The purpose of this project was to determine the effectiveness of an advanced practice nurse-led preoperative telephone assessment in reducing day-of-surgery cancellations of patients at an ambulatory surgery center. We concluded that a good history obtained by a trained and experienced advanced practice nurse or registered nurse can reduce day-of-surgery cancellations. Patients who were identified at high risk for preoperative complications during the telephone assessment were referred to the preoperative evaluation clinic for further evaluation.

Individual, organisational and environmental factors play an significant role in developing and promoting research utilisation among nurses. Building a strong research foundation is important for the future of nursing profession. Research utilisation among newly graduated registered nurses has been reportedly to be low in previous population-based longitudinal studies. Historically, nurses find it difficult to understand the value of a nursing research in the course of their clinical practice therefore a more creative and interactive strategies (experiential learning) are needed to make research relevant to clinical practice. This article describes the efforts of a large teaching hospital in Singapore in promoting and building research competence among nurses in the clinical care setting. An immersion program similar to a research internship offers an in-depth and experiential learning experience. It allows students to learn a new knowledge and skills by being completely immersed and engaged in the prescribed activity. The goal of the immersion program is to develop research skills through active participation in the research process and to develop novice nurses' ability to implement and evaluate evidence-based project that aimed to improve treatment outcomes of patients. An immersion program such as the one described in this article provides a strategy to promote a culture of evidence-based practice. The experiential knowledge gained through this type of program may advance the nursing profession.

Background: Obesity commonly affects postsurgical pulmonary outcomes and is associated with increased oxygen usage, length of recovery and hospital stay, discharge to high levels of care, cost, morbidity, and mortality. Local Problem: No standardized pulmonary care bundle for obese patients after bariatric surgery was available in the postanesthesia care unit (PACU) at a hospital in Singapore. Methods: This quality improvement project was a prospective, single-cohort, pre- and posttest intervention design with 151 patients recruited. Interventions: Teaching and implementation of a modified nurse-led COUGH bundle was carried out on obese patients after their bariatric surgery. Results: Postbariatric surgery patients with the nurse-led COUGH bundle had significantly less consumption of oxygen in the PACU and step-down units. The PACU and hospital length of stay were also reduced. Conclusions: The modified nurse-led COUGH bundle can reduce patients' oxygen usage and hospital stay after their bariatric surgery.