Linda Bloom1, AnnMarie Mazzella2, Jessica Flynn3, Katherine Panageas3. 1. Department of Nursing Perioperative Services, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address: blooml@mskcc.org. 2. Office of Nursing Research, Memorial Sloan Kettering Cancer Center, New York, NY. 3. Department of Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY.
Abstract
PURPOSE: This study examined the incidence of postanesthesia symptoms, postoperative events, and length of stay (LOS) for surgical oncology outpatients in Phase II recovery during three time periods: before, one-month post, and one-year after the implementation of revised PACU I to PACU II transfer procedures and discharge criteria. DESIGN: Data for this retrospective analysis was obtained from the organizations' electronic medical records during the timeframe April 3, 2017 through August 5, 2018 after enhanced PACU I to PACU II transfer procedures were implemented on June 5, 2017. Records of surgical outpatients transferred from PACU I to PACU II who received regional pain control or preoperative anti-emetics were excluded from the analysis. METHODS: Study approval was obtained through the Institutional Review Board [#19-308]. The records [n = 1091] were sorted and analyzed according to symptoms, events, and length of recovery. Incidence of symptoms, use of IV fluids, and medications administered in PACU II was tabulated for each time-period. Kruskal-Wallis tests were used to detect differences in length of stay variables across the three time periods. FINDINGS: A significant decrease in PACU II LOS was observed following the implementation of revised PACU I to PACU II transfer criteria (P< .001). Although blood pressure changes decreased between each time period: 1.4% (T-1), 0.3% (T-2), and 0.2% (T-3), postanesthesia symptoms [dizziness, pain, and nausea] decreased from T-1 to T-2, with a small increase in T-3. The use of fentanyl and continuous IV fluids decreased between all time periods. CONCLUSIONS: Monitoring key variables related to patient outcomes involving LOS and symptom management ensures sustained practice changes, improves care, and optimizes surgical outpatient experience.
PURPOSE: This study examined the incidence of postanesthesia symptoms, postoperative events, and length of stay (LOS) for surgical oncology outpatients in Phase II recovery during three time periods: before, one-month post, and one-year after the implementation of revised PACU I to PACU II transfer procedures and discharge criteria. DESIGN: Data for this retrospective analysis was obtained from the organizations' electronic medical records during the timeframe April 3, 2017 through August 5, 2018 after enhanced PACU I to PACU II transfer procedures were implemented on June 5, 2017. Records of surgical outpatients transferred from PACU I to PACU II who received regional pain control or preoperative anti-emetics were excluded from the analysis. METHODS: Study approval was obtained through the Institutional Review Board [#19-308]. The records [n = 1091] were sorted and analyzed according to symptoms, events, and length of recovery. Incidence of symptoms, use of IV fluids, and medications administered in PACU II was tabulated for each time-period. Kruskal-Wallis tests were used to detect differences in length of stay variables across the three time periods. FINDINGS: A significant decrease in PACU II LOS was observed following the implementation of revised PACU I to PACU II transfer criteria (P< .001). Although blood pressure changes decreased between each time period: 1.4% (T-1), 0.3% (T-2), and 0.2% (T-3), postanesthesia symptoms [dizziness, pain, and nausea] decreased from T-1 to T-2, with a small increase in T-3. The use of fentanyl and continuous IV fluids decreased between all time periods. CONCLUSIONS: Monitoring key variables related to patient outcomes involving LOS and symptom management ensures sustained practice changes, improves care, and optimizes surgical outpatient experience.
Authors: Frédéric Aubrun; Claude Ecoffey; Dan Benhamou; Laurent Jouffroy; Pierre Diemunsch; Kristina Skaare; Jean Luc Bosson; Pierre Albaladejo Journal: Anaesth Crit Care Pain Med Date: 2018-10-16 Impact factor: 4.132
Authors: Janet M McLaren; Joan A Reynolds; Margaret M Cox; Julie S Lyall; Maureen McCarthy; Ellen M McNoble; Veronica R Petersen Journal: J Perianesth Nurs Date: 2015-04 Impact factor: 1.084
Authors: Kathleen C Buckwalter; Laura Cullen; Kirsten Hanrahan; Charmaine Kleiber; Ann Marie McCarthy; Barbara Rakel; Victoria Steelman; Toni Tripp-Reimer; Sharon Tucker Journal: Worldviews Evid Based Nurs Date: 2017-06 Impact factor: 2.931