Meditech 6.8 and trackers

Q: I am curious as we are looking at both UDI Tracker and TrackCore. Is anyone using one of the products with Meditech 6.8?

A: We are not here at Onslow Memorial Hospital.

A: We are using TrackCore. We implemented it when we were using Magic, but now we are 6.07

A: No issues on our end. We implemented TTC in 2010 and just upgraded to the newest version with a data interface from Meditech to TTC. That was a tricky interface, but all in all it went great! I have no issues with TTC and their staff. They have always been good to us!

Discharging with a Taxi

Q: Is it acceptable to allow a patient who has received general anesthesia to be discharged with a taxi as their means of transportation to home?

A: We only allow if they have a responsible party accompanying them in the taxi.

A: Only if they have a responsible adult with them, in addition to the taxi driver.

A: Not without a responsible adult, according to The Joint Commission. It has been a challenge for the last several years for us as doctors want to be able to do it. Get your underwriters to comment on it and a copy of The Joint Commission regulations to show the folks who think it is OK.

A: Although it is not ideal, we have discharged patients home in a taxi but require a surgeon order in writing.

A: I think that could get you in trouble.

A: I assume you mean alone in a taxi. If so, then no that would not be acceptable in my opinion. Post general anesthesia discharge would require someone to take responsibility for being with the patient for the first 24hours after same day surgery. Of course the patient and the designated care provider can go home in a taxi but the patient should not be discharged alone. In the past, we usually insured that prior to surgery. If they showed up alone we would make sure that someone was picking them up and going to stay with them. On several occasions we cancelled surgery for this reason and if we could not cancel surgery then we admitted them overnight.

A: No.

Surgical Smoke

Q: What does your facility do to protect patients and staff from surgical smoke?

A: AORN will release “Guideline for Surgical Smoke Safety” in January. It will provide facilities with evidence on the toxicity of surgical smoke and recommendations on how to reduce and eliminate exposure. One gram of surgical smoke is equivalent to smoking six unfiltered cigarettes in 15 minutes. If anyone is interested to learn more, you can go to www.aorn.org/goclear to sign up for information on how to start a smoke safety program in your facility.

A: When I was working in the OR, and later as the clinical manager of several ORs, I had chronic sinus infections which my doctor told me was due to some sort of environmental exposure which I thought was the surgical smoke. Other nurses were experiencing flu-like symptoms – stuffy heads, scratchy eyes, low energy – and they wanted to avoid the electro-surgery cases as much as possible. At AORN, we’re very interested to know what your experience is – are the smoke removal devices being used consistently? Is their use determined by the surgeon, or the facility?

A: It’s not required, but we are just moving to smoke removal electrosurgical pencils so any case using electrocautery will also remove surgical smoke. Not all surgeons are happy, but it’s for staff health as well as for patients who are exposed (many of our plastic cases are done under MAC without supplemental oxygen).