Staffing....What are guidlelines / formulas for it

Specialties Gastroenterology

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Specializes in Endo, Outpt Surgery, Hospice, LTC, MH,.

When dealing with hospital based Endoscopy labs whew there are techs doing the assistance and scope cleaning, and RNs perform conscious sedation, does anyone have a formula or equation for appropriate staffing levels? Is it based on number of cases or what?

Thanks for the insight...

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edited

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We only do emergency GI procedures at nigh in our ICU. Conscious sedation needs to be 1:1. The nurse must not have any other duties until that RN has determined the patient has recovered from the sedation.

A nursing assistant and another RN are generally in the room to assist with positioning the patient, suctioning, and handing instruments to the physician.

Here is what our Board writes about conscious sedation:

http://www.rn.ca.gov/practice/pdf/npr-b-06.pdf

My favorite part is,

"...The RN has the right and obligation

to act as the client’s advocate..."

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Don't know if this is helpful because our hospital-based Endo lab uses RNs as scrubs and the Techs simply clean the scopes and stock. We have anesthesia push propofol. So each case has 2 RNs (One Scrub and one Circulator) and a CRNA per room. We do around 25-40 cases per day with 2 admit nurses, 3 post op nurses, 2 Techs, and a Charge Nurse to help admit. If it's a slow day, we'll send a couple nurses to another area to help out.

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Specializes in Med-Surg,Critical Care, Radiology,GI.

We have the same situation in La. There is an RN and tech assigned to each room. The RN handles nothing but sedation, the tech assists the MD, We have 2 RNs in recovery, 5-1 ratio for moderate sedation, we have only 5 recovery bays. Our biggest challenge is the endless paperwork heaped on us by JCAHO, documenting that we documented.

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Specializes in Endo, Outpt Surgery, Hospice, LTC, MH,.

5 recovery bays and 2 nurses with a 5:1 ratio....? If you only have 5 bays doesn't that mean you would only have one nurse?

How do you prep the patients? Is there a different area for pre-op? How many nurses work in that area?

How many procedure rooms do you have?

What is the average time it takes to discharge once the patient returns to the recovery bay?

Thanks for your insight......

We have the same situation in La. There is an RN and tech assigned to each room. The RN handles nothing but sedation, the tech assists the MD, We have 2 RNs in recovery, 5-1 ratio for moderate sedation, we have only 5 recovery bays. Our biggest challenge is the endless paperwork heaped on us by JCAHO, documenting that we documented.
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Specializes in Med-Surg,Critical Care, Radiology,GI.

Reply to WaynesvilleRN, We begin our discharge on admit, the patients are given their discharge criteria during the assessment and pre-op, that save valuable time, we also repeat verbally with family prior to d/c. The same 2 RNs work assessment, pre-op, recovery, and discharge. We have 2 procedure rooms. On admit, it takes 20 minutes to assess a patient, get a line, and apply the monitor. Discharge documentation begins in recovery, we now use fentanyl along with versed for sedation, and have found recovery times shorten, the patients leave the procedure rooms awake,alert, and comfortable. We are required to recover our patients back to VS baseline, the patient must be awake and alert, and able to assist with ADLs, and Aldrete score of 8 or above. Most of our patients are at this level when they leave the procedure rooms, so, our recovery and discharge is usually less than 30 minutes.

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Don't know if this is helpful because our hospital-based Endo lab uses RNs as scrubs and the Techs simply clean the scopes and stock. We have anesthesia push propofol. So each case has 2 RNs (One Scrub and one Circulator) and a CRNA per room. We do around 25-40 cases per day with 2 admit nurses, 3 post op nurses, 2 Techs, and a Charge Nurse to help admit. If it's a slow day, we'll send a couple nurses to another area to help out.

Am I ever glad I found this site. I work in a small rural hospital. We have a surgeon that flys in once a month for surgery cases and scopes. We too are staffed with 2 RNs and CNA in the OR for scopes and surgical cases. The two RNs turnover the room and clean the scopes - no aides or techs to help us. We have one RN maybe two IF I am lucky and one aide to admit, recover and dismiss the patients as well as check in the consult patients for the surgeon. We do 5-9 procedures during the day which may include a surgical case or two depending on the month. QUESTION?? Do you think we are short staffed?? Also, would you tell me how you would schedule your patients time wise to come in for the procedures. I have many question but thought I would begin with these two. ALL HELP IS WELCOME! / opcc

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