Single-nurse patient care

Does any ASC provide primary nursing, in which a single nurse follows each patient from pre-op to the OR and then to PACU? I would appreciate any insights on this practice. Thanks!

Started by: Donna Tyer (OR Manager/Supervisor) at December 19, 2011 (3:53 pm)

Comments and Responses

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We do not do this at our hospital as the OPS staff also do OP treatment. We do not have the staffing to do it although it would be a good idea

Sheila S. (OR Manager/Supervisor) at December 23, 2011 (3:09 pm)

We do not do primary care nursing in the ASC setting. Would support many of the comments listed above in that it has been easier for us to cross train nurses to do pre/post then to include intra-op. There are so many surgical specialties that it is difficult to find a nurse who can do pre/post and OR effectively.

Tammy Woolley (Director, Surgical Services/Director of Nursing) at December 20, 2011 (1:24 pm)

It is an interesting concept that I agree patients would prefer. The issue to me is patient safety. Each area of nursing pre-op, OR and PACU require highly skilled nurses. The operating room is a very techical envoirnment and cross training to a true level of "expert" would require months and in some servcie lines years. The concept of primary nursing may be very fitting for pain intervention or cataract where the procedure is very specific and repetative. For multi-specialty centers the risk of negative patient out-comes may increase especially related to positioning and equipment.

Kristine K. (Administrator/Director/Manager/Owner/Exec. Officer) at December 20, 2011 (11:56 am)

We are a free standing ambulatory surgery center and we do primary care nursing. The RN's are cross trained to admit, perform procedures, sedate, and recover. We have tried it the other way with nurses in the pre-op, intra, and post-op but we are a small facility and it takes the same amount of staff. The patients are much happier with primary nursing, as are the nurses, and the physicians. We have performed up to 300 procedures per month, however, with the economy and all of the ASC's around we have decreased in our numbers. However, primary care nursing is still our favorite.

T. Turner (Director, Surgical Services/Director of Nursing) at December 20, 2011 (10:14 am)

We are to busy for primary nursing concept plus we do not have enough OR nurses as it is?

K. Wines (Director, Surgical Services/Director of Nursing) at December 20, 2011 (7:53 am)

We do not do primary nursing in our surgery center. We have 3 nurses in pre-op to admit 5 patients at a time....and 5-6 nurses in PACU for up to 11 patients at a time. It would take too much staff to do primary care!

Maureen A. (Director, Surgical Services/Director of Nursing) at December 19, 2011 (8:04 pm)

In very busy setting cross-training does not really work well. It is constantly changing and cross-trained person often falls behind on "one side". There are also reasons why nurses choose the area they work in and they love what they do. We try to have same PACU nurse from admission/pre op, recovery and discharge, but not OR. The time patient interacts with PACU nurse is much longer, than time of actual interaction with OR nurse. I think that recovery phasing, physical relocation from phase 1 to phase 2, change in personnel at this point has the biggest impact on patients. That's why we combine phase 1 and 2, plus same nurse, our patients feel at home...

MATTHEW L. (Director, Surgical Services/Director of Nursing) at December 19, 2011 (7:30 pm)

I would agree that it would be cost prohibitive on busy days. However, we have done Primary Care on some of our lighter days. We are cross training our staff to be able to function in both OR and Recovery.

David Nicolas (Director, Surgical Services/Director of Nursing) at December 19, 2011 (6:26 pm)

We do this. My nurses admit the outpatients, follow them into the OR, Circulate the case, follow them to the PACU then dismiss the patient. If the patient is an inpatient, the nurse visits with the patient in the room, brings them to the OR, recovers them and returns them to the floor. Patients love it,they feel more comfortable and connected to the nurse.it is safe...you don't have the hand-off from one nurse to another and the nurse knows the patient, they have read the H&P and talked to an awake patient. We are lucky our nurses like it also.

Ermel Heuer (Director, Surgical Services/Director of Nursing) at December 19, 2011 (6:23 pm)

We do not have the staff to do this in our ASC. This would require a lot of staff with the amount of patients we do.

Cheris Craig (Administrator/Director/Manager/Owner/Executive Officer) at December 19, 2011 (5:15 pm)

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