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==OR/Surgical Services==
The YKHC Surgery Department has two operating rooms, one endoscopy room, two PACU rooms, and one four-bed PreOp/PostOP room. An anesthetist is ON-CALL 24/7 for emergent/urgent cases in either the operating room or the emergency department.
Surgical Services consists of five distinct areas, each with a defined scope of service to include independently assessing patient needs and condition, monitoring patient care and safety, education and evaluation of the care provided.
===Pre and Post Operative Care Unit===
There are five pre- and post-operative beds and a Phase I and Phase II Recovery Room. This service is provided from 8 a.m. until no longer required Monday – Friday and as needed for emergencies.  


Treatments and other activities include patient assessment, pre-op teaching, education assessment, nursing history, implementation of pre and post operative physician orders, post-operative assessment, discharge teaching, verification of discharge criteria, documentation of care provided.
===[[Anesthesia Services]]===


‘’’Staff’’’


Staff in the pre and post operative Phase I and Phase II Recovery Room will be provided by Registered Nurses, CRNAs, physicians and other support staff. All RN staff, CRNAs and physicians are BLS, ACLS, and PALS certified.
===[[Dental]]===
===Post Anesthesia Care Unit (PACU)===  
The PACU is available to provide intensive, individualized post anesthesia care to all ages 24 hours a day, 7 days a week. Post-anesthesia nursing care will be provided by a registered nurse. The nurse/patient ratio will be 1:2 with variations based on individualized patient need.
‘’’Treatment and activities will include:’’’
∗ RN’s will assess the patient on admission to the unit and every 5 minutes for the first 15
minutes and every 15 minutes for the first hour, then every 30 minutes thereafter.
∗ Assess for adequate ventilation, body temperature and hemodynamic status.
∗ Follow physician orders as designated.
∗ Verify discharge criteria met
∗ Document care provided
∗ Post-anesthesia care may be provided in other areas (ED) when patient needs dictate. The same standards of care and practice will apply.
∗ Care in the PACU will be provided by registered nurses, nurse anesthetists, and physicians and assisted by support staff as needed.
===Anesthesia Services===
‘’’Scope of Care Provided’’’


All levels of anesthesia services are provided for our patient population. The clinical ages range from 2 years old to the elderly. We do not offer elective surgery to patients under two except for short procedures, i.e. myringotomies. We do not offer elective services to patients with American Society of Anesthesiologist (ASA) classification 3 or above except in emergency circumstances.


The Department of Anesthesiology provides services for elective procedures Monday - Friday, 8 a.m. – 4:30 p.m. Anesthesia services are available on-call for emergencies and emergent cases 24 hours a day, 7 days a week, including holidays.
===[[Endoscopy]]===
Diagnostic, surveillance, and screening procedures are provided for adults and adult-size teens who meet the [[YKHC Low-Risk Endoscopy Criteria]].  Therapeutic procedures require referral a higher level of care.


‘’’Mechanisms Used to Identify Patient Care Needs’’’
===[[Gynecology]]===


The Anesthetist in conjunction with the Operating Surgeon performs the patient evaluation. The ASA classification and anesthesia plan is agreed upon after review of the evaluation by the Operating Surgeon except pediatric dental where additional clearance by the Pediatricians is required.


New agents or techniques are introduced into the practice by didactic learning at a university-sponsored Anesthesia Seminar and may be reinforced with clinical training taking place at ANMC under the tutelage of the Chief of Anesthesiology or his designee. New agents and techniques are first introduced through the Surgical—Anesthesia Committee, and then approved by the Medical Staff.
===[[Obstetrics]]===


‘’’How the Unit is Staffed to Meet Patient Care Needs’’’


A Certified Registered Nurse Anesthetist (CRNA) who works under the general direction of the Chief of Surgery staffs the Department. The Anesthetist is an Independent Practitioner who also has consultative access to the Chief of Anesthesiology at ANMC.
===[[Urgent/Emergent Procedures]]===


The Anesthetist is a member of the Acting Medical Staff and is credentialed through the Medical Staff Office.
[[file:guidelines2017.pdf|page=4|850px]]
‘’’Process used for Acting on Positive or Negative Variances’’’
 
The Anesthetist is on-call 24 hours a day, 7 days a week. Arrangements have been made for this individual to be off six days each month. An Anesthetist who has been credentialed by the Medical Staff provides coverage.
 
In case of sudden unavailability of the Anesthetist, all cases would be diverted until a satisfactory replacement could be found.

Revision as of 19:19, 5 September 2019

The YKHC Surgery Department has two operating rooms, one endoscopy room, two PACU rooms, and one four-bed PreOp/PostOP room. An anesthetist is ON-CALL 24/7 for emergent/urgent cases in either the operating room or the emergency department.

Anesthesia Services

Dental

Endoscopy

Diagnostic, surveillance, and screening procedures are provided for adults and adult-size teens who meet the YKHC Low-Risk Endoscopy Criteria. Therapeutic procedures require referral a higher level of care.

Gynecology

Obstetrics

Urgent/Emergent Procedures

File:Guidelines2017.pdf

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