Stand-by Call Pay

Q: It’s the “age-old” question my friends. Do you all have exclusive pay rates for your heart team or any other exclusive call team?

A: No.

A: No we don’t have an exclusive pay rate for specialized teams. Our CVOR team has premium call rates due to the additional days of call they are responsible for because of the small staff number.

Pest Control in the OR

Q: I am wondering what other facilities are doing related to bug control in their facility. I am in a high mountain area in Colorado and usually bug control is not an issue, but I have had four separate incidents in the last month and a half where someone has found a bug in the OR. Does your facility have a company like Terminix come and spray the OR department on a scheduled basis? Would love ideas on what to do regarding this issue.

A: We are located in south central Pennsylvania. This year we have had no pest issues, but last year was awful. We contract with a pest control company. The company sprays based on health care facilities regulations. We also placed a bug light at entrances surrounding the OR, day surgery, staff entrances. (The pest control company cleans the lights on a regular basis.) We also painted a bug repellant on the frames of outside doors. This triple play approach dramatically reduced the pest issues we were experiencing.

A: We do not have them spray; however, there is a product that can be mixed with the mop water that serves the same purpose. I would contact your local exterminators for suggestions.

A: Our facility does use a pest control company but it is important to spray at the right time. Building and grounds also has to make sure there are no weeds or high grass around the foundation or all the spraying in the world will not keep them away. I think EVS does it every spring and probably as needed. We had these teeny tiny red spiders and were told they came from the roof so we have that sprayed as well. Hope this helps.

A: Do you know the name of the paint that repels bugs?

A: Yes. I am interested as well. Have not heard of that before. Also, another response stated there was a solution to add to the mop water. What is that? •

Second Surgeon for C-section

Q: Does anyone know if there is a standard that states there needs to be a second physician as the surgical assist during C-sections? We are a small rural hospital and have been having a surgeon assist during all C-sections for many years but not sure if that decision was based on evidence or just an organizational decision that was made in the past. The need for a surgeon assist is being questioned.

A: We used to have a MD assist at all C-sections. (Not all were surgeons, some were FPs). We now have nurse midwives assisting as well as a certified first assist scrub technician. A change in allied health privacy and medical staff bylaws was necessary for this to happen.

A: I don’t believe so. They do on occasion for difficult cases, multiple births, etc. We use surgical PAs, RNFA and midwives as assists.

A: We use an RN first assistant on our C-sections.

A: I have never heard of that. We always just had a circulator and two scrubs – one to pass and one to assist.

A: We use scrub personnel, not a surgeon. There is a pediatrician present for all C-sections though.

A: Curious, do you have two scrubs on call at all times? We also use scrub personnel but that requires me to have two on call. We are a small rural hospital and that causes people to take a lot of call since our staff is so small.

A: Yes, I have minimally two persons on-call at all times – usually three, and yes, this creates a lot of stand-by call for my people.