Anesthesia Record

Q: In an attempt to lessen the amount of writing necessary for our anesthesia providers to complete their records and also accommodate the requirement for a DOS anesthesia H&P, we are looking at changing our present anesthesia record. What is the feeling about using a checklist template? A template where the pertinent systems review and patient medical history is in the form of check-offs. Minimizes illegible handwriting. Does anyone feel that this is a problem in the event of a lawsuit? Does anyone have a record they feel accomplishes what we are trying to do that meets current Standards of Care for anesthesia? Thank you.

A: Our anesthesia group went live with electronic documentation in July of last year, and the ROS they complete in SIS is a “checklist” format. I would think the checklist format would work, considering how many checklists are being pushed in positive ways. I’d make sure there was an “other” spot with a little room for MD specific verbiage for the cases that fall out of the norm.

A: Could anyone tell me what electronic record that their Anesthesia Department is using. Our OR uses Meditech and from what I am hearing, Meditech does not work well with anesthesia providers.

A: We are still on paper

A: We are as well. But, we are redesigning our forms.

If anyone is willing to share their Anesthesia record and Anesthesia exam form, please forward to me. Would be much appreciated.

Thanks!

A: We use a Cerner product (Surginet) for OR documentation and will be moving to the Anesthesia record from Cerner.

A: Our Anesthesia group went live with Surgical Information Systems in July and they absolutely love it! It is 100% seamless with the RN documentation from PAT all the way through PACU.

Eye Wash Stations

Q: I am a medical planner and wondered if anyone could tell me where eyewash stations are located within the OR. Where have you normally seen them, if at all? Now that it has been brought to my attention, it might make good sense to have them – and by code they would need to be within nine seconds of an incident. Would it be appropriate to make them an accessory to the scrub sinks? Thanks in advance for any ideas on this.

A: Ours are in the sub-sterile rooms, which are shared by two OR rooms.

A:
We are a small OR with five rooms and two additional endoscopy rooms. We have two eyewash stations. One is in the recovery room close to all ORs and one is in the workroom between the two endoscopy procedure rooms.

A: We have two in Sterile Processing in the instrument decontamination area; two in the main OR and two in the trauma OR – one in the dirty instrument room (due to formalin) and the other near the Steris units (due to paracetic acid).

A: We have one in PACU (Post Anesthesia Care Unit) and one in ASU (Ambulatory Surgery Unit) in their central storage areas. We also have one shared by every two endoscopy suites in their decontamination areas.

A: If you decide to have them at the scrub sinks, make sure that the plumbing will be appropriate. We had put ours at the scrub sinks, but the water was prohibitively hot, and they were not safe to use. We had to remove them. Grrrrrr.

A: Absolutely. There would need to be separate plumbing with temp control. Thanks so much for responding!

A: There is actually a box (I do not know details) that you put into the plumbing that regulates the temperature so that the eyewash can be in your scrub sinks. Just be sure that you do all your checks as The Joint Commission is really following that closely.

A: Yes, it is called a mixing valve.

A: The eyewash station is located by the scrub sinks in our facility. They are seldom used, but are required.

A: We have two eye wash stations in our surgery suite. One is in the OR core and is also in close proximity to our decontam area. The second is in PACU and our pre-op is adjacent to that one. They are also stationed at opposite ends of the floor plan to be accessible for any area. Ours are ‘stand alone’ – not by scrub sinks.

A: We put them at the sinks in the sub-sterile rooms.

A: I suggest you put the eyewash in the CLEAN/DIRTY area. Most of the chemicals are used in this area – not in the OR because you can’t have a water source. Please see the eye wash station requirement from OSHA. Also, you should check with your state requirements. Several states have their own specifications.