RRM Category: Inpatient Nursing
The Operating Room/Recovery (OR/R) room RRM module estimates the number and type of nursing staff for OR/R operations. According to AORN and ASPAN there is no difference between outpatient and inpatient surgery recovery needs and are therefore calculated the same. Like wise, OR operations are the same no matter where the patient goes after surgery. Typically the OR/Recovery is open 8 to 10 hours a day with after hours on call staff for emergency surgery.
Surgery space is planned based on the number of deliveries, endoscopy, and surgical cases with the number of rooms ranging from a C-section only room up to 6 procedure/OR rooms. Facilities requiring more than 6 procedure/OR rooms will be custom planned. The facility planning for surgery is done in two steps, surgical complement #1 for general surgery and gynecology and surgical complement #2 which will add-on orthopedic, ophthalmology, ENT, and urology workloads. Surgical component #2 requires a user population of greater than 30,000.
A Basic OR is two 8hr rooms, the staffing levels can be multiplied by the factor of 2 for other size ORs; for example a 4 room OR would multiply the staffing levels by 2. Utilization is the driver for deciding when to open additional hours of operation, 75% utilization is the threshold that indicates additional time is needed. If a room is planned for longer than 8 hrs that must also be factored in.
The OR/PACU will provide services to support appropriate surgical and recovery services for the user population.
To qualify for OR staff 450 surgical cases are required. This includes inpatient and outpatient surgery plus OB/GYN surgery.
Fixed Registered Nurse - Operating Room staff of 5.0 FTEs for each facility with an operating room, plus 1.33 FTEs Registered Nurse for every 200 above 800 General Surgery, OB/GYN Surgery and Ambulatory Surgery cases.
Fixed LPN/Technician - Operating Room staff of 1.60 FTEs for each facility with an operating room plus 1.0 FTE for every 200 above 800 General Surgery and OB/GYN Surgery cases. (Does not include ambulatory cases.)
Fixed Registered Nurse - PACU staff of 4.0 FTE for each facility with an operating room plus 1.0 FTE for every 600 General Surgery, OB/GYN Surgery and Ambulatory Surgery cases above 600 cases.
Fixed Registered Nurse - Ambulatory Surgery staff of 3.0 FTEs for each facility with at least 350 ambulatory surgery cases.
Supervisory Clinical Nurse – 1.0 FTE
Driving Variables:General Surgery Cases
Ambulatory Surgery Cases
# Operating Rooms
Personnel Categories:Registered Nurses
Licensed Practical Nurses
Minimum Staffing Levels
|Registered Nurse -Operating Room
|Registered Nurse - PACU
|Registered Nurse - Ambulatory Surgery
|>350 Ambulatory Surgery Cases
|Supervisory Clinical Nurse
Variable Staffing Levels:
|Registered Nurse – Operating Room
|Each 200 cases
|Each 200 cases > 800 of general surgery, OB/GYN Surgery and Ambulatory Surgery
|Each 200 cases
|Each 200 cases > 800 for general surgery and OB/GYN Surgery
|Registered Nurse, PACU
|Each 600 cases
|Each 600 cases General Surgery, OB/GYN and Ambulatory Survery above 600 Cases
|Registered Nurse – Ambulatory Surgery
|Each 300 cases
|Each 300 Ambulatory Surgery cases above 350