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PS1006

SARASOTA MEMORIAL HOSPITAL PERIOPERATIVE DEPARTMENT POLICY

TITLE: ADMISSION/DISCHARGE CRITERIA FOR POST ANESTHESIA CARE UNIT ­ PHASE II POLICY #: EFFECTIVE DATE: REVISED DATE: POLICY TYPE: PAGE: 139.1630 5/01 7/06, 10/10

DEPARTMENTAL INTERDEPARTMENTAL DEPARTMENTS PROVIDING NURSING

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Job Title of Reviewer:

Director of PACU

PURPOSE:

To establish criteria for admission to and discharge from PACU Phase II. Any patient (excluding In-patients) who have undergone a general, regional, local, or conscious sedation, and have met PACU Phase I discharge criteria may be transferred to PACU Phase II for observation and instructions prior to discharge home. The following patients may be deemed inappropriate for Phase II in relation to the setting: 1) Pediatric Patients 2) Disruptive/Combative Patients 3) Profound Nausea and Vomiting Patients 4) Uncontrolled Severe Pain Patients None

POLICY STATEMENT:

EXCEPTIONS:

DEFINITION(S): PROCEDURE:

1.

Phase II RN will be notified of patient transfer to Phase II (either from the Satellite or Main PACU Phase I). Family or significant other may be permitted to visit with the patient in Phase II PACU (limit 2 visitors per patient; no children will be permitted). Discharge criteria: a. The patient will have a written discharge order from the surgeon. b. The following discharge criteria will be met: 1) Patient will be awake and oriented. 2) Patient will have stable vital signs (BP within 20 mm torr-baseline)

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TITLE:

Admission/Discharge Criteria for Post Anesthesia Care Unit ­ Phase II 3)

POLICY #: 139.1630 PAGE: 2 of 4

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Patient's surgical dressing/site will be clean, dry, intact; drains will be patient; extremity circulation will be adequate for relevant procedure. 4) Patient will be able to ambulate with minimal assistance, with little or no dizziness (or at preoperative level). 5) Patient will be able to tolerate fluids without active vomiting. 6) Patient will have adequate pain control. 7) Patient will have IV site discontinued and documented. Patients required to void prior to discharge (unless specified by surgeon) are the following: 1) Any patient receiving spinal anesthesia. 2) Patients who have undergone: a) Urology procedure b) Hernia repair c) Rectal procedure d) Circumcision e) Abdominal procedure f) GYN procedure 3) Patient having significant fluid intake. 4) Patients having history of urinary retention postoperatively.

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Patient/significant other will receive written postoperative instructions, written prescriptions, and any special instructions given by surgeon. Patient/significant other will verbalize understanding of instructions. The patient will be instructed not to drive, operate hazardous machinery or drink alcohol for 24 hours. Patients will be discharged as per Policy 01.PAT.52. Surgeon will be notified if patient does not meet criteria for discharge. Documentation will be in accordance with PACU Phase II policy. A discharge note and time will be documented in the patient's record.

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Prepared by: Karen Diffley document in windows internet explorer 10/20/2010

TITLE:

Admission/Discharge Criteria for Post Anesthesia Care Unit ­ Phase II

POLICY #: 139.1630 PAGE: 3 of 4

RESPONSIBILITY:

It is the responsibility of the department director to assure that medical and nursing staff are familiar with and adhere to this policy. Standards of Post Anesthesia Nursing Practice, American Society of Peri-Anesthesia Nurse Standards, 2006. Standards of Post-Anesthesia Care, American Society of Anesthesiologists, 2005. SMH Policy. (2008). Admission, Discharge, and Transfer Process. (01.PAT.52). SMH: Author.

REFERENCE (S):

AUTHOR (S):

Janet Steves, RN, Director of Nursing Resources Chris Henry, RN, Clinical Coordinator, PACU Gale Skiver, RN, CPAN

ATTACHMENT(S):

None

Prepared by: Karen Diffley document in windows internet explorer 10/20/2010

TITLE:

Admission/Discharge Criteria for Post Anesthesia Care Unit ­ Phase II

POLICY #: 139.1630 PAGE: 4 of 4

APPROVALS: Signatures indicate approval of the new or reviewed/revised policy Signature: Title: Janet Steves, Director of Nursing Resources Signature: Title: Signature: Title Signature: Title: Committee/Sections (if applicable): Date

Vice President/Administrative Director (if applicable): Signature: Title: Jan Mauck, Chief Nursing Officer, Vice President

Prepared by: Karen Diffley document in windows internet explorer 10/20/2010

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