Ambulatory Surgery AND Circulator Nurse

(1) Background: The surgical table within a typical ambulatory surgery operating room is frequently rotated and placed in different orientations to facilitate surgery or in response to surgeon preferences. However, different surgical table orientations can impact access to different work zones, areas and equipment in the OR, potentially impacting workflow of surgical team members and creating patient safety risks; (2) Methods: This quantitative observational study used a convenience sample of 38 video recordings of the intraoperative phase of pediatric outpatient surgeries to study the impacts of surgical table orientation on flow disruptions (FDs), number of contacts between team members and distance traveled; (3) Results: This study found that the orientation of the surgical table significantly influenced staff workflow and movement in the OR with an angled surgical table orientation being least disruptive to surgical work...

BACKGROUND: Hip fractures are common in the elderly and are likely to become more prevalent as the US population ages. Early functional status is an indicator of longer term outcome, yet in-hospital predictors of functional recovery, particularly time of surgery and composition of support staff, after hip fracture surgery have not been well studied. METHODS: Ninety-nine consecutive patients underwent hip fracture surgery by a single surgeon between 2009 and 2013...

OBJECTIVE: To analyse ambulatory movements and team dynamics during robot-assisted surgery (RAS), and to investigate whether congestion of the physical space associated with robotic technology led to workflow challenges or predisposed to errors and adverse events. METHODS: With institutional review board approval, we retrospectively reviewed 10 recorded robot-assisted radical prostatectomies in a single operating room (OR). The OR was divided into eight zones, and all movements were tracked and described in terms of start and end zones, duration, personnel and purpose...

PURPOSE: The aim of this study was to examine the differences in primary anterior cruciate ligament reconstruction (ACLR) surgical time and operation room (OR) work efficiency between inpatient and ambulatory facilities within the same institution. METHODS: Patients studied included those who underwent primary ACLR at either the inpatient hospital or the ambulatory facility by a single orthopaedic surgeon on elective surgery days. Time variables were calculated for ACLR to compare the 2 facilities...

OBJECTIVE: We sought to identify factors contributing to wrong-site surgery (wrong patient, procedure, side, or part). METHODS: We examined all reports from all hospitals and ambulatory surgical centers--in a state that requires reporting of wrong-site surgery--from the initiation of the reporting requirement in June 2004 through December 2006. RESULTS: Over 30 months, there were 427 reports of near misses (253) or surgical interventions started (174) involving the wrong patient (34), wrong procedure (39), wrong side (298), and/or wrong part (60); 83 patients had incorrect procedures done to completion...

Developed atrophic ulcer and infected alterations of the foot, as a result of complications of DM, according to the available literature, 40-80% of the performed amputations are not necessary even though in practice they do occur. In our practice even the severely altered and infected extremities which look serious are considered as primarily a savable extremity if the conditions are present. The state of circulation of the extremity and the condition of the limb are evaluated carefully, and the sugar level is monitored continuously...

1. As the number of Ambulatory Surgery Centers increases and the Medicare reimbursements for surgeon first assistants decline, the need for non-physician first assistants grows. 2. Qualifications for a first assistant include knowledge, skill, and devotion to this specialty. 3. The first assistant is part of a medical team that consists of the surgeon, the first assistant, the scrub nurse or technician, and the circulating nurse. 4. The role of the first assistant helps to increase efficiency in the operating room and enhance the quality of patient care...

1. As the number of Ambulatory Surgery Centers increases and the Medicare reimbursements for surgeon first assistants decline, the need for non-physician first assistants grows. 2. Qualifications for a first assistant include knowledge skill, and devotion to this speciality. 3. The first assistant is part of a medical team that consists of the surgeon, the first assistant, the scrub nurse or technician, and the circulating nurse. 4. The role of the first assistant helps to increase efficiency in the operating room and enhance the quality of patient care...

Because of technological innovations and changes in the methods of health care delivery in the ambulatory setting, a new role for the perioperative nurse has emerged, that of monitoring patients who receive intravenous (IV)-conscious sedation during surgery and other invasive procedures. This article describes how to develop a competency-based education program for an ambulatory surgery center advocating the role of both a circulating nurse and monitoring nurse for the care of patients receiving IV-conscious sedation...