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采用新的麻醉后出院用护理工具来改善护理评估和管理,以减少手术患者的风险
Author(s) -
Street Maryann,
Phillips Nicole M.,
Haesler Emily,
Kent Bridie
Publication year - 2018
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.13779
Subject(s) - nursing care , medicine , nursing assessment , medline , nursing , audit , medical emergency , intensive care medicine , management , political science , law , economics
Abstract Aims To evaluate use of an evidence‐based discharge tool, the Post‐Anaesthetic Care Tool and its impact on nursing assessment, communication, and management of patients in the postanaesthetic care unit. Background Postanaesthetic care unit nurses manage patients immediately after surgery and make clinical decisions on discharge readiness. There is a lack of evidence‐based guidance on assessing, documenting, and communicating the patient's postoperative experience. The Post‐Anaesthetic Care Tool, which includes instructions for assessing discharge readiness and incorporates the ISOBAR acronym, was developed following a comprehensive systematic review and expert consultation. Design and Methods This quasiexperimental, multicentre, nonrandomized study was conducted in three postanaesthetic care units in Australia. Participants were nurses providing care to adults postgeneral anaesthesia. Episodes of care were observed before ( N = 723) and after ( N = 694) introduction of the evidence‐based tool. Statistical methods (Chi‐Square and Mann–Whitney U ‐Tests) were undertaken to analyse nursing assessment, communication, and management outcomes before and after implementation of the Post‐Anaesthetic Care Tool. Results The Post‐Anaesthetic Care Tool was associated with statistically significant improvements in the frequency of nursing assessment and responsiveness to complications including pain, nausea/vomiting and hypothermia. After the tool's introduction, nurses requested more medical reviews. This was associated with increased recognition of clinical deterioration and significant improvements in clarity of handover from the postanaesthetic care unit to the ward. Conclusions The structured discharge tool, Post‐Anaesthetic Care Tool, was associated with improved nursing management of patients in the postanaesthetic care unit and enabled early identification and response to clinical concerns.