What Goes in (The OR) Must Come Out

Abstract

The staffing of the Post Anesthesia Care Unit (PACU) is contingent upon the daily schedule of 33 operating and procedure rooms. Efficient PACU patient flow plays an integral part in managing timely operating room flow and costs. Scheduling nurses on fixed shift templates often resulted in a lack of nursing staff present to recover patients or created imbalances that did not support the patient acuity level. These disproportions led to frustration and overall dissatisfaction among the nursing staff. At this institution we use a computerized patient tracking system which allows its users to visualize all patient activity. Icons are representative of the patient’s perioperative progress. This data enables the PACU charge nurse to anticipate the need for an available PACU nurse for patient recovery. Utilizing monthly patient flow graphs that depict the number of patients in the PACU and the time of day allows us to create a cost-effective nursing schedule to provide adequate staffing at the appropriate times in order to ensure patient safety. This analysis revealed that we had been staffing an insufficient number of nurses to accommodate the needs of the operating rooms at specific points of the day and an overabundance of staff at slower periods of the day. The data also demonstrated that our practice of staffing the same number of nurses each day of the week was not meeting the needs of the unit.