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Transport to PACU

Specializes in OR, transplants,GYN oncology.

Hi all. Looking to see what others do in their practice.

Do you accompany the anesthesiologist to transport your patient to PACU? I have always done it this way (21 years) and given a nursing report on arrival.

Now, in the interest of speeding turnovers, they have decided the circulator will call PACU 5-10 mins before the patient is ready to leave the OR. NOT to give report, but to alert them we are almost ready to leave OR. A transporter (not a nurse) will come to the OR and accompany the patient and anesthesiologist to PACU. The nurse will stay behind to help turn over the room.

Some of us are uneasy about this for safety reasons. And some just ticked off that they are prioritizing our housekeeping duties above our patient care role.

Feedback?? Thanks. Linda

CuttingEdgeRN

Specializes in ICU, Surgery.

WOW..hope my facility doesn't hear about this, LOL. We call to alert PACU we are on the way, accompany patient and anest. and give our report. Then (a lot of the times) we have to finish up our "novel length" paperwork, take specimen to path. fridge, and return unused medications to our satillite pharm.

RNOTODAY, BSN, RN

Specializes in NICU, ER, OR.

WOW.... YES, In our facility a RN MUST go with anesthesia to pacu . No exceptions.... what will a transporter do if the pt goes bad? The Rn is responsible until that pt is in the pacu. ..... How we do it is, when extubated, we call pacu, ask if we can come down, they say yes or no, if yes they give us a slot number, the Rn and anesthesia provider go to pacu, give report (anesthesia gives the lengthy one), While this is happening, the scrub is cleaning up the back table/mayo, returning dirty case cart, dropping off specimen at drop off spot, and the turn over team is coming in to turn over the room. As far as meds, we have a pyxis, so we can return at our leisure. I would personally have a big problem with what is happening at your facility.

RNOTODAY, BSN, RN

Specializes in NICU, ER, OR.

How about the "transporter" stay behind and help turn over the room?

elcue

Specializes in OR, transplants,GYN oncology.

how about the "transporter" stay behind and help turn over the room?

well, yeah! seems to make more sense to me too!

we'll see how all of this shakes out. we are inthe "trial" stage right now.

our medical director is also the anesthesia chief, and he is gung ho about this, so it remains to be seen whether the nursing staff really has any voice in all of this..

am hoping to hear more opinions, both pro and con. if anyone thinks this is a sound idea, i 'd really like to hear what they have to say

thanks for your opinions.

linda.

The anesthesia chief has no right to dicate NURSING protocol. This is in violation of some nursing rule I am sure! I don't understand why they don't have extra staff to turn over rooms(like a couple techs extra). You don't need a nursing licence to turn over a room do you?(I don't think you do)

Our anesthsia chief is a real SOB and if he tried this in our facility our CNO would have him for lunch.

Marie_LPN, RN, LPN, RN

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

Nurse goes with pt to PACU. PACU hears us page overhead when we're coming over, this also alerts the housekeepers to get ready to clean the room.

RNOTODAY, BSN, RN

Specializes in NICU, ER, OR.

We have OR assisstants, in addition to houskeeping, that do the turnovers...do you not have these?

Marie_LPN, RN, LPN, RN

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

We have OR assisstants, in addition to houskeeping, that do the turnovers...do you not have these?

Whoever's in the room does the turnovers.

I work on the PACU side of this situation.

I never get report from the circulating nurse, nor does he/she accompany on transport.

Our patients are transported by the anesthesia resident or CRNA who hands the patient off to the PACU nurse and gives report.

I too, think it's odd, inefficient, and most definitely unsafe, to use a tech to transport an unstable patient while assigning an OR RN to do clean-up chores.

Charity, RN, APRN

Specializes in PACU, PICU, ICU, Peds, Education.

Well, if your hospital wants to upset JCAHO, go right ahead...

Our nurses have always come with our patients to PACU (mostly), but since the new 2006 "hand off" safety goals, we now get two reports: one from Anesthesia, and one from Nursing. It has helped so much. Sure, most of the medical history is given by our residents, but they rarely pay attention to things like isolation status ("Oh, yeah, he has VRE. Is that important?), family location/updates, patient positioning, and location of preexisting tubes and such.

This "hand off" is even concluded with "any questions?" just as JCAHO wants. The OR nurses didn't want to HAVE to come with the patient. But our director now gives them no choice.

We have a hand off sheet that follows the patient from check in to their final destination. Info is added as the patient goes along. Report is called to PACU while sub q and skin is being closed with the hand off as a reminder. RN goes with CRNA to PACU where they have already started their paper work we then ask if they have any questions, add anything else that happened in the last few minutes and leave the CRNA to give their report. This has worked out very well for us. It seems to give us more time to be actually listening to each other rather than trying to give report while PACU is trying to assess the pt.

RNOTODAY, BSN, RN

Specializes in NICU, ER, OR.

Whoever's in the room does the turnovers.

Meaning, the circulator and the scrub nurse????:uhoh21:

elcue

Specializes in OR, transplants,GYN oncology.

Thankyou all for your input. Keep 'em coming! I intend to present all of this, pro and con, to our nursing clinical director. Linda

Marie_LPN, RN, LPN, RN

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

Meaning, the circulator and the scrub nurse????:uhoh21:

Circulator, scrub nurses, transporters, housekeepers, whoever is in the room. It's a team effort.

RNOTODAY, BSN, RN

Specializes in NICU, ER, OR.

Circulator, scrub nurses, transporters, housekeepers, whoever is in the room. It's a team effort.

oh, ok marie, I thought you were saying you had NO housekeeping or other ancillary help, etc, that it was just the surgical team in the room that did turnovers!!!! (minus surgeons of course):rolleyes:

Marie_LPN, RN, LPN, RN

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

oh, ok marie, I thought you were saying you had NO housekeeping or other ancillary help, etc, that it was just the surgical team in the room that did turnovers!!!! (minus surgeons of course):rolleyes:

We have two surgeons that will pitch in and mop the floor before they go dictate. They are also two of the most respected docs we have, since they pitch in whenever they can.

So what does the nurse-to-nurse report include? Just curious. We (meaning anesthesia) take the patient to PACU - the OR nurse doesn't go. They are usually finishing with the instruments, etc.

CuttingEdgeRN

Specializes in ICU, Surgery.

So what does the nurse-to-nurse report include? Just curious. We (meaning anesthesia) take the patient to PACU - the OR nurse doesn't go. They are usually finishing with the instruments, etc.

Depends on who your anesthesia provider was! CRNAs usually give an awesome report. Ologists mostly just silently wait on vital signs. My report is more a "nursing" inspired report while anesthesias report is "medical". They tell medications and fluid amt given, what BP and SAT parameters ran..... We (RN's) tell procedure, allergys, relevent medical Hx, urine output, drains, what family is available, any unusual pre-op situations (bruises, loose teeth, rashes...)

Marie_LPN, RN, LPN, RN

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

Our ologists give a very good report, that pretty much mirrors the circulator's.

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