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Hi, Thanks for responding- I have used systems like this before in other areas of nursing myself, and I thought that using them was fine as a staff nurse. I pose this question specically to CRNA's who use it in the OR.... Thanks:)

I am an OR manager for two small hospitals, and we have a pharmacist who wants to get automated drug dispensing machines for the OR's for anesthesia drugs. I do not think this will be received well at all.....I am thinking when you need a drug FAST, having to go through the process of inputting a patient name and number to a vending machine could be a detriment-but, I see the value of this type of system as well. Does anybody use a system like this? What are your thoughts about this? Thanks for the input! Kathy

I am a manager too, and we had similar issues in the past. We are small, and our dept. is the SPD, PACU, OR, and GI lab....so, EVERYONE is responsible for performing ALL duties. When I first hired a CST here (we had always used LPN's in the scrub role in the past...) the one that was hired was of the mind set that she assists with surgery-that's it. That is what I was trained to do-if I wanted to be a housekeeper, I would have been a housekeeper, blah blah blah. She was soon on everyone's #1 hit list, and I was quickly becoming frustrated. I began making it a point to be in the rooms where she was during the work day, and assisting with the duties for awhile....processing trays, turning the room over...I did this for awhile, then we had a team discussion. I explained to them that I was not asking anyone to perform duties that I would not perform myself (hard to argue that point) . I also explained that the patient is the priority, and it is EVERYONES job to ensure high quality care *BTW - to safely move a patient , it takes ideally 4 people, and three at a minimum-at our facility this is RN circulator, CST or scrub nurse, and anesthetist). Because we are small, we will absolutely perform ALL necessary duties, or I am afraid it is OK for them to go somewhere else to work-that simple. If a CST is avialable , he/she better help move a patient, and an RN can certainly help wash down equipment and open supplies. Lack of team work would never work in our facility- Kathy

If you have to do CPR on an OR patient, perineal fallout will be the least of anyone's concerns...

Ah, I don't think that JCAHO has a standard for scrubs...if you know of this, could you please direct me to this standard?? The AORN is an excellent resource, and they do not recommend home laundered scrubs; however, many hospitals are using this practice with no increase in infection rates and feel that this is a "sacred cow". We still wear hospital issued, and I personally prefer this, but this is not a manadate everywhere. I have two OB RN's with a religeous preferance to wear scrub dresses, and I allow them WITHOUT the pants-they do wear hose, and they are not at the field. I do feel like "perineal fallout" is a sacred cow...after all, wear is the perineal fallout going to fall?? On the floor? I won't be laying my patient on the floor... :) Kathy

I have worked in about 5 different places, and there are so many different instrument types and names that it is mind boggling...I can think of 4 different names for a hemostat right off the top of my head!

Thanks for the information- Would you mind sharing what state you are in? We actually do charge a "conscious sedation" code for the RN delivering conscious sedation by the way...I am going to look into reimbursement codes now to make sure that we are doing what is proper. Would you mind sharing the CPT code # that anesthesia is using to get that reimbursement? Thanks for sharing the information- Kathy

It is the acceptable process in a surgical setting that the circulator verifies medication, strength, and expiration date WITH the CST when the CST draws up medication to the sterile field WITH the RN circulator (a licensed and unlicensed co-worker are verifying med). ALL medications and solutions are then labeled on the sterile field. The CST is sterile, and must handle the *sterile* medications on the field. The medications are administered intraoperatively by the physician. There are safe medication practices that are followed in the OR just like on a med-surg unit, but the process is not exactly the same as on a med-surg unit.

Hi, the last posting sounds alot like me and my situation:) Here is a link to an excellent way to network with other OR nurse managers-it's great! http://www.periop.org/subscribe.html Have a great day! Kathy