Are Postoperative Clinical Outcomes Influenced by Length of Stay in the Postanesthesia Care Unit?

被引:24
|
作者
Mann-Farrar, Jamie [1 ,2 ]
Egan, Elizabeth [3 ]
Higgins, Andrew [3 ]
Wysocki, Leigh [3 ]
Vaux, Amanda [4 ]
Arndell, Elise [3 ]
Burmeister, Elizabeth A. [5 ]
机构
[1] Princess Alexandra Hosp, Brisbane, Qld, Australia
[2] Univ Tasmania, Sch Nursing & Midwifery, Hobart, Tas, Australia
[3] Princess Alexandra Hosp, Post Anesthet Care Unit, Brisbane, Qld, Australia
[4] Princess Alexandra Hosp, Emergency Dept, Brisbane, Qld, Australia
[5] Princess Alexandra Hosp, Nursing Practice Dev Unit, Brisbane, Qld, Australia
关键词
postoperative deterioration; rapid response; PACU; postanesthesia care unit; surgical deterioration; rapid response team; MORTALITY; DISCHARGE;
D O I
10.1016/j.jopan.2018.07.004
中图分类号
R47 [护理学];
学科分类号
1011 ;
摘要
Purpose: To compare clinical outcomes of patients who required a prolonged length of stay in the postanesthesia care unit (PACU) with a control group. Design: A single-center purposive-sampled retrospective medical record and database audit. Methods: Patients with prolonged PACU stays were compared to a group of patients whose stay was less than median for outcome measures: rapid response team (RRT) activation, cardiac arrest, unanticipated intensive care unit admissions, and survival to discharge. Findings: A total of 1,867 patients were included in the analysis (n = 931 prolonged stay and n = 933 control group). Prolonged stay in PACU was higher among patients who were older, had higher American Society of Anesthesiologist score, and were discharged to wards during the afternoon or late nursing shift. RRT activation after discharge from PACU occurred in more patients in the study group compared with the control group (7% vs 1%, respectively). There were no cardiac arrests recorded in either group within the 24 hours after PACU discharge period. Conclusions: Prolonged stay in the PACU for 2 or more hours because of clinical reasons appears to be associated with a higher incidence of clinical deterioration in the ward setting requiring RRT intervention within 24 hours after discharge from PACU.
引用
收藏
页码:386 / 393
页数:8
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