ELIMINATE PATIENT TRANSFERS Stretcher tables let you move patients from pre-op to the OR to post-op without transferring them from a stretcher to a surgery table and back.

"Look, there in the hallway. It's a pre-op bed. It's a surgical table. It's a post-op chair. It's a stretcher table!"

The stretcher table can be the Superman of your facility. Functional and flexible, stretcher tables seem tailor-made for the outpatient surgical setting. With the push of a button, they convert from a patient transport chair into a stable operating table. So, should you convert? Take a look at what your colleagues have to say and decide for yourself.

Admissions to post-op
Your first priority is the patient, and stretcher tables provide safety and comfort on that front.

"It's a comfortable means of transport, because the patient can be seated in the chair from admissions through post-op," says Jeff Allen, RN, director of clinical services at Freedom Medical in Exton, Pa. Even better, "this dramatically decreases patient transfers and risk of injury from falls."

Minimizing patient transfers also decreases the risk of injury to nurses and other caregivers, potentially preventing workers' compensation claims, Mr. Allen points out. But it doesn't stop there: Your staff will also enjoy greater functionality and the efficiency that arises as a result (see "Your Stretcher Table Checklist").

Ann Smith, RN, MSN, CAPA, the PACU nurse manager at University of North Carolina Hospitals (UNCH), notes that stretcher tables can be configured with many options — such as arm cushions, IV rods and lap trays — that staff can attach to meet patients' needs. In addition, the ability to have the patient seated, reclined or laid flat gives staff "the ability to handle all the transactions in 1 chair, thus eliminating longer patient stays in each part of the unit," she says.

What's more, if you choose to use stretcher tables during procedures in the OR, there are features geared toward your surgeons.

"The ergonomic design lends itself to the types of ophthalmic procedures we perform, and it's comfortable for the surgeon as well," says Helen Sikes, administrator of the Surgicare Center of Utah. "There is ample leg clearance, and the many options in headrests are designed to ensure that the patient's head doesn't move during surgery."

Michael Hofmann, RN, BSN, director of perioperative services at St. Elizabeth Hospital in Appleton, Wis., tidily sums up stretcher tables: "They're easy to use, easy to move, with no transfers — other than possibly to the surgical table — and they even fit through the bathroom door," a bonus when handling the unsteady post-op patient.

SEAT THEM AND TREAT THEM Stretcher tables should offer full C-arm access and complete surgical positioning.

Here, there and everywhere
You can use stretcher tables for some, most or all of a patient's visit. At UNCH, stretcher tables are used for everything but surgery itself, where traditional OR tables are still used due to the wide variety of inpatient and outpatient procedures they perform.

"Our OR culture is still under the old tradition that the OR table is a must when doing surgery or procedures, to account for the possibility of electrical override or shortage," says Ms. Smith. "So patients are transported to the OR using the stretcher tables. After outpatient procedures — such as inguinal hernia, breast biopsy, laparoscopic cholecystectomy, simple cyst removal, and others — patients are transferred to the stretcher tables from the OR to go to PACU."

Mr. Allen, who works with a number of facilities, notes that stretcher tables are optimal for "99% of all short procedures," including ENT, ophthalmology, podiatric and minor orthopedic cases.

"At our ophthalmic-only surgery center, we use mobile stretcher beds for all our surgical procedures," says Ms. Sikes. "This includes cataract, cornea, glaucoma, retina and facial/oculoplastic procedures."

"All our surgical patients are admitted on a stretcher table, except for bariatric or really tall patients," says Mr. Hofmann. "The tables don't work as well post-operatively for these populations."

Mr. Allen reminds that a stretcher table shouldn't be used if a patient is "at risk for or has shown evidence of an unstable spine or cervical neck injury, or if the procedure requires an extended period of time to perform." Such cases include spine procedures, knee and shoulder arthroscopies, and some laparoscopic abdominal procedures.

MUST-HAVE FEATURES

Your Stretcher Table Checklist

The University of North Carolina Hospitals (UNCH) was looking for stretcher tables that:

• Were easy to maneuver. One person could easily push them.

• Were more compact than recliners, stretchers and OR tables. The telltale test: Is it easy to navigate them through hallways and corridors?

  "The functionality of the stretcher table is very important," says Ann Smith, RN, MSN, CAPA, UNCH's PACU nurse manager. "This means more added and usable functions with little maintenance."

  Jeff Allen, RN, director of clinical services at Freedom Medical in Exton, Pa., highlights some of the features that would come in handy in any surgical facility:

• bariatric weight capacity,
• height adjustability (to accommodate surgeon comfort),
• a slider that lets you transition to chair position,
• split-leg articulation, and
• range of motion from flat-lying/table position to Trendelenberg position.

At the Eye Institute of Utah in Salt Lake City, Utah, Practice Manager Helen Sikes sought a combination of general and procedure-specific features. The former includes optimized battery life, customized programmability for commonly used seating and lying positions, patient comfort, manufacturer support and surgeon preference. Ms. Sikes also needed a stretcher table that would accommodate a variety of options for different head rests, depending on the ophthalmic surgical procedure. She advises taking your case mix into account when considering a transition to stretcher tables.

— Stephanie Wasek

Due diligence and negotiations
At St. Elizabeth Hospital, Mr. Hofmann was able to maintain the facility policy that each patient sits in a chair until going home, "without having to purchase additional chairs at $3,000 each."

"The vendor used some of our data to show how impactful these products can be for the staff," says Mr. Hofmann. That data covered staff travel and work time for the transfer of patients from a stretcher to a recliner, staff travel to get a recliner brought into the room, and the need for 2 staff members to help with the transfer to the recliner or to a wheel chair.

"We included the cost of adding the storage area for the recliners, and took into account the life cycle and maintenance schedule and cost for the recliners," he says. "All these areas were very favorable for the stretcher chair option."

Mr. Allen says vendors will look for ways to help you both "reduce cost and improve patient outcomes, with a versatile product to meet [your] needs."