Preop clinic

Started by acidbase1
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acidbase1

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hello all,

Hospital has asked me to institute a Preop clinic, what kind of advice can you guys give? Has anyone ever done this before? Who runs the clinic? NP? RN?

Thanks in advance
 
We have a large pre-op clinic staffed by many hospital employed RNs. They obtain labs via an ordering matrix that we developed, go over preop meds, obtain part of the history, obtain ECGs, and we review the charts they request to be reviewed for specialist consultation prior to surgery or if any lab values are way out of whack. Most patients with significant medical histories go to the preop clinic.
 
Aether2000 said:
We have a large pre-op clinic staffed by many hospital employed RNs. They obtain labs via an ordering matrix that we developed, go over preop meds, obtain part of the history, obtain ECGs, and we review the charts they request to be reviewed for specialist consultation prior to surgery or if any lab values are way out of whack. Most patients with significant medical histories go to the preop clinic.
Click to expand...

Can you go into detail on your lab ordering matrix?

Who gets EKG? Anyone with cardiac history and larger cases
 
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This may not be the type of preop setup your looking for, but my program has 1 attending in clinic every day with several NP/residents. The non attendings see all the patients, and present them to attending who then decides what labs, tests, or consults to order. Attending doesnt see the patient usually unless they want to. We also decide what medications, including anticoagulants the patient should be taking. We will order our own stress tests if we feel they are needed, only refer to cards if we want consideration for a cath or something. We do have some set medication guidelines. EKGs are very attending specific. Some want them on almost anyone with a cardiac history. Personally, I would only get an EKG if you feel it will change your management in some way. Like if you think someone actively has an arrhythmia. Or if you think seeing new ischemic changes will push you to get a stress test or cards referral. Or if you want a baseline bc you think there is a high enough chance they may develop EKG changes periop.

An aside, I really wish we got to see the patients in clinic, work them up, and then do their anesthetic. I'd say about 30% of my patients ask if I'm doing their anesthetic and I have to say no :_(. I know, it would be a scheduling impossibility. But maybe some tech wizard could figure out how to make it possible.
 
acidbase1 said:
hello all,

Hospital has asked me to institute a Preop clinic, what kind of advice can you guys give? Has anyone ever done this before? Who runs the clinic? NP? RN?

Thanks in advance
Click to expand...
Why do they want a preop clinic?

who is doing the preops now?
 
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