Pacu Moderate Sedation Audits

Q: Does anyone know if audits for moderate sedation cases are required to be performed for CMS COP? If so, how often?

A: I do believe it is a requirement. On our last Joint Commission survey the team asked us for our policy and the audits to demonstrate that this is monitored. Per our policy, any adverse event triggers an audit. At other facilities, for every moderate sedation event a report was completed even if no adverse event occurred.

Starting IVS

Q: It is not uncommon to lose IV start skills as an OR RN. Patients going to the OR usually arrive with an IV in place. When pediatric cases are booked, an IV usually gets started in the OR, however the patient is more often than not masked down and doesn’t feel the stick. Are there any suggestions on how to help OR RNs keep up their IV start skills?

A: Ours, if they need to “refresh” their skills, go out to the pre-/post-op area and start some of their IVs. Also, anesthesia is always happy to do some in-services with the staff.

A: Consider rotating them through OPS monthly or quarterly and you could make this part of annual competency programs.

Intercom System in OR

Q: Has anyone found a way to communicate with everyone in the OR without using an intercom system? Just wondering if ASCOM phones are an option or if by going electronic soon will help reduce the need?

A: Vocera is awesome.

A: We use ASCOM phones and this has helped to diminish overhead paging

A: We used the Vocera. If set up correctly and enough Vocera’s are purchased, then it works great for the area or the whole facility. If interested, I can share the PPT that was made about it.

Transition To Electronic

Q: When transition was made from paper to electronic was the case volume limited during this time to get adjusted?

A: We double documented (paper during case and electronic in-between cases) during the testing phase for a month prior to “go live” and did not diminish case loads … by the end of the month the RNs were so happy to go to electronic documentation that it was a smooth transition.

A: We asked that elective cases be at a minimum the first day of “go live,” it de-creased stress for sure.