2013 AANS Annual Report - page 17

Advancing and Accelerating Teamwork
in the Operating Room
Twyila Lay, NP, MS, Leads the Charge for Educating Mid-level Practitioners
uring the 2013 AANS Annual Scientific Meeting
in New Orleans, nurse practitioners (NPs)
and physician assistants (PAs) attended a
plenary session designed exclusively for mid-level
neurosurgical staff. Twyila Lay, NP, MS, co-director
of the AANS Mid-Level Practitioners course, wanted
the session — held for the first-time amid workshops
and seminars for attendings and residents — to reflect
her beliefs on the role of these team members in
the operating room. “The goal of the plenary was to
promote [patient] safety and to recognize the work that
nurse practitioners and physician assistants are doing
in the neurosurgical field,” she said.
The mid-level plenary session at the Annual Scientific
Meeting is only the AANS’ most recent foray in
lending educational support to NPs and PAs. Since
2010, the popular
From Cranial to Spine: An Overview
of Neurosurgical Topics for the Mid-Level Practitioner
course has been addressing what Lay considers a
huge need. “We started the course because we found
nothing out there to support the needs of NPs and
PAs in neurosurgery, nothing that allowed us to talk to
peers working within the same field,” Lay said, noting
that mid-level training programs are not specialty-
focused but offer general preparation instead. “[When
the course began,] we were hoping for maybe 30
attendees, but got at least 175 participants every year.
The course has even maxed out at 225, and we’ve had
to close the doors.”
Soaring interest in the course suggests what some
perceive as a cultural shift in how an NP and PA are
viewed in the OR. “There are [more than] 3,000-plus
combined NPs and PAs working in the field,” Lay says.
“There is a lot of literature demonstrating that the
use of [mid-level practitioners] on surgical services
like neurosurgery improves continuity of care and
decreases length of stays…All of those things increase
patient satisfaction.”
Lay, who works as an acute care nurse practitioner
and neurotrauma program coordinator at the
University of California, San Francisco, believes that
teamwork is at the heart of patient safety and positive
surgical outcomes. “It really takes a team to care for
patients…The goal of [the course and Annual Scientific
Meeting session] is to provide unified educational
opportunities to look at care and to be educated from a
multidisciplinary standpoint.”
Membership and involvement in the AANS is another
way that NPs and PAs can connect to their colleagues
and to the specialty. “This year, we’re doing a huge
push to encourage NPs and PAs to become members.
We’re increasing awareness, letting people know that
[the AANS] is where [they] should come,” noted Lay,
who has been active on the AANS Nursing Liaison
Education Practice committee, among others. “[We
want to show mid-level practitioners] that they are
important to the AANS. That goes a long way — just
saying ‘Yes, you belong,’ ‘Yes, you have a voice,’
and ‘Yes, you are a part of this parent organization.’
Because [in neurosurgery,] we’re a team. It’s not just
the neurosurgeons. It’s a multidisciplinary effort.”
In addition to her role as acute care nurse practitioner,
Twyila Lay earned a Bachelor of Science degree from
California State University, Long Beach, and a Master’s
of Science in Nursing degree from the University of
California, San Francisco. In addition to her work
for the AANS’ Mid-Level Practitioner courses, Lay
has served as the nursing liaison to the National
Neurotrauma Society and as a presenter at events by
the World Federation of Neurological Surgeons and
the American Association of Neuroscience Nurses.
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