Turnover times... - page 2
Hey guys, How long is turnover time where you all work, and do you have trouble meeting it? Our director has told us that turnover is expected to be 15-20 min. Turnover meaning from the time... Read More
Jun 7, '05Quote from nurselily3Does anesthesia in your institution transport the patient to PACU and give report? Just curious...our turnover times are approx 30 min, and sometimes they are waiting on us (anesthesia) but that is only because I took the patient to PACU, gave report, made sure patient was stable before I left, and set up machine for next case....or wait on anesthesia to get their **** together....I'm sure it would be a heck of a lot faster.
Jun 7, '05Quote from hearticu[font=book antiqua]does anesthesia in your institution transport the patient to pacu and give report? just curious...our turnover times are approx 30 min, and sometimes they are waiting on us (anesthesia) but that is only because i took the patient to pacu, gave report, made sure patient was stable before i left, and set up machine for next case.
at our facility, the crna or anesthesia resident take the pt to pacu or icu along with the surgical resident. the nurse rarely goes along, except to help during transport. i give a brief call to pacu about 25 minutes ahead of time.
Jun 7, '05Quote from suzanne4We worked the same way. I would go with anes. to bring pt. to CCU, transfer pt to their monitors, give report and go. By the time I returned to OR the room had been cleaned and the tech was opening. Our door-to-doors were 30 minutes at most some days we could get it down to 20, then again I have had one as long as 90 minutes because the pt. started to crash when we were rolling out. Our team still had to fill out a How we can improve sheet eventhough they knew the pt crashed(and that is what I wrote on mine.) I have to say that the heart room was always given special treatment. If two rooms called out at the same time the heart room was always cleaned first, we had all our instruments in the room so they never had to be pulled.One facility that I worked back in Michigan, had a thirty minute turn-over time and this was on an open heart team. From the time the patient crossed the thresh-hold going to the unit, until the next patient was supposed to be on the table, was 30 minutes. And it got done and can be done. But only if everyone works together.
I guess it helped that one of the surgeons was also chief of staff.
Jun 21, '05Boy o boy am I ever jelouse! I worked in a facility where I had to pre-op my surgical patients, open the case and as my scrub person stayed in the room and set up, got the patient, hooked up the patient to the monitors, did all the normal stuff circulators do, and then after transporting to PACU, went back to the room and turned it over by myself. This includes mopping, taking out the trash, getting the linens changed, changing anesthesia machine set up for the next patient. The scrub person was usually busy cleaning and sterilizing the instruments for the next cases. All of this and my turn over times were on average 20-25 mins. But talk about being exhausted at the end of the day! Pheeeewwwwww
Jul 11, '05Okay how do I address this...First, we have about a zero turnover time (we flip all of surgeons from one room to another, when he or she is closing we get their next patient in a clean room). We have no ER (the reason I say this is that, we start our day with a set amount of cases and when they are finsihed we are done!). I have worked in large county hospitals and the lack of support from ancillary people, and the shutdown that people go through around 1pm when they get off at 3pm was ridiculous. The only way that I can see that it is effective to cut down on turnover times is to have a clean room with staff ready to go. In fact, we have to slwo down a lot so that the surgeon can take a break.
Jul 24, '05When I worked in the OR the hospital administration wanted our turnover times between cases to be 15-20 minutes. This was for major surgeries. The outpatient surgery area was supposed to turnover in 7-10 minutes. Of course, there was blame at each other all over as to causes in delay of turnover times.
The result was the nurses in the Main OR came up with a data collection tool as to cause of delay in turn over time. The tool included surgery start time, stop time, surgeon's name, and procedure but no patient information . It made more paperwork for the circulating nurse but eventually helped identify the problem areas. Some of the choices were surgeon, anesthesia, instruments not available/ready (we did a lot of flashing of instruments), patient, prior case ran over, and delayed from pre-admitting. The form started in pre-admiting so they could document if the patient was late to the hospital.
All the doctors were aware these forms were being used. They were still being used when I left the OR. Before I left the OR manager began giving incentives to those who, one circulating nurse and one scrub tech/nurse per month, had the best average turnover time. At the very least, the manager has something to go to administration with when they complain about turnover being too slow.
One of the good things that came from this was they were considering down sizing non-licensed staff. The OR manager was able to show the difference in turnover times when a non-licensed staff was off for a week of vacation and not replaced to "normal staffing days". This resulted in no loss of non-licensed staff and now they replace them even using overtime staff. After this study, they tried to have two floating nurses to help turn rooms over and relieve staff for breaks and lunches.
Quote from nurselily3I have been so upset lately about our turnover times and the possibility that they are going to make the RN's mop the floors between cases I did a little research yesterday. We were told in our weekly staff meeting that our AVERAGE turnover time was 38 minutes. That it ususally took 12 for the nursing/scrub staff, 5 for housekeeping (which they are getting rid of) and 9 for Anesthesia. We are still having problems getting the docs to update their H and P's and make sure the consent is proper...answer their patients questions and all that jazz.
So, yesterday I was doing some Oral Surgery cases, Lefort 1's and Fractures. They are usually between 2 1/2 hour to 4 hour cases depending on the difficulty. I had all my stuff ready and my scrub nurse and I were ready in the designated 12 minutes. That was from first patient out, to second case ready to come back....and it still took anesthesia 40 minutes to get ready!!!! But clearly, the problem lies with the room staff. Ok, just had to vent about that.
I agree...you have to have everyone on board with a common goal. THE PATIENT! Sometimes getting anesthesia to do that is like pulling teeth!