BARNA devised the forum ‘BARNA TALKS’ to allow discussion about key management and  clinical issues in anaesthesia and recovery practice.  The group discussions allow participants to recount their experience of the problem in the light of the evidence presented.  Conclusions are reached within the group which then feeds back to the general assembly and may be used as a basic for audit, standard setting, conference presentation or article.

BARNA Talks have focussed on :
  • Staffing the PACU [2010]
  • Paediatric Forum [2016]
  • Revalidation [2016]
    ​
Staffing the PACU
This is an intractable problem given the dynamic nature of PACU bed occupancy, patient acuity and the staffing skill mix.  BARNA worked on this management problem in 2010 as follows:
  • 2 ‘BARNA Talks’ Seminars were held in November 2009 in London, then Manchester in March 2010 at which evidence on staffing the PACU from literature was presented to participants and the topic discussed in the light of this evidence.  
  • A presentation ‘Staffing Ratios in the PACU’ was presented at the BARNA Annual Conference in Manchester : May 2010
  • An article was published in the British Journal of Anaesthetic and Recovery Nursing in 2010 as a result of the conference presentation.  The article recommended undertaking a national survey on staffing the PACU.​
  • A National Survey on Staffing was then carried out and the results written up in the British Journal of Anaesthetic and Recovery Nursing
  • An article was published in the British Journal of Anaesthetic and Recovery Nursing [2012]
​Safe Staffing in the Post Anaesthetic Care Unit : No Magic Formula : BJARN 
​Ongoing work on Staffing 

Staffing PACU has become an even more complex problem since the Covid pandemic in March 2020 for the following reasons:
  • Many NHS PACU units are now used as overflow ICU destinations disrupting the normal flow of PACU patient throughout with enormous implications for the use of PACU staff nursing extremely sick, ventilated patients.   The question must be raised as to how quickly will PACU revert to normal practice when the pandemic is, eventually controlled.   Will the PACU thereafter become the accepted area for overflow ICU patients in normal service?  How will this implicate training for PACU staff?
  • For the PACU which is still being used as a PACU – how has Covid impacted on normal staffing and delivery of services?
  • To what extent will NHS staff extreme exhaustion impact on retention of highly qualified and experienced PACU staff?
  • To what extent will the opportunity to work in Intensive Care persuade PACU nurses that they would rather continue in ICU post pandemic?

Ongoing audit of practice will be essential in the post pandemic period.  
Paediatric Management
Paediatric management in adult recovery units remains a problem.  For staff with little paediatric experience, taking a child to recover is a challenge.  While ideally children should be nursed by paediatric registered staff – this can be a problem as the number of paediatric registered, trained PACU staff is small.
To examine this area more fully,  BARNA held a Paediatric Forum [BARNA Talks] in London in January 2016.
​
The aim of the Forum was to put together a plan to develop a BARNA Forum for Paediatric Care searching for evidence from literature and empiric experience to  develop  Standards, Competencies and Teaching Materials specific to paediatric care.  

A limited audit on paediatric practice was carried out following this forum but the results inconclusive. A larger audit/ survey of paediatric practice in the PACU  needs to be developed and disseminated.
Management of current and future issues that need examination :
  • Management of Overflow Patients in PACU 
  • The Role of the Associate Nurse in the PACU 
  • Staff stress and exhaustion [Covid related]
  • Infection control [Covid related]
  • Covid : effects on staff deployment : training : job satisfaction