Planning For The Rapidly Emerging Digital OR

Nurses working in today's operating room environments are faced with new technologies being added as the trend toward the digitalization of ORs becomes a reality. Many hospitals across the country are currently undergoing renovations to include updated equipment. This means nurses must adapt to new systems and become familiar with the driving forces behind the trend and how it will affect their daily work. Here, the author explores why digital ORs are increasingly becoming the norm and what today's nurses need to understand in order to be effective in this emerging environment.

Patients in today's hospitals are receiving care using the latest technology and medical techniques, but they are usually unaware of the tremendous amount of work involved in producing that high level of care.

Modern hospital operating rooms are changing dramatically with the advent of minimally invasive surgical (MIS) techniques and digital technology. Healthcare professionals are finding themselves faced with many new challenges as they work with engineers and planners to redevelop many of the aging healthcare facilities in existence today.The consultation process that is involved when a hospital embarks on the redevelopment of its surgical suites involves close contact with all of the stakeholders who use these facilities - this includes patients, operating room nursing staff, surgeons, administrators, manufacturers, and other healthcare workers. It is increasingly important for these users to understand the complexities of the technology so that planners, architects, and engineers can ensure that all digital changes accommodate both the technological requirements and the needs of the people using the technology. The need for digitalization is clear and it is occurring rapidly in healthcare facilities across North America. A survey of new projects in Canada and the United States, and discussions with hospital surgical teams and equipment vendors, revealed the digital revolution is a top priority for many healthcare facility planners.

Cardiac Catheterization reports, Magnetic Resonance Imaging (MRI) scans, Computed Tomography (CT) scans, film imaging or ultrasound, patient medical history and vital signs are all becoming increasingly computerized and available in digital format.

Despite the convenience that results from the ease of access to digital information, moving into this environment does pose challenges for the nursing staff. The goal is to seamlessly integrate this new dimension of the hospital OR into the daily routine. That process begins by understanding exactly how, and why, the new digital OR is becoming predominant and what factors need to be considered in order to effectively digitalize the OR components.

In addition to updating the OR, cutting-edge technology can also be used to help provide user groups with a clearer understanding of the redevelopment process. 3D and interactive computer modeling programs can be used, in addition to traditional plan and elevation drawings, to illustrate how new equipment will be placed in the room and how it can be moved around.

CHANGES IN THE DIGITAL OR

The technology and equipment supporting MIS may be more portable, but it also requires more space in the OR than was needed in the past to support more invasive procedures. A typical OR was approximately 44 square metres. A new digital OR requires 60 square metres. The additional space is the result of several factors, including: the space required for flat-screen digital monitors, the equipment connected to them, and the service booms that house them (as well as medical gases and a range of other equipment). New double-articulated boom systems, which can swing freely about the entire OR, act as the central piece of equipment for accessing most surgical devices.

These double-articulated boom systems are central to the digitalization of the OR because they can house what used to be located on two or three freestanding carts - carts that often caused overcrowding of medical staff during surgeries and procedures. Traditional display methods resulted in the need for monitors and equipment to be centrally located for ease of viewing by the surgeon and nursing staff - this involved the dedicated use of a lot of room in the OR. In the digital OR equipment such as scope equipment, bair huggers, cautery devices, and flat-screen monitors, can be moved around the surgical suite more easily and efficiently on the double-articulated boom systems.

The University of Alberta Hospital in Edmonton (UAH) is a prime example of the trend toward digital ORs. Between 2004 and 2007 they will expand existing facilities from the current 14 ORs to 19 ORs in total, plus two procedure rooms. The Level Three surgical suite renovations include provisions to replace the existing Central Sterile Room (CSR) with a cutting-edge Central Service Supply Product Distribution (CS-SPD) that also incorporates a new case Cart system. New MIS techniques, particularly endoscopic and laparoscopic procedures, benefit greatly from the new boom systems because it allows the equipment to be separated from the display monitors. This provides a clearer image to everybody who is part of the surgery or procedure, not just those located near the equipment. Data can now be recorded in real time and made available to remote locations or central monitoring desks in the OR itself. The potential now exists to have that information sent digitally to off-site teaching facilities for use in classroom settings.