P A I N
M A N A G E M E N T
Mike Morel, CRNA, APN, MSNA, the director of
IN THE BAG Windy Hill Hospital's
circulating nurse Kathy Bigilin, RN, CNOR,
is in charge of starting antibiotic infusions.
anesthesia at 70-bed Volunteer Community
Hospital in Martin, Tenn., has enlisted a few
kindler, gentler recruits in his fight against postop pain: non-opioid IV analgesics, regional
blocks and patient-controlled analgesia for athome pain relief. The use of intravenous
EARLY STRIKE Target pain receptors
before discomfort hits.
patient-controlled analgesia (IV PCA) is a popular approach that has supplanted the
use of as-needed (PRN) intramuscular injections for the management of pain after
major surgery.
"For many of our cases, we use IV acetaminophen and toradol as the major postoperative components of our pain control," says Mr. Morel. "We've gotten very good
reports from outpatients. They're very satisfied."
Mr. Morel is amazed to read
reports of several studies indicating that 75% of post-surgical
patients complain of inadequate
pain relief. "If 75% of our
Administer
Antibiotics
On Time,
Every Time
P
re-op prophylactic antibiotics
must be administered within 60
1. Rely on the circulator
minutes of initial surgical incisions
Does this sound familiar? In the hustle and
E-mail doconnor@outpatientsurgery.net.
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SUPPLEMENT
TO
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and ready for transfer to the OR, and mak-
report that antibiotics weren't delivered on
ing sure needed paperwork is completed,
time. We've been using the program I'm
every member of our clinical team used to
about to describe for 5 years, and have
help confirm, hang and chart the appropri-
seen our monthly on-time start rates
ate antibiotic. But because so many hands
were involved in the process, the job didn't
get done properly. Pre-op nurses said they'd
start the antibiotics. Anesthesia providers
again.
rail." OSM
even 1 minute too soon will require you to
worry about improperly timed IV starts
"we'd be run out of town on a
bustle of getting patients properly identified
Follow our lead, and you'll never have to
their pain control," he says,
or procedure start times. Starting infusions
improve from less than 90% to 100%.
patients were dissatisfied with
promised they'd take care of it. Circulating
J A N U A R Y 2013 | S U P P L E M E N T
TO
O U T PAT I E N T S U R G E R Y M A G A Z I N E
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