AORN Blog - The Periop Life

3 Ideas to Improve Your Robotics Program

3 Ideas to Improve Your Robotics Program

January 18, 2018     

Robotic surgical programs can vary greatly in size and focus across the country, but there is one certainty with robotic surgery—demand will continue to grow. And patients are taking note of not only which organizations have robotics, but also which have the best outcomes.

To learn more about what perioperative teams are doing to ensure robotics excellence, we spoke with the robotics team from Cleveland Clinic. Mary Szostakowski, MSN, RN, CNOR, perioperative nursing manager of urology and gynecology oversees all robotic procedures at Cleveland Clinic’s main campus in Cleveland, Ohio. At this campus, 13 of the 101 ORs are robotic rooms for urology, gynecology, ENT, cardiothoracic, general surgery, pediatric surgery, and neurosurgery.

Here are three ways Szostakowksi suggests a perioperative team along with the robotics coordinator can promote program growth, viability, and sustainability.

1. Establish Effective Communication and Team Work

With so many components and distractions in the robotics room, including ambient noise from the robot itself, team performance and the patient can be impacted, Szostakowski cautions. She says the robotics team must have a clear and collaborative method for communication to ensure every team member is on the same page for safety and good patient outcomes. She gives the example of communicating with anesthesia if the patient will be placed into the steep Trendelenburg position, necessitating close monitoring of the patient’s physiological changes.

2. Facilitate Robust Education and Training

Cleveland Clinic robotics team members must complete a four-hour didactic program followed by specialty-specific, hands-on education with the robot before they are cleared to work in a robotics room.

Szostakowski’s colleague Alex Vasilevskiy, RN, BSN, an assistant nurse manager with several years of robotics experience, explains. “Even steps that seem simple, such as docking the robot, can be very dangerous if the surgical team does not know to pay close attention of where the robot is spatially in relation to the patient.” He says robotics teams are trained to work in a specific specialty because there are critical nuances with instrumentation and approach specific to procedure and even the patient, such as with a pediatric procedure. “Even experienced robotic team members engage in rigorous education before a new technique is introduced—as patient advocates nurses play a critical role in driving this tailored education.”

The robotics coordinator also plays a vital role in educating and training the staff. Having to oversee the robotic rooms along with purposeful rounding allows the robotics coordinator to build a rapport with the staff and fine-tune education and training in areas that may be lacking. In addition, the robotics coordinator provides for some valuable teaching moments including complex situations and robotic malfunctions.

3. Secure a Safe Robotic Environment

Safety is critically important in all procedures, particularly in robotic cases that involve more technology and equipment. That’s why education and competency must address knowledge of robotic equipment, troubleshooting, and implementing all evidence-based practices for safe care in every phase of the robotic patient’s care, Szostakowski stresses. “Close collaboration with the vendor is very important but it’s equally important to know how to troubleshoot an issue and handle robotic instrumentation and equipment—that know-how on the front line increases safety.”

She also says this advanced knowledge in a robotics OR can support innovation and a smooth transition into safely adopting a new technique or procedure into a robotics program, something Szostakowski believes is critical to sustaining robotic success as it evolves.

“You want to be cutting edge and innovative. You also must be savvy in considering cost and what new approaches will have the best return on investment to meet patient needs for optimal outcomes and satisfaction,” Szostakowski says.

This March at AORN’s annual conference in New Orleans Szostakowski, Vasilevskiy, and colleague Kay Tighe will be sharing their tested approaches to robotic program growth, viability, and sustainability that can make or break a successful robotic surgery program.