The Perioperative Services Department provides high-level, quality care for patients ranging from pediatric to geriatric and for elective, scheduled procedures and emergency procedures. Perioperative Services encompasses inpatient surgery, post-anesthesia care unit (PACU), outpatient surgery (OPS), outpatient diagnostics (OPD) and the GI lab.
Nursing personnel in the Perioperative Services Department include RNs, LVNs, surgical technicians, multi-care technicians and instrument technicians.Nursing duties in the department involve patient and family education, safety, medication administration, infection control, maintenance of medical record, evaluation of care, disinfection/sterilization of instruments and equipment, IV therapy, patient assessment, maintenance of skin integrity and setting up and maintaining a sterile field.
Elective surgical procedures are performed Monday through Friday between 7:30 a.m. and 11 p.m., starting with seven rooms and decreasing as the day progresses. Saturday and Sunday surgeries are performed 8:30 a.m. to 4:30 p.m. in one or two rooms, as needed. Off hours are covered by on-call staff and there is, at all times, an extra team to cover unforeseen emergencies. All perioperative areas are staffed with staggered shifts. This practice provides more staff during times when there is an increased patient load. Staffing for the areas that serve the Operating Room is adjusted so that patients will be admitted and discharged in a timely manner.
The inpatient surgery facility includes eight operating rooms, a urological room, four sub-sterile rooms located between the operating rooms, four scrub areas, equipment storage rooms, sterile supply storage area, instrument cleaning and decontamination area and instrument packaging area. There are also clean and dirty utility rooms dedicated for operating room use.
The Operating Room is staffed with a minimum of one team for each case. The team consists of an RN and a surgical technician or two RNs. One RN is assigned to all cases to function as a circulator. Acuity of particular cases may require additional staff.
Post-Anesthesia Care Unit (PACU)
The facility has 10 bays for patient care, as well as a room dedicated for pediatric patients. There is one isolation room. Utility rooms and a medication room are conveniently situated. The PACU is staffed by patient acuity, with a usual nurse-to-patient ratio of 1:2 or as acuity demands. There is a PACU nurse who may be elicited to help in the event of unanticipated emergencies. During off hours, the hospital house supervisor may be called for help. All PACU nurses are critical care trained and ACLS, BLS and PALS certified.
Some of the typical patients that PACU handles include recovery from:
- Post-operative, post-cardiac catheterization, post-lithotripsy and post-GI procedures
- Endoscopy, ERCP, as well as special procedures, including cardioversion.
Outpatient Surgery (OPS)
OPS provides services for outpatients, AM admits, pre-operative assessment, pre-operative patient prep and post-operative phase-two recovery through discharge. The Surgery Center includes areas for family waiting, admitting, radiology and pre-assessment, as well as 16 patient care cubicles, five recliner chairs and four operating rooms.
The outpatient surgery facility is connected by two restricted corridors to inpatient surgery and the post-anesthesia care unit (PACU). The layout of the outpatient surgery facility allows direct access to the patient care areas and the admitting area. Utility areas are conveniently located. A central nursing station, satellite nursing station and medicine rooms are strategically situated. There is one isolation room.
Outpatient Diagnostics (OPD)
The OPD provides pre- and post-procedure care for patients undergoing diagnostic procedures, including cardiac catheterization, lithotripsy, liver biopsy and GI procedures.
The facility consists of one room to perform esophageal manometry, one room for urodynamics, six semi-private rooms, one private room and a four-bed ward. An admitting area and family waiting room are conveniently situated. The nursing station and utility rooms are strategically situated within the facility.
The GI Lab
The GI lab provides care for patients while they are undergoing GI procedures, including upper and lower endoscopies and ERCP. The facility contains three procedure rooms, a phase-one recovery area, utility areas, one medication room and two holding rooms for inpatients.
The GI lab is staffed with a minimum of one team for each case, with an RN functioning as team leader.