Turnover Madness and Patient Safety!!!!!

[miloisstinky]

This is an add on to my previous thread regarding a situation where the patient appeared to be OK, then i rolled her out to the hallway and she was NOT OK.

TURNOVER TURNOVER!!!! Whatever anyone says, it is VERY important in private practice, so how are you balancing patient safety with room turnover and common sense? I mean as soon as the case is done, the staff wants to move the patient to the stretcher, forget the case took 3 hours, and expect you to extubate and exit in 5 minutes (or less!!!), so i know this CAN be done, but what are your thoughts and how do YOU do it safely????

Thanks in advance everyone.

[ebear, BSN, RN]

Milo,

I don't care who's pushing you to turn the room over! Make certain the pt. is stable and able to respond to simple commands before moving to PACU. It is ultimately your rear end in the slinger if complications occur. This is a problem in most OR's where I've worked. "Time is money" sometimes results in the patient paying. This breakneck speed needs to stop. IMHO, it is a real safety issue!

ebear

[versatile_kat]

I work in a private practice hospital and have really gotten adept at extubation with the dressing being put on. Once the stitches start going in, I reverse them (if needed), get them back breathing, titrate in any additional narcotics and get all my ducks in a row for extubation (face mask nearby, suction, oral airway, cannula, etc.).

I extubate deep 95% of the time, so there's no worry about them bucking. I do this for almost all of my cases - from AAA's to LumLam's to Crani's. This way, once they're bringing the bed in, it's been about 5-7 minutes and the patient's regained their reflexes (enough to move them onto the stretcher and roll them out the door without real worry of a spasm).

You can't be perfect 100% of the time ... your staff should be a little more tolerant of your needs at the end of the case. It'll get better as time goes on. How long have you been at this facility?