Dedicated spine nurses and scrub technicians improve intraoperative efficiency of surgery for adolescent idiopathic scoliosis

Murgai, Rajan; Andras, Lindsay M.; Nielsen, Ena; Scott, Gary; Gould, Hazel; Skaggs, David L.

doi:10.1007/s43390-020-00037-0

Cited by 18 publications

(12 citation statements)

References 21 publications

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“…Murgai et al in 2020 studied the effect of dedicated orthopedic spine scrub nurses on patient outcomes and found that when <60% of nurses or scrub techs were dedicated to the spine service, OR times increased by 34 minutes on average; there was also 30% more estimated blood loss and 113% more allogeneic transfusions required [16]. Similarly, Henaux et al in 2019 found that dedicated surgical teams can improve team satisfaction by significantly decreasing subjectively reported workflow disruptions [17].…”

Section: Discussion Of Study Findingsmentioning

confidence: 99%

Intraoperative Scrub Nurse Handoffs Are Associated With Increased Operative Times for Total Joint Arthroplasty Patients

et al. 2021

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Background: Surgeons typically remain scrubbed in for the duration of a surgical case, while scrub nurses are shift-workers who handoff mid-operation. These handoffs can intuitively create inefficiencies, but currently, no orthopedic research has studied the impact of these handoffs. This study analyzed the effect of intraoperative scrub nurse handoffs on operative times for total joint arthroplasties (TJAs). Methods: A retrospective chart review was performed for primary total hip (THA) and total knee arthroplasties (TKA) performed between May 2014 and May 2018. Operative times, number of scrub nurse handoffs, surgeon, and patient information were collected. A multivariable linear regression was performed to assess the association between patient and surgeon characteristics, intraoperative handoffs, and operative times. Results: A total of 1109 TKA and 1032 THA patients were identified. Multivariable linear regression demonstrated that for TKAs, 1 handoff was associated with a 3.89-minute longer operative time (P value ¼ .02), and 2þ handoffs were associated with a 15.99-minute longer case (P value < .001). For THA patients, 1 handoff was associated with a 6.20-minute longer operative time (P value < .001), and 2þ handoffs were associated with an 18.52-minute longer case (P value < .001). Conclusions: Although causation cannot be established, when controlling for multiple confounders, intraoperative scrub nurse handoffs were associated with statistically significant increases in operative times for TJAs. Optimizing scrub nurse staffing models to decrease intraoperative handoffs could thus have practical ramifications on TJA patients.

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Section: Discussion Of Study Findingsmentioning

confidence: 99%

Intraoperative Scrub Nurse Handoffs Are Associated With Increased Operative Times for Total Joint Arthroplasty Patients

et al. 2021

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“…[1][2][3][4] The impact of other surgical staff interventions on operative efficiency has been well established, however, and existing literature has shown that OR staffing interventions are prime targets for improving patient outcomes. 5e8 In the orthopaedic literature for example, Murgai et al 9 showed that having dedicated orthopaedic scrub nurses decreases operative times and blood loss in adolescent idiopathic scoliosis surgery. 9 For this reason, identifying structural factors that increase surgery length, like intraoperative handoffs, preoperative delays, postanesthesia care unit bed unavailability, and more can have a substantial impact on overall patient care by decreasing costs and surgical complication rates.…”

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confidence: 99%

“…5e8 In the orthopaedic literature for example, Murgai et al 9 showed that having dedicated orthopaedic scrub nurses decreases operative times and blood loss in adolescent idiopathic scoliosis surgery. 9 For this reason, identifying structural factors that increase surgery length, like intraoperative handoffs, preoperative delays, postanesthesia care unit bed unavailability, and more can have a substantial impact on overall patient care by decreasing costs and surgical complication rates. [10][11][12] After all, each minute in an OR costs $62 on average and can be as high as $133 per hour in states like New York, 11 and 15 extra minutes can increase infection risk by 13%.…”

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confidence: 99%

“… 5 , 6 , 7 , 8 In the orthopaedic literature for example, Murgai et al. 9 showed that having dedicated orthopaedic scrub nurses decreases operative times and blood loss in adolescent idiopathic scoliosis surgery. 9 …”

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confidence: 99%

“… 9 showed that having dedicated orthopaedic scrub nurses decreases operative times and blood loss in adolescent idiopathic scoliosis surgery. 9 …”

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confidence: 99%

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Intraoperative Scrub Nurse Handoffs Are Associated with Increased Operative Times for Lower Extremity Orthopaedic Sports Procedures

Hammoor

Kaidi

Crutchfield

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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The purpose of this study was to evaluate the effect of intraoperative scrub nurse handoffs on surgical times for arthroscopically-assisted anterior cruciate ligament (ACL) reconstructions and hip arthroscopies. Methods: A retrospective chart review was done at a major, urban academic medical center for all patients who underwent arthroscopically-assisted ACL reconstructions and hip arthroscopies for femoroacetabular impingement syndrome between May 2014 and May 2020. All ACL reconstructions were performed by 1 of 6 sports medicine fellowshipetrained surgeons, and all hip arthroscopies were performed by a single surgeon. Operative times, number of scrub nurse handoffs, surgeon, patient demographics, and procedure-specific information were recorded. The association between patient characteristics and the number of handoffs, as well as the association between patient characteristics and operative times, stratified by scrub nurse handoffs, were calculated. A multivariable linear regression was performed to assess the association between intra-operative handoffs and operative times. Results: Eight hundred twenty ACL reconstructions and 269 hip arthroscopies were identified. Multivariable linear regression demonstrated increasing intraoperative scrub nurse handoffs were associated with increased operative times for all patients. For ACL reconstructions, when including all possible covariates, 1 scrub nurse handoff increased operative times by 21.1 minutes (95% confidence interval [CI]: 15.36 to 26.89; P < .001), and 2þ handoffs increased operative times by 34.2 minutes (95% CI: 26.28 to 42.15; P < .001). For hip arthroscopies, 1 scrub nurse handoff increased operative times by 7.0 minutes (95% CI: 0.31 to 13.74; P ¼ .04). Conclusion:Although a causal link cannot be made, intraoperative scrub nurse handoffs were associated with statistically significant increase in operative times for both ACL reconstructions and hip arthroscopies. Level of Evidence: Level III, retrospective cohort study.

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Thoracolumbar Fractures

Bransford,

Kark

2024

Orthopaedics and Trauma

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Dedicated spine nurses and scrub technicians improve intraoperative efficiency of surgery for adolescent idiopathic scoliosis

Cited by 18 publications

References 21 publications

Intraoperative Scrub Nurse Handoffs Are Associated With Increased Operative Times for Total Joint Arthroplasty Patients

Intraoperative Scrub Nurse Handoffs Are Associated With Increased Operative Times for Total Joint Arthroplasty Patients

Intraoperative Scrub Nurse Handoffs Are Associated with Increased Operative Times for Lower Extremity Orthopaedic Sports Procedures

Thoracolumbar Fractures

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