Opinion

Audiovisual specialists can make life in the OR easier

ideo equipment use in the OR is increas- V ing. Because all procedures requiring endoscopes (eg, laparoscopic cholecystec- tomies, arthroscopies, gynecologic laparo- scopies) have video potential, soon using video equipment in the OR will be standard proce- dure.

A perioperative audiovisual person is a spe- cialist who maintains and operates video equip- ment. He or she is responsible for the standard video cabinet setup and all additional equip- ment. The standard setup includes a monitor, a video camera control unit, a fiberoptic light source, a printer, and a videocassette recorder.

If a hospital does not have a person assigned to maintain and operate audiovisual equipment, it must rely on service people from the compa- nies where the equipment was purchased to solve all technical problems. The question that arises is whether these people belong in the OR. Having a permanent audiovisual person greatly reduces the need for company service people.

Some hospitals have special departments with audiovisual people who handle technical problems; however, if a hospital does not have a designated audiovisual department, or if the salesperson is unavailable, perioperative nurses should have the knowledge necessary to handle

Maryann Wells

Maryann Wells, RN, MS, CNOR, is a perioper- ative head nurse at the University of Pennsylvania Hospital, Philadelphia. She earned her AD in nursing from Hahnemann University, Philadelphia; her BA in biology from Immaculata (Pa) College; and her MS in health education from St Joseph’s University, Philadelphia.

Karen Leddy

Karen Leddy, RN, BSN, ONC, is a periopera- t ive staff nurse and f i r s t assistant a t the University of Pennsylvania Hospital , Philadelphia. She earned her BS in nursing from Villanova (Pa) University.

The authors acknowledge Gina Pellegrino for her assisstance in the preparation of this article.

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emergency video equipment problems. To ensure that nurses have this knowledge,

the salesperson holds in-service programs for the nursing staff and the audiovisual people. The in-service program teaches the nurses to handle the equipment in emergency situations when an audiovisual person or salesperson can- not be reached. The in-service program that teaches the audiovisual people to inspect, moni- tor, and operate all equipment is a more in- depth session than the one the staff nurses attend.

Responsibilities

efore the patient enters the OR, the audio- B visual person sets up the video equipment based on procedural restrictions and the sur- geon’s preference. The video cabinet should be placed opposite the operative extremity if pos- sible. For example, the equipment is placed at the foot of the table for a laparoscopic chole- cystectomy unless the surgeon specifically states otherwise.

The audiovisual specialist connects the main power and ensures that each piece of equipment is switched on. All the equipment should have three-prong grounded connections. The audio- visual person ensures that all equipment is working properly by checking the monitor for a clear picture, color accuracy, brightness, pic- ture clarity, and focus, and by inspecting the picture for shaded areas that could indicate scratches on the camera lens. Additionally, he or she checks the fiberoptic light cord for bro- ken fibers and replaces the cord if necessary. Broken fibers appear as black areas at the ends of the light cord. The audiovisual specialist then changes the bulb in the light source if nec- essary, makes certain the printer has enough paper and ink, and ensures that the videocas- sette recorder is functioning properly and has the correct tape inserted.

After the preoperative checks are completed and the equipment is ready for use, the audiovi- sual person checks with the perioperative nurse to ensure that all the necessary equipment is sterile (eg, video camera, monitor, printer, light

cord, sheath/trocars, endoscopes). The audiovisual person monitors the equip-

ment during the entire procedure. He or she pays special attention to the light source and makes periodic adjustments. The audiovisual person also is responsible for printing pictures of the procedure at the surgeon’s request.

Even with preoperative inspections, occa- sional equipment failure occurs. A backup sys- tem is necessary for these situations. If a prob- lem that the audiovisual specialist cannot solve occurs during a procedure, he or she imple- ments the backup system and notifies the sales- person as soon as possible. Postoperatively, the audiovisual person turns off all equipment and inspects it for cleanliness.

Recommendations

urse administrators need to allocate budget N funds for audiovisual specialists because they are quickly becoming permanent and nec- essary members of the perioperative team. Managers should arrange initial in-service pro- grams with salespeople and allow the audiovi- sual people to provide future in-service pro- grams for the nursing staff. Administrators should implement preventive maintenance pro- grams, where an audiovisual person checks all equipment weekly, records the findings in a logbook, and notifies the salesperson of any equipment that needs repair or replacement.

Conclusion

aving a permanent audiovisual person on H staff greatly increases a hospital’s efficien- cy. Not only does an audiovisual specialist allow nurses to concentrate on their other responsibilities, but he or she eliminates the need for company service people. The audiovi- sual person provides staff education, performs equipment maintenance, and serves as a liaison with the salesperson. Performing all these func- tions makes the audiovisual person a valuable addition to the perioperative team.

MARYANN WELLS, RN K A R E N LEDDY, RN

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