Cesarean Sections staffed by L&D nurses and techs

[paularnc]

I'm looking to change a practice to where the L&D RNs circulate and recover all the of the C/S patients. I'm looking to then hire OB techs to scrub. Does anyone have the following:

1. Standards of care

2. Required education

3. Costs ratios for L&D staff vs. OR staff to perform

4. Other written info I may need to prepare business plan

Thank you very much

[twentytenRN]

I used to be an OB tech, may be able to help you answer questions from that point of view.

[FLAlleycat]

How large is your hospital? I work in a community hospital that does about 125 deliveries/month. We have two OR rooms on our Women's Unit where we perform scheduled and emergency sections. The L&D nurse circulates. We have OB techs that scrub; however, we also have several L&D nurses who scrub. If a labor nurse is scrubbing, she will turn care of her pt over to another RN until she is out of OR. The circulating RN is the same RN the pt had throughout labor or is assigned a scheduled section and then picks up a labor pt after surgery. Unless your hospital is quite large, I can't imagine staffing an OR 24/7 in case of emergency section at 2am. L&D nurses are already at the hospital on the job. Our hospital's OR team could not possibly respond within 30 minutes in the middle of the night. If we have OB tech on duty, she has other responsibilities such as stocking labor/triage/PACU rooms, assisting in deliveries, cleaning triage rooms, etc., so she is not just gathering dust if there are no sections.

The main hospital for the community hospital does about 10,000 births/year. When I work down there at night and have a pt that needs to be sectioned, I transfer her to our OR area which is staffed round the clock for sections.

Perhaps you could meet with or call L&D nurse managers of a few hospitals your size and get some answers.

Alley

[NurseNora, BSN, RN]

Check with the OR and PACU to find the AORN and ASPAN standards, or go to their websites and order a copy of their standards.

If your hospital requires PACU nurses to have ACLS, then your OB nurses recovering C/S patients will need ACLS.

My current hospital just started doing our own sections and recoveries about 6 months ago. We worked very closely with the OR and PACU. The OR staff put together a very good program for us on sterile technique for circulating nurses. They also trained all our OB techs to scrub. RNs had to circulate at least 3 sections in the OR and recover them to get checked off by the OR preceptors. The scrub techs spent a few weeks in the OR doing sections, gyn surgeries and any abdominal case to get their experience.

Here at AllNurses there are boards for OR nurses and PACU nurses, you could post some questions there too. Good luck.

[paularnc]

Thank you. I will do what you recommend. In the process of my responses to senior manaement,i need to also include financial considerations. I think those will have to come from our hospital. I believe that having our L&D staff perform the C/S, we will provide safer care.