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Laparoscopic surgery in traditional operating rooms
requires lots of machinery that must be brought in on
carts or towers and plugged into wall sockets, said
Robert Rege, MD, professor and chairman of the department
of surgery at the University of Texas Southwestern Medical
Center at Dallas. “They had nurses running all
over the place from one cart to another.”
But the newest rooms have put much of the equipment
onto booms that hang from the ceilings. “The first
ones were quite bulky and took up a lot of space in
the room,” Rege said. The latest ones have flat
screens rather than bulky TV monitors and the booms
tuck away. Physicians and nurses can use voice- or touch-panel-activated
controls to turn on a light source or activate a camera.
They can pull up X-rays and put them on a screen or
send requests to the blood bank by computer. In some
places, they consult with colleagues in other parts
of the hospital or in offices.
“What they’ve done is to take technology
that is already pretty good,” Rege said, and integrate
it so it works together.
Nurses who use the integrated operating rooms say the
new technology makes procedures easier and safer for
patients, reducing the amount of time they are under
anesthesia and the chance for error.
“The Endosuite has given us more flexibility
to help patients in a minimally invasive way,”
said Jill Mortenson, RN, CNOR, a general surgery and
plastic reconstruction resource nurse at Abbott Northwestern
Hospital in Minneapolis. “It does anybody good
to see a patient heal from a major operation and be
back to work in a week.”
Efficient systems
Perioperative nurses say the latest OR technology also
does something most technology does not do: It saves
time.
When Jane Foshay, RN, CNOR, a staff nurse in charge
of orthopedics at Kalispell (Mont.) Regional Medical
Center, first saw the new Endosuite at her hospital,
her first thought was, “Wow, this is great!”
And then, “How much work is this going to be?”
At first, she thought the system seemed slow. But after
getting to know and trust it, she sees a definite advantage.
Nurses no longer have to hold lights or work foot pedals,
she said. They can set up an operating room in five
minutes instead of 20. They don’t have to move
heavy equipment in and out of rooms or risk damaging
the equipment by bumping it. The neat, tidy room—with
nothing on the floor, nothing to get wet, no cords to
trip over or equipment to move—is a perioperative
nurse’s dream.
In the past, said Christine Pizzulli, RN, assistant
director for clinical operations for the main operating
room at the UCLA Medical Center, nurses had to run in
and out of operating rooms to get supplies, go to the
blood bank, take out specimens.
“The biggest thing for the nurses is that they
don’t like to leave the room,” she said.
“They really feel that’s important.”
With the new systems, nurses can place their orders
by computer. Supplies are brought in on carts and nurses
have more time to assess and open supplies as needed.
The efficiency of the new technology leaves nurses
more time to spend with their patients and coordinate
the surgical team. Mortenson estimates she spends at
least 10 extra minutes talking to her patients before
surgery about what will happen during and after the
procedure—time she otherwise would have spent
helping set up the room. Forshay, a scrub nurse, said
she feels less stress when she knows her circulator
won’t be leaving the room to get supplies or equipment.
During surgery, nurses have more time to mentor colleagues,
complete documentation, watch the positioning of the
patient, assist with anesthesia, keep track of instruments,
maintain sterility and watch the procedure on their
own monitors.
“I feel more fully integrated with what’s
going on,” said Aletta Harres, RN, specialty coordinator
for pediatric/adult, general, laparoscopy and robotics
at Presbyterian/St. Luke’s Medical Center in Denver.
Just as physicians are drawn to hospitals with the
latest technology, nurses also seem attracted to the
new operating rooms, and some hospital managers see
the technology as a recruitment tool.
“People really like it,” said Deb Cooksey,
RN, patient care manager for general operating rooms
and minor surgery at the University of Maryland Medical
Center in Baltimore, which recently opened a new surgical
facility. “It’s really exciting to see the
amount of pride because of the technology that’s
been made available to them.”
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