Critical Equipment Allocation and Add-On Cases

[stevierae]

Is anybody aware of any guidelines or standards--AORN, JCAHO--or even policies or recommendations from your own operating room nurse or nurse managerial experience--that address how to best allocate critical equipment in the event of add-on elective cases?

Shodobe, I know you must have one, or maybe your own OR policy that you can share. I am reviewing a case that occurred in 1995 in which a critical piece of monitoring equipment was given to an elective add-on case, and the case for which it was requested--and scheduled--went without.

Common sense would tell me that an add-on would never get priority over a scheduled case when it comes to "who gets" critical equipment, but I would like to see something in writing, if possible.

Wherever I have worked, we sent a cab to another facility, if need be, to ensure that EVERYBODY had the equipment they needed--and, if staff to run the critical equipment was an issue, we got them from whereever, even registry or by calling people at home to see if they wanted to come in --and, of course, there was always the option of rescheduling or rearranging room assignments-

Then again, I realize that not every hospital has equipment co-ordinators and/or nurses in charge of various specialty services to ensure that their case needs are met--but in that case, the responsibility would fall to "the desk" and to the OR nurse managers--there must be some general guidelines out there somewhere, in the interest of optimal patient care and safety--

Thanks, everybody!

[orrnlori, RN]

I thought your question was very interesting because I've seen it happen over and over again where I work. I checked our written polices, etc. Nothing in writing about it. Basically when a case is scheduled or added on our computer will show the case in red on the screen if there is a possible problem or conflict with general equipment. But no one seems to pay much attention to that. Our biggest problems seem to come from too many ortho cases running at the same time, not enough C arms to do them all concurrently or enough small frag sets, etc. The other problem is with laser cases. Only so many laser nurses and lasers. Still no one seems to notice or care. The docs get mad, throw fits, in the mean time patients wait in holding for excessive periods of time, or worse case, lay asleep in the OR's until something gets shaken free to complete the case.

[shodobe]

I posted a reply to stevierae and didn't put it here. We have very good and well trained unit secretaries who keep a very close eye on conflicts with equipment. We have very few problems because of them. They stay on top of things so we look good! Mike