Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Oct 1996
Engineering for quality in the postanesthesia care unit: an outcomes approach.
For the past 18 months, we have been monitoring three categories of outcome indicators. This process has aided us in decreasing overall patient length of stay (LOS) and improved the quality of care we provide our PACU patients. Using a local area network (LAN) computer program, we track the following: a set of sentinel indicators, a set of proximate clinical outcome indicators, and a set of system indicators based on nonclinical issues that prolong PACU LOS. ⋯ Quality improvement tools to facilitate further scrutiny of processes and aspects of care felt to be of particular relevance to perioperative nursing have also been developed. We are entering an era in which external accrediting agencies and third-party payers are placing an increasing emphasis on measuring and optimizing patient outcomes. This overall program will position the PACU at an advantage in meeting such challenges.
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Postoperative nausea and vomiting is an all too common side effect of surgery and anesthesia. The usual occurrence of vomiting within the first 24 hours following surgery involves one quarter to one third of all patients. ⋯ Patient dissatisfaction, adverse physiological sequelae, delays in discharge from the ambulatory facility, unanticipated hospital admission, and added cost are problems associated with postoperative vomiting. This article will review the multiple factors contributing to postoperative nausea and vomiting and discuss contemporary strategies for the management of these factors.
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Postanesthesia nursing requires advanced assessment skills and prompt intervention by the nurse. This article discusses the cause, pathology, diagnosis, and management of postanesthesia cardiogenic and noncardiogenic pulmonary edema. An annotated bibliography is included as an additional clinical reference.