Continued from Page 1

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.”