Portrayal of the performance of the post-anesthesia care unit, based on the perception of the professional nursing staffs
Keywords:
Anesthesia recovery period, Education, Nursing, Patient care, Qualitative research, Patient safety
Abstract
Introduction:
The post-anesthesia care unit has been identified as a vulnerable area for the occurrence of adverse events. Here, the nursing staff is responsible for managing and taking care of patients.
Objective:
To explore the perception of the professional nursing staff about the performance of the post-anesthesia care unit, and portray certain aspects of its operations.
Materials and methods:
This is a mixed sequential study including an observational, descriptive and quantitative cross section phase and a qualitative, descriptive, interpretative phase, using grounded theory.
Results:
Nurses perceive the PACU as "a place for care" with weak processes such as patient handover and monitoring, communications among care providers, lack of specific skills of the ancillary staff and lack of teamwork. Work overload, extended administrative tasks that take away focus from patient care, in addition to a lack of compliance with protocols, are all conducive to the occurrence of adverse events.
Conclusions:
Nurses perceive the unit as a place of complex processes and particular char acteristics that make the unit prone to adverse events. Institutional factors, work team and professional-related aspects become threats that undermine the safety environment that should always prevail in every PACU. Specific strategies are discussed to turn the recovery unit into a safe care service for the surgical patient.
References
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12. Association of Anaesthetists of Great Britain and Ireland. UK National Core Competencies for Post-Anaesthesia Care, 2013; 2013. London. 31 pp.
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14. Milby A, Bohmer A, Gerbershagen MU, Joppich R, Wappler F. Quality of post-operative patient handover in the post-anaesthesia care unit: a prospective analysis. Acta Anaesthesiol Scand. 2014;58:192-7.
15. Randmaa M, Martensson G, Swenne CL, Engstrom M. An observational study of postoperative handover in anesthetic clinics; the content of verbal information and factors influencing receiver memory. J Perianesth Nurs. 2015;30:105-15.
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23. White C, Chuah J, Robb A, Lok B, Lampotang S, Lizdas D, et al. Using a critical incident scenario with virtual humans to assess educational needs of nurses in a postanesthesia care unit. J Contin Educ Health Prof. 2015;35:158-65.
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25. Mamaril ME, Sullivan E, Clifford TL, Newhouse R, Windle PE. Safe staffing for the post anesthesia care unit: weighing the evidence and identifying the gaps. J Perianesth Nurs. 2007;22:393-9.
26. Dexter F. Why calculating PACU staffing is so hard and why/how operations research specialists can help. J Perianesth Nurs. 2007;22:357-9.
27. Apfelbaum JL, Silverstein JH, Chung FF, Connis RT, Fillmore RB, Hunt SE, et al. Practice guidelines for postanesthetic care: an update report by the American Society of Anesthesiologists Task Force o Postanesthetic Care. Anesthesiology. 2013;118:291-307.
28. American Society of PeriAnesthesia Nurses. Perianesthesia nursing standards, practice recommendations and interpretive statements. American Society of PeriAnesthesia Nurses; 2016.
29. Jones A, Johnstone MJ, Duke M. Recognising and responding to 'cutting corners' when providing nursing care: a qualitative study. J Clin Nurs. 2016.
30. Kaderli R, Seelandt J, Umer M, Tschan F, Businger A. Reasons for the persistence of adverse events in the era of safer surgery - a qualitative approach. Swiss Med Wkly. 2013;143:w13882.
31. Manojlovich M, Harrod M, Holtz B, Hofer T, Kuhn L, Krein SL. The use of multiple qualitative methods to characterize communication events between physicians and nurses. Health Commun. 2015;30:61-9.
32. Hernandez Sampieri R, Fernandez Colado C, Baptista Lucio Mdel P. Metodología de la Investigación. Quinta ed. Méjico, D.F.: Mc Graw Hill; 2010. p. 613.
33. Odom JL. The emerging role of risk management. J Post Anesth Nurs. 1990;5:120-3.
2. Hines R, Barash PG, Watrous G, O'Connor T. Complications occurring in the postanesthesia care unit: a survey. Anesth Analg. 1992;74:503-9.
3. Van der Walt JH, Webb RK, Osborne GA, Morgan C, Mackay P. The Australian Incident Monitoring Study. Recovery room incidents in the first 2000 incident reports. Anaesth Intensive Care. 1993;21:650-2.
4. Rose DK. Recovery room problems or problems in the PACU. Can J Anaesth. 1996;43 Pt 2:R116-28.
5. Cutugno C. Evolution of postanesthesia care units: a legacy of politics, funding, and patient safety concerns. Policy Polit Nurs Pract. 2013;14:142-50.
6. Luengas Amaya S. Seguridad del paciente: conceptos y análisis de eventos adversos. Centro de Gestión Hospitalaria Via Salud; 2009. p. 48.
7. Odom-Forren J. Accurate patient handoffs: imperative for patient safety. J Perianesth Nurs. 2007;22:233-4.
8. Sullivan EE. The safe transfer of care. J Perianesth Nurs. 2004;19:108-10.
9. Kreckler S, Catchpole KR, New SJ, Handa A, McCulloch PG. Quality and safety on an acute surgical ward: an exploratory cohort study of process and outcome. Ann Surg. 2009;250:1035-40.
10. Halverson AL, Casey JT, Andersson J, Anderson K, Park C, Rademaker AW, et al. Communication failure in the operating room. Surgery. 2011;149:305-10.
11. Whitaker DK, Booth H, Clyburn P, Harrop-Griffiths W, Hosie H, Kilvington B, et al. Immediate post-anaesthesia recovery 2013. Anaesthesia. 2013;68:288-97.
12. Association of Anaesthetists of Great Britain and Ireland. UK National Core Competencies for Post-Anaesthesia Care, 2013; 2013. London. 31 pp.
13. Palmonari A. Una mirada ala psicología social desde la perspectiva de la teoría de las representaciones sociales. In: Romero E, editor. Representaciones Sociales. Puebla, México: Benemérita Universidad Autónoma de Puebla; 2004.
14. Milby A, Bohmer A, Gerbershagen MU, Joppich R, Wappler F. Quality of post-operative patient handover in the post-anaesthesia care unit: a prospective analysis. Acta Anaesthesiol Scand. 2014;58:192-7.
15. Randmaa M, Martensson G, Swenne CL, Engstrom M. An observational study of postoperative handover in anesthetic clinics; the content of verbal information and factors influencing receiver memory. J Perianesth Nurs. 2015;30:105-15.
16. Siddiqui N, Arzola C, Iqbal M, Sritharan K, Guerina L, Chung F, et al. Deficits in information transfer between anaesthesiologist and postanaesthesia care unit staff: an analysis of patient handover. Eur J Anaesthesiol. 2012;29:438-45.
17. Segall N, Bonifacio AS, Schroeder RA, Barbeito A, Rogers D, Thornlow DK, et al. Can we make postoperative patient handovers safer? A systematic review of the literature. Anesth Analg. 2012;115:102-15.
18. Weinger MB, Slagle JM, Kuntz AH, Schildcrout JS, Banerjee A, Mercaldo ND, et al. A multimodal intervention improves postanesthesia care unit handovers. Anesth Analg. 2015;121:957-71.
19. Moller TP, Madsen MD, Fuhrmann L, Ostergaard D. Postoperative handover: characteristics and considerations on improvement: a systematic review. Eur J Anaesthesiol.2013;30:229-42.
20. Fortier LP, McKeen D, Turner K, de Medicis E, Warriner B, Jones PM, et al. The RECITE study: a Canadian prospective, multicenter study of the incidence and severity of residual neuromuscular blockade. Anesth Analg. 2015;121:366-72.
21. Ead H. Perianesthesia nursing-beyond the critical care skills. J Perianesth Nurs. 2014;29:36-49.
22. Greenfield ML, O'Brien DD, Kofflin SK, Mhyre JM. A cross-sectional survey study of nurses' self-assessed competencies in obstetric and surgical postanesthesia care units. J Perianesth Nurs. 2014;29:385-96.
23. White C, Chuah J, Robb A, Lok B, Lampotang S, Lizdas D, et al. Using a critical incident scenario with virtual humans to assess educational needs of nurses in a postanesthesia care unit. J Contin Educ Health Prof. 2015;35:158-65.
24. Aiken LH, Sloane DM, BruyneelL, Van den Heede K, Griffiths P, Busse R, et al. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. Lancet. 2014;383:1824-30.
25. Mamaril ME, Sullivan E, Clifford TL, Newhouse R, Windle PE. Safe staffing for the post anesthesia care unit: weighing the evidence and identifying the gaps. J Perianesth Nurs. 2007;22:393-9.
26. Dexter F. Why calculating PACU staffing is so hard and why/how operations research specialists can help. J Perianesth Nurs. 2007;22:357-9.
27. Apfelbaum JL, Silverstein JH, Chung FF, Connis RT, Fillmore RB, Hunt SE, et al. Practice guidelines for postanesthetic care: an update report by the American Society of Anesthesiologists Task Force o Postanesthetic Care. Anesthesiology. 2013;118:291-307.
28. American Society of PeriAnesthesia Nurses. Perianesthesia nursing standards, practice recommendations and interpretive statements. American Society of PeriAnesthesia Nurses; 2016.
29. Jones A, Johnstone MJ, Duke M. Recognising and responding to 'cutting corners' when providing nursing care: a qualitative study. J Clin Nurs. 2016.
30. Kaderli R, Seelandt J, Umer M, Tschan F, Businger A. Reasons for the persistence of adverse events in the era of safer surgery - a qualitative approach. Swiss Med Wkly. 2013;143:w13882.
31. Manojlovich M, Harrod M, Holtz B, Hofer T, Kuhn L, Krein SL. The use of multiple qualitative methods to characterize communication events between physicians and nurses. Health Commun. 2015;30:61-9.
32. Hernandez Sampieri R, Fernandez Colado C, Baptista Lucio Mdel P. Metodología de la Investigación. Quinta ed. Méjico, D.F.: Mc Graw Hill; 2010. p. 613.
33. Odom JL. The emerging role of risk management. J Post Anesth Nurs. 1990;5:120-3.
How to Cite
1.
Arias-Botero JH, Padrón-Mercado CM. Portrayal of the performance of the post-anesthesia care unit, based on the perception of the professional nursing staffs. Colomb. J. Anesthesiol. [Internet]. 2017 Oct. 1 [cited 2024 Apr. 24];45(Supplement):16-23. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/182
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Published
2017-10-01
How to Cite
1.
Arias-Botero JH, Padrón-Mercado CM. Portrayal of the performance of the post-anesthesia care unit, based on the perception of the professional nursing staffs. Colomb. J. Anesthesiol. [Internet]. 2017 Oct. 1 [cited 2024 Apr. 24];45(Supplement):16-23. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/182
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