Compliance to Post-Anesthesia Care Unit Discharge Score Practice Among Nurses at Post-Anesthesia Care Unit in the Jimma Medical Center in Ethiopia: A Best Practice Implementation Project, 2021

Abstract

Background: PACU discharge score criteria facilitate a risk safe and timely discharge of surgical patients under satisfactory safety conditions, thereby improving post-operative patient outcomes and requiring minimum resources. The aim of this best practice study was to provide best evidence-based practice on post-anesthesia discharge score criteria among nurses at the post-anesthesia care unit in the Jimma Medical Center. Methods: An audit and re-audit inter-professional study was employed. Twenty-four post-anesthesia care unit nurses were interviewed for baseline audit and 118 post-anesthesia care unit discharge scoring opportunities were observed for follow-up audit using three audit criteria. Results: First stage of the audit showed a performance of 37.5% for successful pain assessment, level of consciousness, nausea, vomiting, and blood pressure prior to patient discharge from the post-anesthesia care unit, and 62.5% for routine use of discharge criteria score to determine discharge readiness of patients from the post-anesthesia care unit. Re-audit results revealed an average of 40% improvement of the audit criteria practice toward post-anesthesia care unit discharge score. Conclusion:This study revealed that the use of various strategies such as role modeling, posting reminders about PACU discharge criteria, and presenting guidelines to the recovery teams resulted in improved practice toward best available evidence for postanesthesia care unit discharge score practice. Including the stakeholders in determining the strategies to upgrade practice is crucial in the accomplishment of promoting successful PACU discharge score. To ensure sustainable compliance to successful PACU discharge score criteria, a planned schedule of random report was employed by the clinical team.