Pre-op flow

brownbook · Jun 21, 2018

I have mainly worked pre op in out patient surgery. We do a few healthy stable minor peds cases.

We can be very busy, but are usually well staffed.

Every pre op I've worked in the pre admission nurse, which can be an LVN, is responsible for calling the patient, or parent, or significant other a few days before surgery. She does the pre op nurse assessment paperwork. A lot of the information is confirmed upon arrival, but it really helps. Especially if something serious or unusual is discovered by the pre admission nurse.

When we have almost all the admission assessment done prior to patient arrival it saves a lot of time.

She also makes sure the PCP's H & P is in the chart, up to date, labs, EKG, etc.

If all that stuff is done prior to arrival,the admit is simple. Get vitals, witness consent, start IV.

Maybe you're already doing all this? What is your issue or problem?

Footballnut · Nov 18, 2018

There are many ways to configure pre-op flow. Some places have a provider team to see and evaluate patients about a week before surgery and optimize any health conditions that need to be addressed. All the paperwork is put in place, medication list is prepared, pre-op education is done so that patients arrive as ready as possible the day of surgery. What is left the day of surgery is a current physical assessment, implementing current orders, checking med reconciliation, orientation to the day, assessment for the day and starting an IV.

Our unit had a team made up of nurses who did the daily work that looked at each tiny step of the current flow. The team kept what worked well and made recommendations for what needed to change. We used the LEAN process with a trained facilitator. If you have access to that process at your facility I'm sure they would be happy to help. Otherwise, just break it down into pieces and look at each area. You will find some answers.