통원 수술환자의 안전한 귀가 결정을 위한 퇴실기준에 관한 연구
A Study about Discharge Criteria to Determine Patients’ Readiness for Safe Return to Home after Ambulatory Surgery
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Purpose: This study was conducted to compare three discharge criteria; 1) discharge criteria of S Hospital determined by nurses, 2) discharge readiness determined by patients, and 3) the Modified Post-Anesthetic Discharge Scoring System (MPADSS). The usefulness of MPADSS as a discharge criteria for the patients’safe return to home after ambulatory surgery was also evaluated. Methods: A total of 370 day surgery cases were investigated. The MPADSS was employed in every 30 min. in parallel with discharge readiness assessment by nurses and patients. The percentage of the patients who were categorized as being ready to discharge were compared according to three discharge criteria. Results: The percentage of patients scored to be as MPADSS > 9 in 30 min, 60 min, 90 min were 96.5%, 99.5%, 100% respectively. Whereas 11.1%, 44.3%, 71.1% of patients rated themselves as being ready to discharge and 2.7%, 23.5%, 54.3% of patients actually discharged by nurses according to discharge criteria of S Hospital. Conclusion: Nurses tend to keep patients longer in the hospital when compared to the patient's own assessment about their readiness to home and to that of MPADSS. Faster discharge in the evening than day time suggests patient discharge can be influenced by nursing factors. This brings out the importance of scoring system to determine the safe discharge. The MPADSS could be a useful tool in evaluating patients for safe discharge.
Abstract
Purpose: This study was conducted to compare three discharge criteria; 1) discharge criteria of S Hospital determined by nurses, 2) discharge readiness determined by patients, and 3) the Modified Post-Anesthetic Discharge Scoring System (MPADSS). The usefulness of MPADSS as a discharge criteria for the patients’safe return to home after ambulatory surgery was also evaluated. Methods: A total of 370 day surgery cases were investigated. The MPADSS was employed in every 30 min. in parallel with discharge readiness assessment by nurses and patients. The percentage of the patients who were categorized as being ready to discharge were compared according to three discharge criteria. Results: The percentage of patients scored to be as MPADSS > 9 in 30 min, 60 min, 90 min were 96.5%, 99.5%, 100% respectively. Whereas 11.1%, 44.3%, 71.1% of patients rated themselves as being ready to discharge and 2.7%, 23.5%, 54.3% of patients actually discharged by nurses according to discharge criteria of S Hospital. Conclusion: Nurses tend to keep patients longer in the hospital when compared to the patient's own assessment about their readiness to home and to that of MPADSS. Faster discharge in the evening than day time suggests patient discharge can be influenced by nursing factors. This brings out the importance of scoring system to determine the safe discharge. The MPADSS could be a useful tool in evaluating patients for safe discharge.
참고문헌 (28)
- 곽미숙, "통원 수술에 대한 인지도 및 만족도 평가", 대한마취과학회지, 35(1), pp.138~143 (1998)
- 김양수, "일일입원 전신마취환자를 위한 Discharge Score 개발", 임상간호연구, 6(2), pp.63~74 (2001)
- 전윤석, "통원 수술 환자의퇴원기준으로서PAR Score와 Modified PADSS의유용성", 대한마취과학회지, 35(5), pp.983~987 (1998)
- 조현성, "통원 수술센터의 운영 현황", 대한마취과학회지, 32(2), pp.289~296 (1997)
- Aldrete, J. A., "Discharge criteria", Bailliere’s Clinical Anaesthesiology, 8(4), pp.763~773 (1994)
- Aldrete, J. A., "Modifications to the postanesthesia score for use in ambulatory surgery", Journal of Perianesthesia Nursing, 13(3), pp.148~155 (1998)
- Awad, I. T., "Factors affecting recovery and discharge following ambulatory Surgery", Canadian Journal of Anaesthesia, 53(9), pp.858~872 (2006)
- Chung, F., "discharge criteria changing?", Journal of Clinical Anesthesia, 5(Suppl 1), pp.64~68 (1993)
- Chung, F., "Discharge Criteria-A new trend", Canadian Journal of Anaesthesia, 42(11), pp.1056~1058 (1995)
- Chung, F., "Recovery pattern and home-readiness after ambulatory surgery", Anesthesia & Analgesia, 80(5), pp.896~902 (1995)
- Chung, F., "A Post-Anesthetic Discharge Scoring System for home Readiness after ambulatory surgery", Journal of Clinical Anesthesia, 7(6), pp.500~506 (1995)
- Chung, F., "Factors contributing to a prolonged stay after ambulatory surgery", Anesthesia & Analgesia, 89(6), pp.1352~1359 (1999)
- Chung, F., "Postoperative pain in ambulatory surgery", Anesthesia & Analgesia, 85(4), pp.808~816 (1997)
- Jenkins, K., "Post-operative recovery: Day surgery patients’ preferences", British Journal of Anaesthesia, 86(2), pp.272~274 (2001)
- Jin, F., "Should adult patients drink fluids before discharge from ambulatory surgery?", Anesthesia & Analgesia, 87(2), pp.306~311 (1998)
- Kearney, R., "Withholding oral fluids from children undergoing day surgery reduces vomiting", Paediatric Anaesthesia, 8(4), pp.331~336 (1998)
- Landis, J. R., "The measurement of observer agreement for categorical data", Biometrics, 33(1), pp.159~174 (1977)
- Macario, A., "Which clinical anesthesia outcomes are important to avoid? The perspective of patients", Anesthesia & Analgesia, 89(3), pp.652~658 (1999)
- Marley, R. A., "Patient discharge from the ambulatory setting", Journal of Post Anesthesia Nursing, 11(1), pp.39~49 (1996)
- McGrath, B., "Postoperative recovery and discharge", Anesthesiology Clinics of North America, 21(2), pp.367~386 (2003)
- Pavlin, D. J., "A survey of pain and other symptoms that affectthe recovery process after discharge from an ambulatorysurgery unit", Journal of Clinical Anesthesia, 16(3), pp.200~206 (2004)
- Pavlin, D. J., "Factors affecting discharge time in adult outpatients", Anesthesia & Analgesia, 87(4), pp.816~826 (1998)
- Saar, L. M., "Use of a modified postanesthesia recovery score in phase II perianesthesia period of ambulatory surgery patients", Journal of Perianesthesia Nursing, 16(2), pp.82~89 (2001)
- Schreiner, M. S., "Should children drink before discharge from daysurgery?", Anesthesiology, 76(4), pp.528~533 (1992)
- Shirakami, G., "Delayed discharge and acceptability of ambulatory surgery in adult outpatients receiving general anesthesia", Journal of Anesthesia, 19(2), pp.93~101 (2005)
- Thapar, P., "Assessing recovery after day-case surgery", Current Anesthesia & Critical Care, 5(3), pp.155~159 (1994)
- Vaghadia, H., "A quantification of discharge readiness after outpatient anaesthesia: patients’ vs nurses’ assessment", Southern African Journal of Anaesthesia & Analgesia, 9(4), pp.5~9 (2003)
- Wu, C. L., "Systematic review and analysis of postdischargesymptoms after outpatient surgery", Anesthesiology, 96(4), pp.994~1003 (2002)