Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
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OSM560-April_DIGITAL_rev_Layout 1 4/8/13 11:08 AM Page 95 the proper care but, if you have the means, invest in newer models with the latest optic advancements every 7 to 10 years. Most surgeons want the very best optics available so they operate while viewing optimal detail in the eye. They also want microscopes that are easily adjusted to their preferred settings, easily and effectively focused, and with the capability to send surgical images to separate flat screens on which scrub nurses can watch the progression of cases, anticipate surgeons' next moves and have needed instruments at the ready without having to look through their own set of optics (and potentially knock the microscope out of position). Circulators are also able to track cases on the flat screens, giving them a better sense of when to open implants or call for the next patient. The more imaging technology you're able to put into an eye room, the more each member of the surgical team will be engaged in procedures. • Phaco machines. Keep your phacoemulsification machines current by either buying new models or updating your current models according to manufacturer recommendations. Our phacoemulsification machines (we have 2 for 1 room, a primary unit and a backup) are about 8 years old, but we updated the software late last year. The upgrade didn't dramatically change the machine's capabilities (it gave ours slightly more power and lets surgeons make smaller incisions, leading to better and faster healing), and came with new, more ergonomic handpieces Updating our phaco machines cost $20,000 which, to me, isn't that much to improve the machines' performances. It's also much more cost effective than investing in new units. 3. Adequate instrumentation. A single eye tray costs thousands of dollars and, because you likely host many procedures in a day, investing in enough sets to keep up with case volume is a costly proposition (we have 10 trays, and if we're able to get a planned second eye room up and running, we'll have to add 4 more.) But because efficient eye cases are built on standardized supplies and processes, having an adequate inventory of instruments so they can be sterilized between cases without resorting to immediate-use sterilization (all our eye trays are run through ultrasonic cleaning, soaked, washed and sterilized) help limit the unexpected delays that can disrupt the entire day's schedule. 4. Improved ergonomics. Ophthalmic procedures are repetitive in nature; surgeons operate in static positions during numerous back-to-back cases over several hours. We let our docs pick their own stools — some like to sit up high, some like to sit low, others prefer saddle- or bike-like seats. They're also particular about the armrests they lean on during procedures, whether they're on a stool, the bed or microscope, because they impact the positions of their hands during surgery, how they're able to maneuver and operate instruments as well as their overall comfort. My docs are very important to me and the success of the center, so they don't get much of a fight when requesting equipment that can help them perform better surgery or ease their physical strain during days packed with money-making cases. — Sandy Berreth, RN, BS, MS, CASC Ms. Berreth (sberreth@brainerdlakessc.com) is the administrator of the Brainerd Lakes Surgery Center in Baxter, Minn. A P R I L 2 013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E | 9 5