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美国加州戴维斯医学中心日间手术中心

  • 时间:2018年8月23日   浏览次数:1108

  

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.
日间手术中心(SDSC)由4间手术间,一个12张床位的PACU和供应中心组成。SDSC是一个专业的部门,配备了最新的技术,适用于现有的手术、麻醉、围手术期和麻醉护理。
 
 

 

                                                                                             
 
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.
手术室为门诊患者或者是符合SDSC条件的住院患者提供了一个专门的手术区域。PACU为术前和术后的患者提供专门的护理。可以在SDSC进行的外科手术包括骨科、运动、眼科、耳鼻喉科、整形外科和泌尿外科,以及一些选中的普通外科病例。手术室的日程安排由手术间数量及工作时间决定。
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.
SDSC作为医疗团队的一部分,无论种族、肤色、信仰、社会地位或者经济地位,在围手术期/麻醉期,满足所有患者的需求。这是计划和管理与相关服务相结合,为患者提供一个安全、舒适和治疗的环境。卫生保健小组各学科的合格从业人员共同合作,确保提供安全医疗服务。
 
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.
SDSC的运行时间为周一至周五0600-1900。周末及节假日休息。
 
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.
所有门诊患者由外科接待中心(SAC)评估。所有在SDSC接受治疗的患者必须符合SDSC患者选择/治疗方案中规定的标准。住院患者到SDSC手术,在转送前必须由主治麻醉医师进行评估。住院患者去SDSC之前,必须先完成手术同意书。患者ASA分级必须达到Ⅰ或者Ⅱ级。ASAⅢ级的患者必须由麻醉科主任或者主治麻醉师进行评估,不符合标准的手术将被取消。
 
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.
由管理者负责与围手术期服务主任沟通,制定从7月到6月每个会记年度的年度预算。工作人员的预算是基于患者的数量和工作时长。培训和专业休假的替换时间也包含在预算里。基本设备要求与单位预算分开审议。
 
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.
本部门员工应遵守标准预防措施,当工作人员无论何时接触到血液或含有血液的分泌物时,都应使用手套、隔离衣、口罩、护目镜等防护措施。工作人员应每年接受标准预防的培训,流行病学和感染控制小组有责任每年或者每两年进行一次感染控制检查。检查结果应记录档案,并应向管理者提出改进措施。
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.
SDSC的工作人员每周工作5天,周一至周五06:00-18:30(节假日除外),护理人员由专业人员和非专业人员组成。注册护士会一直在护理单元,运用护理程序负责指导和提供护理。PACU的护理人员为手术患者提供术前和术后护理。护士与患者的配比是1:2;会根据患者的能力和护理等级调整。所有手术患者术后会转送PACU。一旦达到出PACU的标准,麻醉医生会评估患者是否可以回家,住院患者是否可以送回病房。住院患者回病房由注册护士陪同。
 
           
 
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.
这里有最先进最全的仪器设备。术后使用的器械会先进行扫描,便于追踪,然后存放于密封车内,消毒供应中心会派人来取,每天三到四次,根据器械多少情况而定。
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.
SDSC虽然比手术室小,但是可以说是麻雀虽小,五脏俱全,一进门有工作人员通道和患者家属等候室, 为患者配置了储物柜,存放随身物品,很是体贴。SDSC也是涵盖了术前、术后,护士合理安排,根据需要随时调动。手术需要的仪器设备、技术人员等也是相当齐全。当然从预约到手术到术后,都是信息化处理,这是很先进的地方,医生、护士不需要手工书写太多,都是电脑记录,值得我们学习。
                        
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.
SDSC观摩收获不少,运作一个部门确实不容易,当然患者的安全是最重要的,我们始终是要为患者提供安全、舒适的护理。
                                                                                  (黄其静)