Outpatient Surgery Magazine - Subscribers

Melt Your Job Stress Away - January 2014 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://outpatientsurgery.uberflip.com/i/236454

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Page 72 of 142

Page 73 O U T P A T I E N T E V O L U T I O N Outpatient Evolution This is the first installment of a year-long series that will make the case for performing more procedures in outpatient surgical facilities, where more efficient care leads to significant cost savings and improved patient satisfaction. Check back next month for a look at ventral hernias. something surgical facilities can and should start to consider. My patients (and their parents) are a select group. They live within an hour-and-a-half of New York–Presbyterian Hospital, a tertiary care medical center in New York City where I operate, so they're not driving as far for care as they might in less-well-served areas. We exclude children who have medical conditions such as severe asthma, bleeding disorders, cranio-facial abnormalities and morbid obesity — anything that would place them in a high-risk population. Presby is filled with incredible pediatric anesthesiologists and nurses who understand how to maintain safe, efficient care. Nurses spend more time with surgical patients than physicians do, so having seasoned RNs who work as a team is essential to performing these cases on an outpatient basis. The recovery room staff is highly trained in monitoring pediatric adenotonsillectomy patients, having undergone in-services with anesthesiologists and otolaryngologists. An anesthesiology resident works in the PACU and is available for nurses to consult if questions or concerns arise during recovery. Plus, I'm always around and available. The kids undergo a great deal of observation by highly trained caregivers before being discharged. We assess underlying medical conditions that could raise red flags, and review surgeries to determine if they were routine or more difficult than expected. Patients have to tolerate a minimum of 6 to 8 ounces of fluid, depending on their age. Their oxygen saturation level needs to be above 95% for at least 2 to 3 hours after the administration of pain medication.

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