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Refining nursing assessment and management with a new post-anaesthetic care discharge tool to minimise surgical patient risk

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posted on 2025-10-28, 01:25 authored by Maryann Street, Nicole M Phillips, Emily HaeslerEmily Haesler, Bridie Kent
<p dir="ltr">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. </p><p dir="ltr">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. </p><p dir="ltr">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. </p><p dir="ltr">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. </p><p dir="ltr">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.</p>

Funding

Health Contributions Fund (HCF) Research Foundation

History

Publication Date

2018-01-01

Journal

Journal of Advanced Nursing

Volume

74

Issue

11

Pagination

11p. (p. 2566-2576)

Publisher

Wiley

ISSN

0309-2402

Rights Statement

© 2018 John Wiley & Sons Ltd This is the peer reviewed version of the following article: Street M; Phillips NM; Haesler E & Kent B (2018). Refining nursing assessment and management with a new post-anaesthetic care discharge tool to minimise surgical patient risk. Journal of Advanced Nursing, 74(11), 2566-2576, which has been published in final form at http://doi.org/10.1111/jan.13779. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

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