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Post-anaesthetic discharge scoring criteria: key findings from a systematic review

Phillips, Nicole Margaret, Street, Maryann, Kent, Bridie, Haesler, Emily and Cadeddu, Mary 2013, Post-anaesthetic discharge scoring criteria: key findings from a systematic review, International Journal of Evidence-Based Healthcare, vol. 11, no. 4, pp. 275-284.

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Title Post-anaesthetic discharge scoring criteria: key findings from a systematic review
Author(s) Phillips, Nicole Margaret
Street, Maryann
Kent, Bridie
Haesler, Emily
Cadeddu, Mary
Journal name International Journal of Evidence-Based Healthcare
Volume number 11
Issue number 4
Start page 275
End page 284
Total pages 10
Publisher Joanna Briggs Institute
Place of publication Carlton South, Vic.
Publication date 2013
ISSN 1744-1595
1744-1609
Keyword(s) Discharge assessment
Nursing assessment
Post-anaesthetic care unit
Systematic review
Summary Background
Patient safety depends on nurses' clinical judgment. In post-anaesthetic care, objective scoring systems are commonly used to help nurses assess when a patient is ready to go back to the ward or be discharged home after day surgery. Although there are several criteria used to assess patient readiness for discharge from the post-anaesthetic care unit, evaluation of the validity and reliability of these criteria is scarce.

Aims
This article presents key findings from a systematic review conducted to identify the essential components of an effective and feasible scoring system to assess patients following surgical anaesthesia for discharge from the post-anaesthetic care unit.

Methods
The protocol for the systematic review of quantitative studies investigating assessment criteria for discharge of adult patients from the post-anaesthetic care unit was approved by the Joanna Briggs Institute and conducted consistent with the methodology of the Institute. Twelve databases and grey literature, such as conference proceedings, were searched for published studies between 1970 and 2010. Two reviewers independently assessed study eligibility for inclusion. Reference lists of included studies were appraised.

Results
Eight studies met the inclusion criteria; only one was a randomised controlled trial. Variables identified as essential when assessing a patient's readiness for discharge from the post-anaesthetic care unit were conscious state, blood pressure, nausea and vomiting, and pain. Assessment of psychomotor and cognitive recovery and other vital signs were also identified as relevant variables to consider.

Conclusions
There was limited high-quality research regarding criteria to assess patient readiness for discharge from the post-anaesthetic unit. The key recommendations, with moderate to high risk of bias, include that assessment of specific variables (pain, conscious state, blood pressure, and nausea and vomiting) should be made before patient discharge. These key findings have informed a subsequent study to reach international consensus on effective assessment criteria and a project to test the clinical reliability of a tool for use by nurses in assessing patient readiness for discharge from post-anaesthetic care.
Language eng
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2013, Joanna Briggs Institute
Persistent URL http://hdl.handle.net/10536/DRO/DU:30060448

Document type: Journal Article
Collections: School of Nursing and Midwifery
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.