1. DESCRIPTION OF SAME DAY SURGERY CENTER 日间手术中心简介
The Same Day Surgery Center (SDSC) is composed of 4 operating rooms, a 12-bay PACU, support spaces and offices. The SDSC is a specialized clinical setting equipped with updated technology applicable to current practices of surgery, anesthesia, perioperative and perianesthesia nursing.
The Operating Room (OR) provides a specialized area in which surgical procedures are performed on an outpatient basis, and/or for those inpatients identified in the Patient Selection/Protocol for SDSC who are returned to the inpatient setting. The Post Anesthesia Care unit (PACU) provides specialized care to the patient both preoperatively and postoperatively. Surgical procedures performed in the SDSC include Ortho, Sports, Ophthalmology, ENT, Plastics and Urology, and selected General surgery cases. OR commitment schedule defines the number of rooms to be operational at a given hour of the day.
The SDSC functions as a part of the health care team in the peri-operative/peri-anesthesia settings to meet the needs of all patients regardless of race, color, creed, social status or economic status. This is planned and administered in combination with related services to render a safe , comfortable and therapeutic environment for patients. Qualified practitioners in all disciplines of the health care team collaborate together to ensure safe delivery of care.
2. HOURS OF OPERATION工作时间
The SDSC hours of operation are 0600-1900 Monday through Friday. The SDSC is closed on weekends and holidays.
3. ADMISSIONS 入院
It is recommended that all outpatients be evaluated by Surgical Admissions Center (SAC). All patients treated in the SDSC must meet the criteria stated in our Patient Selection/Protocol for SDSC. Inpatients being transported to the SDSC for surgery must be evaluated by an attending anesthesia provider prior to transfer. Consent and orders will be completed prior to arrival of inpatient to SDSC. The patient must be an ASA Ⅰor Ⅱ. Patients who are ASA Ⅲ must be evaluated by the Anesthesia Medical Director/Attending Anesthesiologist. Case that do not meet criteria will result in cancellation.
4. BUDGET 预算
It is responsibility of the Manager, in collaboration with the Director of Perioperative Services to formulate the annual budget for each fiscal year from July through June. The staffing budget is based on the number of surgical patients and OR hours. Replacement time for training and professional leave are included in the budget process. Capital equipment requests are considered separately from the Unit budget.
5. INFECTION CONTROL 感控
Standard precautions are to be followed by employees in this department. Gloves, gowns, masks and goggles are available, and used by employees whenever contact with blood or secretions containing blood occurs. Employees receive annual training about standard precautions. Epidemiology and Infection Control shall be responsible for making Infection Control rounds in the OR biannually with the Manager of the area. These rounds shall be documented, and a request shall be sent to the Manager.
6. BLOCK SCHEDULING 手术预约
Block time will be allocated by Perioperative Services by SERVICE, not by physician.
Available block times per day are:
Monday, Wednesday, Thursday, Friday 7:30AM to 5:00PM
Tuesday 8:30AM to 5:00PM
Saturday, Sunday No cases
Open booking rooms are available
through Central Scheduling on specific days 7:30AM to 5:00PM
Open booking will be done on a 1 st come 1 st serve basis.Open booking room hours of operation are Monday and Thursday from 7:30-5:00PM. If the first case of the day is scheduled to start later than 7:30/8:30AM, then that case may ba bumped by another procedure which is available to start at 7:30/8:30AM.
预约停止时间是由围手术期服务中心决定，而不是由医生分配。每天的预约手术时段为：每星期一、三、四、五7:30AM to 5:00PM,每星期二8:30AM to 5:00PM，周末不预约。预约手术遵循先来后到的原则，预约手术间的时间是周一和周四7:30-5:00PM。当天第一台手术必须7:30/8:30开始，如果不能开始的话将会被可以准时开始的手术替换。
7. NURSING 护理
Staffing will be such to cover 5 days each week, Monday-Friday (excluding Holidays) from 06:00-18:30. The nursing staff in the OR consists of professional and non-professional staff members. RNs will be on the unit at all times and are responsible for directing and giving nursing care using the nursing process. Nursing staff in the PACU provide ongoing pre- and post-operative care to the surgical patient.Staff assignments of PACU are 1 RN per 2 patients; adjusted to patient acuity and level of care. All patients are transferred postoperatively to the PACU. Once discharge criteria has been met and patients evaluated by anesthesia all outpatients will be discharged home and all inpatients will be returned to the inpatient setting. All transports to the inpatient setting will be accompanied by an RN.
8. INSTRUMENTS 器械
There are the most advanced and completely instruments and equipment. The scrubs need to scan instruments after surgery, then saved in the cart.The SSC will come to take the cart for three to four times every day.
Although SDSC is smaller than the OR, it can be said that it is small in size, but it has all kinds of internal organs. It has staff access and waiting room in the door and it is considerate to have lockers for patients to store their belongings. The SDSC covers pre-op，post-op and the nurses are arranged reasonably and transferred at any time as required. The instruments, equipment and technicians needed for the operation are also quite complete. From appointment to surgery, there are all computer records which are worth learning, Doctors and nurses do not to write too much.
After observing SDSC, I have gained a lot. It is not easy to operate a department. Of course, the safety or patients is the most important. We should provide individualized safety comfortable nursing care to patients.