Our team spends a lot of time in ORs with the perioperative staff. They began noticing that many nurses were conveying frustration over the amount of time they were spending dealing with admin and supply duties that kept them away from surgeons and patients. We set out to better understand what was going on. Was it just our impression or was this a real issue that has been documented in official surveys and interviews? The results of our research are summarized here.
By nature, the OR environment is always critical, urgent and unpredictable. The clinical team must be continuously focused on patient care and safety. Yes, they have been asked to take on an ever-growing number of non-clinical responsibilities that have significantly reduced the time and attention they are able to give to their patients. They deal daily with unique procedure carts, surgeon preferences, missing inventory, expired and recalled items, and scheduling uncertainty. In addition, there is constant pressure from Materials Management over inventory levels in surgical supply rooms.
Over the years, these pressures, alongside a dramatic increase in the OR case load have left OR nurses frustrated and discouraged that they are not providing the highest quality care patient care. A survey of over 300 OR clinicians found that 23% of those surveyed did not have enough time for patients and 26% reported that too much paperwork was the most stressful part of their job.
OR Nurses are Frustrated and Discouraged: Can We Help Them?
We’ve identified several pain-points that OR nurses routinely face—responsibilities that distract from patient care and may be directly traced to their frustrations, fears and ultimately burn-out.
1. Fear of Not Being Able to Protect Their Patients’ Safety
Surgical procedures may involve medical implants, narcotics, surgical kits, and medical equipment. A tight, efficient workflow ensures that only pre-checked items are cleared for use. Even one mistake can have serious consequences. Because Materials Management has limited access to operating rooms, OR nurses are responsible for weeding out recalled and expired items. TIME AWAY FROM SURGEONS AND PATIENTS.
2. Fear of Drowning in Non-Clinical Tasks
Admin and supply duties have only increased over the past decade. A recent review of published studies found that for medical providers that implemented EHRs, there was a 22-46% increase in the time spent in the documentation for both nurses and physicians. In addition, there is an on-going tension between Materials Management and the OR staff. Materials Management tends to treat supplies sent to the surgical department as consumed inventory, even though many items may remain intact on the shelves for months where they may expire or need to be recalled. The final responsibility falls on the OR nurse. A recent survey (February 2021) found that 65 of the 100 nurses questioned reported that their hospital’s system for documenting supply usage is too time consuming. TIME AWAY FROM SURGEONS AND PATIENTS.
3. Fear of Running Out
Due to the urgent, unpredictable nature of the OR environment, scrambling for items not planned for is a daily occurrence. While nurses strive to ensure that each item, in a
ll possible sizes and variations are at their fingertips, Materials Management’s goals are to lean-out the supply chain, reducing waste and duplication. One survey found that nearly 50% of OR clinicians practice hoarding which creates even more inventory management for them. TIME AWAY FROM SURGEONS AND PATIENTS.
4. Fear of Disappointing and Not Being There for the Surgeon
OR nurses are extremely dedicated, striving to provide superior patient care and to support the physician whenever needed, yet they increasingly feel the pressure to “not screw up.” OR nurses know that they need to be available to assist surgeons or answer questions, yet administrative tasks often distract them, making them unavailable for varying periods of time. Another constant fear is that surgeons may request a specific surgical tool that was not foreseen sending the nurse scrambling to find it. One survey noted that 95% of nurses surveyed cited inaccurate physician preference cards as a cause for unnecessary. TIME AWAY FROM PATIENT CARE.
5. Fear of Being Non-Compliant
As the various parts of the new UDI (Unique Device Identification) regulations take effect, it is becoming clear that many healthcare institutions are unable to meet them. Inadequate data collection systems are cited as a major barrier to compliance. TIME AWAY FROM SURGEONS AND PATIENTS.
6. Fear of Being The Scapegoat
All of the issues described above has led many OR nurses to fear becoming the scapegoat for whatever could go wrong in the surgical department: surgeon rebuke for not having a specific item or tool on hand, blame for inadvertent use of expired or recalled items, and worst of all, being responsible for unsatisfactory patient outcomes.
Dealing with the issues cited above has left many OR nurses dissatisfied with their chosen vocation and with a deep distrust of the support mechanisms that should be assisting them rather than burdening them with additional, non-clinical responsibilities. A survey of 100 nurses found that 86% reported that supply chain systems bring them stress and may be contributing to burnout.
OR Nurses’ Faith in the System Must be Restored
It’s clear that we need to offer our OR nurses better tools to cope with the various non-clinical responsibilities that have become part of their daily routine. Tools developed specifically for the unique OR environment that will actually reduce time away from patients and surgeons and will help restore nurses’ confidence in a supply system that truly supports them.
Snap & Go Was Developed for the OR Environment
IDENTI Medical has combined new, sophisticated technologies such as computer vision, advanced image processing, machine learning and artificial intelligence into a novel data collection system, Snap & Go, developed specifically for the OR’s unique environment. A nurse places a consumed item’s packaging under a camera and “snaps” a photo. A green light indicates that the item has been successfully photographed. This is where OR staff involvement ends and IDENTI’s proprietary system takes over, capturing ALL information on the package. Within seconds, data is routed through a global database and processed with IDENTI’s artificial intelligence/machine learning algorithms. Relevant information is then sent directly to hospital ERP and EHR systems. The rare, unidentified item is resolved by IDENTI’s Back Office Service Team.
Snap & Go systems from IDENTI Medical are in use in medical centers around the world. These institutions are reporting 100% item capture and data reliability, complete elimination of expired inventory and stock-outs, and an inventory reduction of up to 25% in the first year. Most importantly, they also reported that nurses spent 17% less time on supply management tasks. That’s 17% more time to attend to their patients.
OR personnel cannot be expected to take on inventory and admin responsibilities if we do not give them the tools to do so quickly and efficiently. They are critical personnel and deserve our support to help them focus on their primary responsibilities—superior patient care and outcomes.
If you are a healthcare system director, an OR nurse, or part of the materials management team, we invite you to learn about our Snap & Go solution and contact us. Your perioperative team deserves it.
Read the white paper: 2022 GOALS: TARGETING ZERO EVENTS.