Small hospital preparing to gear up for Ortho

[RNiel]

I work in a 25 bed hospital in a rural area. We have two ORs, but only one anesthesia provider at a time (so essentially one OR). We have just learned that we are going to be getting an orthopedic surgeon with in the next month or two. We have not had ortho in over five years and only 3 of our 6 staff members have previous ortho experience. All of our power equipment is obsolete and will be replaced. Our trays are fairly well equipped (we will need an instrument or two). Can anyone share advice or give recommendations on what we should do or what you would do to prepare? Do you know of any good articles, texts, videos, or other educational tools?

This surgeon sounds to be much like the stereotypical orthopod. He stated his two pet-peeves are turn around times and not having what he wants when he wants it. We want to start out on a good foot w/ him and not have him lose confidence in us on the first day.

It sounds as though he will be doing knee scopes, total knees and hips, shoulders, rotator cuffs. He probably wont be doing much trauma as he lives over 2 hours away and will only be here once a week, so the trauma would have to be coincidentally timed w/ his arrival.

Any thoughts/advice would be appreciated.

[Argo]

Make sure your rooms have proper airflow for current standards. Airhandlers have to turn your air over 20 times per hour minimum. Be up to par on scip protocol. Do you have all positioning equipment for those cases.... beach chair, peg board, sand bags, axillary rolls, fracture table..... do you have tourniquets, hand tables, fluid management systems/pumps, casting and splinting material ...

[canesdukegirl, BSN, RN]

It would help to know what you already have, as the ortho specialty is VAST.

[Argo]

do you have all the implant trays there? is there a rep in the area for each case you plan on doing?

[canesdukegirl, BSN, RN]

If you are going to do total joints, you need to have the surgeon's preference as to which system he likes to use...DePuy, Smith and Nephew, Zimmer, Biomet, etc. There are several different pumps you can use for arthroscopy surgery, and a few are pretty user UNfriendly.

What kind of power are you upgrading to? Stryker 6? Do you have stuff for Gamma nails and stuff for ex-fixes? I am curious.

[RNiel]

Thank you Argo - I think we are on the right track. Our OR is new (two years old). When they built it they were hoping to use is as a drawing card for an orthopod, so it has the proper air exchange. It's also 900 sq ft! You gave me a lot of good advice. We have some positioning equipment, but we need to look it over and inventory it. We were able to go to "the mother house" last week and observe the provider. We got his preference cards and talked to the staff that he works with. His Stryker rep called ours and passed along a lot of helpful info as well. He will be using Smith & Nephew and we will have the same rep, which I can only imagine will be a benefit. Thank you for your thoughtful recommendations!

[RNiel]

Canes - Thank you for your reply. Yes, we are upgrading to Stryker 6 (from Command 2). I don't think we have the Gamma nails or ex-files stuff. Which pump would you recommend for arthroscopy?

[canesdukegirl, BSN, RN]

I personally like the Stryker arthroscopy pumps the best. They are user friendly. Your Stryker rep will get you the stuff for ex-fixes and Gamma nails.

[Mr. & Mrs. RN]

I would ask the reps to come and inservice you all so you know how the systems work. That's what we do when we get a new system. They hold a day where you get to work the instruments and implants on saw bones.

[Argo]

I really like the depuy FMS pumps. They are easy to use and I have never once had one fail on me. I have used them hard and put them up wet... literally(with cleaning fluid). I dont think I have ever sent one in for warranty either. They also have interfaces for pretty much any shaver system, I have used dyonics and stryker with them and they work great.... get some absorbant pads for the floor and a fluid tower(allen medical makes a good one) also.