Anticipation of appropriate staffing levels in the operating room is key to the safe, effective and efficient utilization of the operating room. Hospital policy and legal standards set by the governing committees provide the minimum guidelines for staffing.
For our model, we will use a six room operating room in a community hospital with a moderately busy, Trauma Level II emergency room. In most jurisdictions in the United States, a Registered nurse must be present during surgery. So if all six rooms are booked with surgeries, a minimum of six RN’s should be scheduled. Allowing for breaks for rest and lunch, another RN should be scheduled, this one called a Floater in some institutions, a Facilitator in others.
Paraprofessional staff includes Operating room technicians, also utilizing Licensed Practical Nurses in this role, which is known as the scrub person. At least one scrub person per room plus an extra should be scheduled.
Additional staff may be needed if complicated surgeries requiring more than one scrub person are booked. For instance, if a camera is being used, a scrub person may be used to hold the camera. Specially trained nurses run equipment such as lasers, while the nurse assigned to the room takes care of the regular tasks.
In some institutions, the ‘floaters’ are also responsible for organizing the instrumentation and supplies that will be used during each case. This important task can save valuable time between cases. Everything that is needed in the room is prepared and gathered together.
Environmental workers such as maintence and housekeeping are essential to the smooth turn over of cases. Ideally, two cleaning persons should be available to clean as soon as a case is finished. If the clean up is delayed, the turn over of cases and ultimately the transition of cases is slowed down which can increase costs due to overtime.
A well run Operating Room has, at its core, an adequate staff.
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