nurse knowledge, confidence, and competency. Guided by the Plan-Do-Study-Act (PDSA) framework, the intervention consisted of an 8-week competency-based orientation incorporating standardized learning objectives, competency validation, simulation-based learning, preceptor-guided clinical experiences, and Mosby's online educational modules.

Seven registered nurses participated in the project, with six completing the full orientation program. Outcomes were evaluated using Mosby's online knowledge assessments, the Casey-Fink Graduate Nurse Experience Survey, standardized competency checklists, and weekly preceptor evaluations. Mean knowledge assessment scores increased from 82% pre-intervention to 93% post-intervention. Casey-Fink survey results demonstrated improvements in role confidence, managing patient care, support, role satisfaction, organizational commitment, and reduced stress and burnout, while resilience scores remained unchanged. All participants who completed the program successfully achieved the required competency validation activities.

Implementation of the standardized orientation program was feasible within the MTF and contributed to improved orientation consistency, nurse preparedness, and competency development. The findings support the use of standardized, evidence-based orientation programs to strengthen specialty nurse transition and provide a sustainable framework that may be adapted for other military perianesthesia practice settings.

Language

English

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Included in

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