1. Zone offense
At Regina Hospital in Hastings, Minn., administrators noticed their
room turnovers seemed a bit disjointed. The problem? Each staff
member had a role and was essentially irreplaceable. The RN circula-
tor had a role, the scrub tech had a role, anesthesia had a role and
housekeeping had a role. If any of those staff members got called
away or were delayed, it held up the whole process. That kind of inef-
ficiency won't help your turnover.
Last year, they took on turnover from a new angle, and it has made a
difference. They did away with the rigidity of their old system and went
with "zones" in the OR, assigning turnover tasks based on areas of the
room. As soon as the patient has left the OR for recovery, the members
of the turnover team head to their zones.
• In Zone 1, which includes the bed and lights, the first staffer in the
room cleans the handles and any visibly soiled areas of the overhead
lights. He also cleans the bed, including the remote, the wheels if visi-
bly soiled and the mattress, lifting it up and wiping both the top and
bottom.
• In Zone 2, the scrub tech or the second person in the room cleans
the anesthesia machine and all its knobs, handles and cords. That per-
son disinfects the scanner, keyboard and mouse of the computer, and
the keyboard, flat surface and drawers of the medication cart. He's
also responsible for the IV pole and the forced-air warming unit, top
to bottom. Lastly, he cleans the handles and doors of the cabinets, the
tops and bottoms of the tables (including the wheels if visibly soiled),
the razor, door and trash bins.
• In Zone 3, the nurse or last person in the room after the patient
leaves cleans the nurse's station. That includes the door and handles,
the patient board, phone and light switches; the front, back and knobs
of the fluid suction device; the cautery machine and cords; the broom
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