Stretcher Chairs at Your Service

Ophthalmology

By: Victoria Wiltshire

Published: 6/11/2020

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Keeping patients on a single surface throughout their stay is key to our cataract surgery success.


Our boutique ophthalmic surgery center caters to cataract patients who pay out of pocket for premium lenses and expect a higher level of comfort and service. We roll out the red carpet when they arrive and then roll them through the facility on their own stretcher chair, a mobile unit that houses an IV pole and racks to hold monitoring equipment and charts. Our two state-of-the-art ORs are outfitted with a femtosecond laser and the latest in phaco technology, but it’s the four stretcher chairs that help drive our success by streamlining patient throughput, improving room turnovers and increasing patient satisfaction.

Upon arrival, patients ease into a stretcher chair parked in pre-op to get their pupils dilated and remain seated as they’re wheeled first to the femtosecond laser room, then to the operating room where phacoemulsification and lens implantation take place, and finally to the last stop in recovery. Keeping patients on the same surface adds to their comfort level and increases their overall satisfaction with the surgical experience. It also eliminates the physical stress and worry of having to transfer patients between a stretcher and procedure tables multiple times during their care. During transport, the chairs are easy for staff to maneuver down halls, around tight corners and into rooms.

Perhaps their best feature is the durable and wireless remote attached to each one that staff use to transform the chairs into recliners and surgical tables. A chair’s remote can be used to make slight adjustments to its configuration on a case-by-case and patient-by-patient basis. We primarily use it to cycle the chair through preprogrammed positions that improve our clinical efficiencies. In pre-op, a nurse punches position “1” on the remote to place the patient in Semi-Fowler’s — seated comfortably with their legs up and head slightly elevated. They recline in comfort as the nurse dilates their pupils, readying them for the journey ahead. When the patient is wheeled into the femtosecond laser suite, a nurse pushes “2” on the remote to recline the patient for positioning at the laser unit.

END OF THE LINE Stretcher chairs are wiped down after use and returned to pre-op for another spin through the perioperative circuit.   |  Victoria Wiltshire, MBA, RN

After patients are moved to the OR where cataracts are replaced with lens implants, the circulating nurse hits “3” on the remote to position patients according to our surgeons’ preferences. Instead of fiddling with the remote to position the patient just so, she taps a button and readies the room for surgery while the chair automatically repositions the patient. In PACU, a nurse punches up position “4” on the remote, returning the patient to Semi-Fowler’s to relax and recover. The patient can also use the remote to make slight adjustments to the chair’s position to add to their comfort. In pre-op and PACU, staff can lower the chair and slide-away arm guards make it easier for the patient to sit down and stand up.

We’ve placed marks on the floor in each OR, so we know exactly where to place the chair’s wheels to ensure the patient in aligned properly for the procedure. The preset positions and the marks on the floor have streamlined the patient prep process. We know the chair and patient are perfectly positioned for the surgeon every time he enters the room.

Now more than ever

Our ORs have recently reopened after being shut down during the coronavirus outbreak and our surgeon is working through a backlog of cancelled cases. The surgeons primarily perform bilateral cataract surgery, meaning patients enter our facility only once to have their full vision restored and are therefore at less risk of transmission and infection. Stretcher chairs let us move patients through the facility with utmost efficiency, meaning they’re in our facility for the least amount of time possible and back with their loved ones quickly.

These are all clear benefits during the this new COVID-19 reality.

REMOTE CONTROL Patients are positioned perfectly for various stages of their care with just the push of a button.   |  Victoria Wiltshire, MBA, RN

We’re reducing unnecessary contact as much as possible and requiring that patients and family members wear masks when in the facility. We’ve also stopped letting family members watch the femtosecond laser portion of the procedure from a special viewing area adjacent to the first OR.

The Florida Department of Health’s reopening protocols made us take a second look at our infection control practices. We’ve always been particular about ensuring infection prevention practices are followed, so we were ready for the new mandates, which include ensuring all high-touch areas and surfaces are thoroughly cleaned between cases.

We use disinfectant wipes to clean the surface of the stretcher chair, the blood pressure cuff and pulse oximetry monitor — anything that could have touched the patient. Because the patient stays on a single surface from pre-op to post-op, our nurses don’t have to sanitize surgical tables in both ORs — they simply wipe the stretcher chair once at the end of the patient’s journey before it’s returned to pre-op for another trip.

We’re perhaps a bit more diligent in our surface cleaning practices, but we’ve always gone above and beyond with our infection control practices. Our turnaround times have remained consistent despite the extra attention given to surface cleaning during the pandemic. Moving patients through the facility on stretcher chairs isn’t the only reason for that consistency, but it certainly helps.

We’re encouraged that our clinic is at 75% capacity for new patient evaluations. We expect to soon be running at full capacity as we work during the post-pandemic era. When we are, our stretcher chairs will be along for the ride. OSM