Abstract
Purpose
Anesthesiologists are constantly striving for improvement in health care delivery. We assessed the patient flow in the Post Anesthesia Care Unit (PACU) to determine if patients are being transported out of the PACU when ready.
Methods
A University student recorded the flow of 336 patients who recovered in our Post Anesthesia Care Unit. The corresponding nursing and orderly complements were recorded. If a delay arose between the time the patient was deemed fit for discharge by the PACU nurse and the time the patient was transported from the PACU, the student determined the duration and cause(s) of the delay.
Results
The number of patients, nurses, and orderlies increased from three to twelve, three to seven, and one to two respectively throughout the elective working day. Seventy-six per cent of patients studied were delayed in transport from the PACU, with 26% of patients waiting 30 min. The average delay in discharge for patients increased during the day from 0 to 65 ± 54 min from the time of fit for discharge, as determined by the PACU nurse, until transport. Five causes were identified as contributing to the delay: orderly too busy (41%), awaiting Anesthesia assessment (36%), Post Anesthesia Care Unit nurse too busy (15%), receiving floor not ready (6%), and patient awaiting radiographic interpretation (2%).
Conclusion
Our study has shown that system errors unnecessarily prolongs the stay of patients in the PACU.
Résumé
Objectif
Les anesthésiologistes s’efforcent constamment d’améliorer les soins de santé. Nous avons évalué le débit de patients à la salle de réveil afin de déterminer s’ils sont transportés à l’extérieur de la salle dès qu’ils sont prêts.
Méthode
Un étudiant d’université a enregistré les déplacements de 336 patients en récupération dans notre salle de réveil. Il a noté les effectifs infirmier et aide-infirmier correspondant. Si un délai survenait entre le moment où l’infirmière jugeait que le patient était prêt à quitter la salle et le moment où il était transporté, l’étudiant déterminait la durée et la ou les cause(s) de ce délai.
Résultats
Le nombre de patients, d’infirmières et d’aides a augmenté de trois à douze, de trois à sept et de un à deux respectivement au long de cette journée de travail. Soixante-seize pour cent des patients étudiés ont connu un délai de transport, dont 26% ont dû attendre 30 min. Le délai moyen d’attente pour les patients s’est accru pendant la journée, passant de 0 à 65 ± 54 min. Cinq causes ont été identifiées comme ayant contribué au délai: les aides-infirmiers sont trop occupés (41%), on attend l’évaluation anesthésique (36%), l’infirmière de la salle de réveil est trop occupée (15%), la chambre du malade n’est pas prête (6%) et le patient attend l’interprétation radiographique (2%).
Conclusion
Notre étude a montré que des erreurs d’organisation prolongent inutilement le séjour des patients en salle de réveil.
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Ms. Mitmaker was funded by the SMBD-Jewish General Hospital Department of Anesthesia Fund.
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Tessler, M.J., Mitmaker, L., Wahba, R.M. et al. Patient flow in the Post Anesthesia Care Unit: an observational study. Can J Anaesth 46, 348–351 (1999). https://doi.org/10.1007/BF03013226
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DOI: https://doi.org/10.1007/BF03013226