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Second Opinions > Who can watch post-op patients?

Who can watch post-op patients?

If a post-op knee scope patient has met all discharge criteria, can they wait for their ride in the waiting room and be watched by the receptionist?

Started by: susan berg (Other) at February 16, 2013 (11:20 am)

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Thank you, useful.

Thank you, useful

But to be frank, it doesn't tell in detail what should we do to choose a best one, agree?

I don't think it's good to buy a new hard dirve, why not change the laptop? Lol.

carrcarr10 ken (Administrator/Director/Manager/Owner/Exec. Officer) at May 12, 2013 (1:00 am)

Things to consider when shopping for the best hard disk drives
If you are shopping for the best laptop hard drive, you're going to have your work cut out for you, especially buy laptop hard drive online. Finding a reliable hard drive to purchase is not going to be as easy as 123. You may have to spend some time looking around on the Internet and doing some comparison shopping so that you can find a hard disk for sale that will satisfy your expectations and meet your needs as well, before you make a determine you can just know about the laptop hard drive cost in the field. Using a laptop means that you're going to need enough space to store your files, install your software and do everything that you want to do on the computer. There a lot of things to consider when you purchase a new hard drive for your laptop. Below, you will find with some of these things are and why it's important to shop around for hard disk drives for sale so that you can find the precise laptop hard drive that you want to buy.

1,Look for a hard disk drive that has enough space to meet your needs
Knowing how much space you need on your hard drive can be a difficult thing. Often times, people don't think they need much space but then they come to realize that they needed more than they originally thought. For instance, some people think that they just need to purchase a hard drive that is going to cover their files. For instance, if they have about 10 gigabytes of files, they may purchase just a 20 to 40 gigabyte hard drive. The problem with this is that you are not accounting for the operating system. If you plan to run an operating system like Linux or Windows on the computer, then you need to purchase a hard drive that has enough space to properly run the operating system and store your files. There are other things to keep in mind as well, for instance, what software are you going to be putting on the computer? Software can take up a lot of space on a computer, especially games and software that is very complex. These types of software titles can get up into several gigabytes of space, so you need to have a big enough hard drive to accommodate for these applications.

2,Remember that it's okay to go over what you need but it's not okay to go under
Of course, you can easily see there are so many laptop hard drive for sale online, when purchasing a hard drive, it's okay to purchase more gigabytes than you actually need, just like me, I love installing lots of games, so I bought a big sony laptop hard drive in advance. However, if you were to purchase less gigabytes than you actually need, this is not going to be okay because you won't be able to do the things that you want to do on your computer. Be sure to shoot for more disk space. Keep in mind that installing a hard drive on a laptop can be more complicated than installing a hard drive on a desktop computer. You also need to accommodate for the installation costs when you're going to have a company install this for you. Look online and do some comparison shopping so that you can find the best laptop hard drive for a price that makes sense for your budget.

Need more info about laptop hard drives or purchasing, please go harddrivestore.org


Thank you, useful.

Thank you, useful

But to be frank, it doesn't tell in detail what should we do to choose a best one, agree?

I don't think it's good to buy a new hard dirve, why not change the laptop? Lol.

carrcarr10 ken (Administrator/Director/Manager/Owner/Exec. Officer) at May 12, 2013 (0:58 am)

Once the patient meets discharge criteria, and instructions are reviewed with them and their responsible adult, they are taken via wheelchair to the car. A member of our staff MUST stay with the patient and assist them into the car. We have been advised by our legal resources, that the patient is our responsibility until they leave the facility. Whether or not the patient has been "discharged" does not release us from responsibility if the patient would fall or suffer some other adverse event while on our property.

Valerie Mills (OR Manager/Supervisor) at March 18, 2013 (11:33 am)

An Executive lounge for in a Plastics ASC for example may be the answer, but as one post stated some Administrators and Managers (including myself) do not even have an office. Space and finances are tight and an airport lounge type of room encourages non compliant behavor as all of aor patients are advised thaeir 'responsible adult' must be available at all times when they are in our center. We do not have the space for patients 'on the runway and ready for departure'!!

Sue L. (OR Manager/Supervisor) at March 18, 2013 (10:37 am)

This is in response to Maria Todd's post, which states, "What's to say you couldn't have an Executive style lounge staffed by a nurse that is similar to the airline VIP clubs, with Bose headsets and music, internet, flat screen, recliners, beverages, lite snacks etc., books, magazines, and so forth. This moves them out of PACU and into a post-PACU setting and frees up the beds for incoming PACUs coming off the table."

Really? Perhaps if we were being paid HOPD rates, this idea would work. I know ASC Administrators who don't even have offices, let alone an "executive lounge staffed by an RN". Extra space at a well run facility will be:
a) revenue generating....or
b)outfitted to meet a regulatory requirement...or
c) will address some gross inadequacy that hinders operational efficiency (ie. lack of storage).
What's really going on here?
The question isn't about your discharge criteria, it's about what you do when the patient's rides are not present to take the patients home after they have met your discharge criteria. We are always looking for ways to prevent this from happening, NOT ways to accomodate it by outfitting a lounge.
We require all responsible parties to sign-in with the patient at the time of registration. If they're not going to wait at the facility we make certain that we'll be able to reach them and they'll be able to reach the facility within 15 minutes when they are contacted from the PACU staff. If it's a different person picking the patient up, we get in contact with them BEFORE the patient is admitted to pre-op. The process of educating the patients regarding the surgery center's day-of-surgery requirements starts with the MD's offices and continues during pre-operative calls from the facility.
We're not successfull 100% of the time, but we're close. I don't know what the perfect solution is for my facility or for anyone else's, BUT I do know that accomodating non-compliance from patients in a manner that increases staffing expenses, uses precious (and often non-existent) space, and increases the Center's liability by keeping patients longer than required is NOT the answer and given the current reimbursement climate, it's not even realistic.

Amanda G. (Administrator/Director/Manager/Owner/Exec. Officer) at February 19, 2013 (8:39 pm)

Our post-op patient are monitored in the PACU until discharge criteria is met, discharge instructions reviewed with the patient and their responsible adult. Then the patient is escorted to the car by wheelchair.

Trudy Zeiler, R.N. Nurse Administrator

Gertrude Zeiler (Director, Surgical Services/Director of Nursing) at February 19, 2013 (8:33 pm)

Our policy is to keep any patient that has received any sedation or anesthesia in our Ambulatory Surgery Dept. until they have met our discharge criteria, discharge instructions are reviewed with patient and whomever is responsible for the patient at time of discharge and then they are escorted by wheelchair to the car. Local cases may be discharged ambulatory within 30 minutes after their procedure.

Janice batt (Other) at February 19, 2013 (6:42 pm)

How responsible are we? If we determine that the patient is "discharge-able" then why would we need an additional licensed individual to watch them? If that level of care is needed then they are not ready for discharge. I think a waiting room, staffed with someone would be fine.

Robin Fredericks (Director, Surgical Services/Director of Nursing) at February 19, 2013 (6:12 pm)

"Meeting discharge criteria" is not the same as "discharged". A discharged patient may wait elsewhere in the facility, while a patient "meeting discharge criteria" but not yet discharged must be monitored according to state regulations and facility by-laws and standards. Put another way, "discharged" does not meal "has left the building". This discussion revolves around appropriate use of the terminology, and the answer is not uniform across the USA.

Carl Noback (Medical Director/Chief Surgeon) at February 19, 2013 (5:31 pm)

You need to check your state regulations. Here is a direct quote from the Florida regs governing ASC's:
reg. 59A-5.0085(3)(d), F.A.C.
" A registered professional nurse shall be present in the recovery area at all times when a patient is present."
After the procedure physician and the anesthesiologist have signed off on discharge we have our patients sit in lounge chairs in our post-op area where there is always at least one R.N.
If their ride is not in the building they wait there until such time as they arrive.
Ann Brody CASC

Ann Brody, CASC (Administrator/Director/Manager/Owner/Exec. Officer) at February 19, 2013 (4:33 pm)

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