floor to surgery

[djsroom]

We are having a problem at the hospital I work at with getting patients to surgery in a timely manner. Surgery shows up to take patient to surgery and find out patients ekg is abnormal physician signed it ,but did not sign of abnormality, no one knows if surgeon has been made aware of this. This is just one of the problems. Surgery staff blame the floor and floor staff blame surgery when the patient is ready to leave as soon as they get to the floor to take them to holding. Problems with making sure all labs are done, ekg read and chest xray on charts. Anesthesia also want surgical tubing on the patient, so you have to take the pump tubing down and change it over to what they require. Patients have pre-op visits and have all the labs, xray, and ekgs done then, but if problem with any of them we are trying to handle it the day of surgery. This like all med/surg units is very busy, admits come and patients may crash and the nurse assigned to patient still must get the patient 100% ready. Surgery is supposed to call before they come for the patient, but this does not always happen, they just show up and want to know why patient is not ready. Patient ratio is normally RN1:7-8 patients on days with 1 Lpn for the floor and 1 CNA. RN takes 2- 3 total care patients. The surgical unit is 21 patients with includes overflow from the medical unit. And some days the RN simply does not have time to admit the surgical patient and make sure everything is completed and normal.

The long and short of it is we are trying to find a better way of doing things and would appreciate any ideas or share how your facility does this. We want to stop the blame. Help

[plumrn, BSN, RN]

At our hospital pre op labs are reviewed as they are done before being placed on the chart by the nurse and any abnormals are either faxed or called to the physician. (Same with the EKG).The pre op check list is started and/or completed by the night shift.

As for the anesthesia tubing?... The can change their own tubing!!!

Most surgeries come thru Day Surgery it seems, and this is already done. Anyone on the floor for surgery has usually been there a day or two and all the pre op testing is done.

We had one physician that insisted on admitting his pts to the floor the morning of surgery @ 0600, due in surgery @ 0730 with NO preop testing done. Including having to have the EKG read by a cardiologist! Well, after a time the surgery crew got tired of waiting for us to complete everything and they kind of forced the surgeon to bring them thru DSU with all or most of the preop testing done.