DISCHARGE PLANNING

[C.DOSS]

HOW DOES YOUR PACU HANDLE DISCHARGE PLANNING?

DOES THE ANESTHESIOLOGIST VISIT THE PATIENT PRIOR TO DISCHARGE?

I CURRENTLY WORK AT AN AMBULATORY CARE WITH DAY SURGERIES. OFTEN WE HAVE ONLY ONE DOCTOR ALL DAY AND HE IS IN ONE OR ANOTHER CASE. WE HAVE BEEN ASKED TO FILL OUT HIS ANESTHESIA SHEET WITH THE TIME OF DISCHARGE NEXT TO HIS SIGNATURE.

CAN WE AS NURSES WRITE ON THE DOCTORS RECORD OF ANESTHESIA? I WONDER ABOUT THE LEGALITY OF THIS ACTION. ANY INPUT? ANY ANSWERS? WE HAVE DISCHARGE CRITERIA THAT IS MET PRIOR TO DISCHARGE, SO WE HAVE BEEN RELEASING THE PATIENT AT THE TIME IT IS MET.

PLEASE TELL ME HOW ELSE THIS IS BEING HANDLED. THANKS.

[RN_Amy, RN]

I used to work in the PACU to a 10-theatre OR specialising in all major adult surgery (except obstetrics).

In terms on discharge planning from the PACU... we had a set of criteria that every patient had to meet prior to discharge eg. had to be awake enough to lift there head of the pillow for 5 seconds (post GA), had to have a pain score of less than or equal to 2 out of 10, had to have an epidural block at T4 or below, had to have a body temp of greater than or equal to 36.0 celcius, etc etc.

The anaesthetist accompanied the patient from the theatre to the PACU and handed over. If anything was an issue in terms of discharge from PACU it was mentioned at this time eg. to ensure adequate urinary output, for further review prior to discharge from PACU.

If their were no issues, the patient could be discharged after they met the standard criteria, without further medical review.

Also, nursing documentation was totally separate to that of the anaesthetist.

Hope this helps....

Amy

[sharann, BSN, RN]

I would NOT write anything, not even a comma on an anesthesiologist paperwork, whether asked or not. Document your own paperwork with times and Aldrete and pain scores etc. Writing the time is up to THEM. They can come back to you one day and deny D/Cing that pt, and whose writing is on that anesthtists papers????

Nope, uh uh, no way