Phase I/ Phase II recovery

[boyzmomrn]

We need help! There is a difference of opinion in our unit as to what ASPAN is stating in describing Phase I and Phase II level of care. We are a 14 bed inpatient PACU. Some believe Phase I level of care extends from the arrival of the patient from the OR, until all the "critical elements" are met. Then the patient would be considered as being in phase II. The patient would stay in phase II while being monitored, being treated for any issues like decreased urine output, pain, etc...Once the patient has finished being recovered he would be transported to the floor. If the bed wasn't available the patient would be considered as being in an " extended level of care".

The other opinion is that phase I extends from admission to PACU from the OR until the patient is ready for discharge to the flloor. If the bed isn;t available then the patient is considered as being in a Phase Ii level of care. In this scenario we are not sure what the "extended level of care" might be. Any clarification on this matter would be greatly appreciated.

Thanks

[ChadleyNC]

In my facility phase 1 is from adm to pacu until back to floor for inpts. Phase 2 is only used for outpts. If theres a bed delay then we place the pt in a hold status until ready for transfer. Hope this helps.

[boyzmomrn]

thanks!

[anasarca2]

Phase 2 is when the patient no longer requires phase 1 level of nursing care. The Anesthelogist has signed off on the patient's care and the surgeon's post operative orders are now to be implemented. Delaying phase 2 care because of transfer of bed delays has negative outcomes on patient care. This is a real challenge for PACU RNs because when you have a mix of phase 1 and phase 2 patients, your attention is always going to be focused on the phase 1 patient who is "by definition" the most vunerable patient within the hospital setting.

[summeroflov]

At our hospital phase 2 is only for patients being discharged to home. All main OR patients (with the exception of ICU patients) go to phase 1 (main recovery room) until they meet the requirements of stability. Then inpatients go to the floor and outpatients go to phase 2 to eat/drink, go to the bathroom and get up and ambulate before discharge to home. We also have am ambulatory surgical center for minor cases which operates completely separate from the main OR.

[gizmopacurn]

Our facility has a phase 1 which is immediately from the O.R. to pacu, then they transition to ready for DC from pacu, then to being DC to floor/room for all inpatients. For output's they go from phase 1, ready for DC from pacu, Phase II, ready for DC from phase II, to DC from phaseII.