Title: Incidence of complications, nursing management and outcomes in patients at post anesthesia care unit (PACU)
Saranya Chularee, PhD, RN
Suranaree University of Technology, Thailand
Abstract: This retrospective study aimed to assess the incidence of postoperative complications (POCs), nursing management and clinical nursing outcome in post-anesthesia care unit (PACU) and analysis factors for predicting POCs. The sample consist of 495 cases were selected by purposive sampling. Inclusion criteria were; 1) both male and female, 2) 15 years old and above 3) elective and emergency surgery at Suranaree University of Technology Hospital (SUTH) between May - August, 2016. The measuring instruments were recording form developed by the researcher. Correlation analyzed between personal data and incidences were analyzed by using Chi-square test, Fisher's exact test or F-test. Binary logistic regression analysis was used to determine independent predictors for POCs.
The finding showed that the incidence of POC was found at 38.8 percentages. There were three POCs: 1) postoperative pain (POP) (28.1%) mean pain score was at median level (mean 6.530.19). Nursing management used were both pharmacological and non-pharmacological methods. The outcome of POP was decrease at mild level (mean 3.580.18) before transferring patients back to the ward; 2) Postoperative shivering (POS) (9.5%), nursing management used were forced-air heated blanket, pharmacological and observation. The outcome of POS was disappearing before transferring patients back to the ward; 3) Postoperative nausea and vomiting (PONV) (1.2%), nursing management used were using antiemetic drug and observation. The outcome of PONV was disappearing before transferring patients back to the ward. The significance predicted factors of POP were; gynecological surgery (OR 22.76), ear nose throat surgery (OR 5.46), urological surgery (OR 3.34), duration of anesthesia less than 1 hour (OR 8.04) and 1 – 2 hour (OR 5.43), Duration of operation (OR 6.41), elective surgery (OR 3.57) together predicted (at 46.1%) and 81% predict accurately (p<.05). The significance predicted factors of POS were; duration of anesthesia less than 1 hour (OR 3.87) and anesthesia methods (OR 2.60) together predictable (28.1%) and 89.9% predict accurately (p<.05)
The results of the study suggested for the development of clinical practice nursing guidelines for POP reduction, especially in gynecological surgery and POS in patients undergoing anesthesia for less than 60 minutes.
Audience Take Away:
- Obtain basic information about incidence of postoperative complications in the recovery room
- The information of incidence of postoperative complications in the recovery room can be apply to develop the guidelines for postoperative patients in the recovery room.
- Improve nursing service quality in the postoperative period, especially in the recovery room.
I’m graduated PhD in curriculum and Instruction from Faculty of Education and got master degree in Adult nursing from Faculty of Nursing, Khon Kaen university, Thailand. I work at adult & elderly nursing, Institute of Nursing, Suranaree University of Technology, Thailand.