I work in a 4 bed surgical eye dept. in a hospital. We do all surg procedures except Lasik. We use the wonderful parallel process for turning over. We're told at the end of case the circ and crna take pt to recov. On the way back the circ checks next pt then goes back to room alone. Couple minutes later after giving report crna walks back, stops to check pt and brings the pt. The scrub at end of case takes dirty instr to case cart, goes to sink to scrub and then right back into room while others clean and open for next case, (so they say).
We went from however long (for years) to 15 minutes (for 2 weeks) to 10 minutes (this week) max turnover alowed "pt out to pt in".
It takes the scrub less than 60 sec to pack up, rub with Avaguard and walk back in. In that time we're suposed to wipe the table, empty trash, mop and open next case. We have the next case outside the door, an attendant and one RN to turnover and a charge nurse breathing down our necks to speed up turnovers. How do others do it? I don't think mopping is needed, cataracts might have a drop of blood on a Weck Cell.
Thanks for you input,
May 12, '09
Had a very good discussion on the AST.org board. Where I used to work, I scrubbed a lot of eye cases. The turnover time is about 5 minutes. The cleaning crew does not come to clean the room. The surgical team pretty much takes care of the trash and opens the next case. It's crazy. That's why many people do not like eye cases. Also mistakes can be made with meds when everyone is rushing. I never circulated any eye cases and I would hate to have the meds mixed up with the quick turnaround.
May 16, '09
It really depends on what's going on in the room that day. Where I work the scrub has to take their dirty trolley to an area and load the dirty trays in this dumb waiter type thing. Then dispose of linen, rubbish etc which takes time. The circ has to take patient out to recovery, if the recovery nurse is too busy to handover to then we have to wait for them. Then the circ and scrub comes back and cleans up the room, then bring sin new set up. Sometimes it can take 5 minutes, if we've done a big case like a liver where there is a lot of cleaning up and equipment to put away it can take up to 20 mins.
May 18, '09
For the fast surgeons we use two circulators to speed up turnover time. One circ does the case in the room while the other circ goes to see the next patient and gathers all equipment and meds needed for the next case. Circ who did the case drops off patient with CRNA while other circ stays behind to turn the room over. Our aides come right in and bag up trash and laundry and wipe down surfaces. We don't mop between cases. The patient never leaves the stretcher and there's nothing on the floor to mop. By the time the scrub drops off the dirty instruments and scrubs
with Sterilium we have the pack open and his/her gown and gloves open. We sometimes have turnovers of 3 minutes when everything goes just right. When there is only one nurse turnovers tend to be around 10 minutes since we have to stop and interview the next patient on the way back from dropping the previous one off. I circulate all services but I love the speed and efficiency of the eye room.
May 21, '09
At my facility - we do mostly PPVs, laser, cryo, and scleral buckles...we are allowed 20 minute max turnover time (although the diopter lenses take thirty minutes in the sterris)...our eye surgeons all bring a private scrub with them - so we just put an RN to circ...I personally love the "eye room" because the mood is nice, the music is usually good, and no one ever bothers you...kind of a lost and forgotten fortress of tranquility...
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