A prospective observational study comparing a physiological scoring system with time-based discharge criteria in pediatric ambulatory surgical patients

Armstrong, James G.; Forrest, Helen; Crawford, Mark W.

doi:10.1007/s12630-015-0428-6

Cited by 18 publications

(11 citation statements)

References 22 publications

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“…The present study demonstrates that the mobile application, 317NAPP, can be used to monitor the short-term recovery of children undergoing day surgery, and is a time saver during follow-up. This result was consistent with the findings of previous reports [15,17,19,20] that showed improved recovery of day surgery patients with the use of a mobile application. Nilsson et al [20] applied a mobile application to monitor recovery in adult patients, and showed that it was cost-efficient and had a positive effect on recovery.…”

Section: Discussionsupporting

confidence: 93%

Monitoring of home recovery using the 317-nursing mobile application following day-case surgery in children

Li¹,

Huang²,

Su³

et al. 2019

Medicine

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The number of elective day-case surgeries has considerably increased in recent years, especially in China. Few studies have investigated the ability of mobile applications to assist recovery for patients having undergone day-surgery; however, these studies have indicated that the use of mobile applications is cost-efficient and has a positive effect on recovery after surgery. This study aimed to evaluate the utility and efficacy of using the 317-nursing mobile application program (317NAPP) for monitoring home recovery following day-surgery involving high ligation of the hernial sac in pediatric patients. Prospective clinical study involving 2 parallel groups. Patients were randomly divided into the “intervention 317NAPP group” (n = 64) and the control group (n = 63). Patients were followed-up using the 317NAPP in the intervention group and via telephonic consultations in the control group. All patients were enrolled after being provided sufficient guidance with respect to discharge and health education. The health index, including the physiological function, ability to perform daily activities, and the injury response, was evaluated before and 24 hours after surgery. The time duration of each follow-up session was also evaluated in both groups. The preoperative (T1) health index scores were significantly higher than the postoperative (T0) ones in both groups ( P = .00). The quality of recovery (T1–T0) of the intervention group (10.75 ± 5.28) was better than that of the control group (11.78 ± 5.16), but the differences were not significant ( P = .27). In the intervention group, the follow-up time duration was significantly lower in comparison to that in the control group ( P = .00). This study demonstrated that 317NAPP had a positive effect on recovery following day-surgery, and the time-duration for follow-up was shorter than that performed using telephonic consultation. Monitoring recovery using 317NAPP was safe, efficient, inexpensive, and relatively easy; therefore, it may help improve the recovery of patients having undergone day-surgery.

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Section: Discussionsupporting

confidence: 93%

Monitoring of home recovery using the 317-nursing mobile application following day-case surgery in children

Li¹,

Huang²,

Su³

et al. 2019

Medicine

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“…Despite a consensus that ambulatory surgery is safe for children, data to guide discharge readiness is limited for children 6 months and older of age and absent for those younger than 6 months. 11 , 12 The 2015 American Academy of Pediatrics (AAP) policy statement on the critical elements for the pediatric perioperative anesthesia environment states that former preterm (<37 weeks PCA at birth), <55−60 weeks PCA, and full-term infants older than 4 weeks and younger than 6 months are monitored for at least 2 hours after surgery because of the prolonged effects of general anesthesia. 9 …”

Section: Introductionmentioning

confidence: 99%

“…9,10 Despite a consensus that ambulatory surgery is safe for children, data to guide discharge readiness is limited for children 6 months and older of age and absent for those younger than 6 months. 11,12 The 2015 American Academy of Pediatrics (AAP) policy statement on the critical elements for the pediatric perioperative anesthesia environment states that former preterm (<37 weeks PCA at birth), <55−60 weeks PCA, and full-term infants older than 4 weeks and younger than 6 months are monitored for at least 2 hours after surgery because of the prolonged effects of general anesthesia. 9 In this retrospective, single-institution study with multiple anesthetizing locations, we reviewed our experience with infants younger than 6 months of age having ambulatory surgery and diagnostic imaging requiring anesthesia with the primary endpoints of adherence to the recommended 2-hour time-based discharge criteria and adverse events after ambulatory procedures.…”

Section: Introductionmentioning

confidence: 99%

Adverse Events in Infants Less Than 6 Months of Age After Ambulatory Surgery and Diagnostic Imaging Requiring Anesthesia

Uffman

Kim

Quan

et al. 2022

Pediatric Quality &Amp; Safety

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Introduction: AAP guidelines recommend infants less than 6 months of age are monitored for at least 2 hours following surgery. This retrospective study evaluated if adherence to the 2-hour monitoring guideline decreased the risk of adverse events associated with ambulatory procedures in infants younger than 6 months. Methods: We queried the hospital’s electronic medical record to identify patients younger than 6 months of age who received anesthetic care from January 2015 to March 2020. Demographic data, intraoperative adverse events, and returns to the emergency department (ED) or urgent care within 7 days were captured for each patient. We calculated the number and frequency for categorical data and median and interquartile range (IQR) for continuous data. Chi-square or Fisher’s exact test were used to compare patients who experienced an adverse event to those that did not. Results: One thousand one hundred seventy-seven patients who had 1,261 unique anesthetic encounters were analyzed. Forty-four adverse events were identified, 20 (1.6%) before discharge, including 3 unplanned admissions, and 24 (1.9%) returns to the ED/UC within 7 days postoperatively. We did not observe differences in postoperative recovery time in patients who experienced an adverse event and those who did not (88 min vs. 77 min, respectively, P = 0.078). None of the ED/UC returns would have been avoided by a longer PACU stay. Conclusions: With the appropriate patient selection, once physiological discharge readiness is met, adherence to a strict 2-hour time-based discharge criteria does not increase safety for infants younger than 6 months of age after ambulatory procedures.

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“…Para poder valorar la severidad del dolor en el posoperatorio, se debe tener en consideración el grado de la cirugía (menor, intermedia y mayor) 4 y la intensidad del dolor mediante una escala de medición 6,[16][17][18][19][20] . El manejo del dolor inadecuado es una de las condiciones de los países en desarrollo 4 .…”

Section: Introductionunclassified

Adherencia a principios del manejo del dolor establecidos por la OMS en cirugía mayor electiva.

Velásquez

Salas²

2020

Alerta

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Introducción. A partir del sufrimiento por dolor de los pacientes con cáncer, se elaboró el manual “Alivio del dolor en el cáncer” de la OMS que propuso 5 recomendaciones para la analgesia. Se han hecho modificaciones del planteamiento inicial para adaptarse al manejo del dolor agudo el cual va en sentido inverso: de más severo a más leve, pero los principios fundamentales se mantienen. Objetivo. Conocer la adherencia a los principios de la escala analgésica de la OMS en el manejo del dolor postquirúrgico en cirugía electiva en el Hospital Nacional Rosales en el periodo iniciando en abril 2018. Diseño y métodos. Se utilizó un diseño observacional, descriptivo, longitudinal, de concordancia de la indicación analgesia en pacientes de cirugía mayor electiva del Hospital Nacional Rosales desde el 1ero de agosto de 2018. Se compararon las indicaciones del centro estudiado contra lo ideal según los principios propuestos. Resultados. De 360 pacientes se encontró que la modalidad quirúrgica electiva más utilizada fue ingreso hospitalario 75.3%. 215 (59.7%) pacientes recibieron anestesia general. El índice de concordancia kappa para la adherencia a los principios analgésicos para el manejo del dolor post quirúrgico de la OMS en el Hospital Nacional Rosales fue pobre en los cuatro momentos medidos, con una tasa de adherencia del 0%, y no uso de escala analgésica para evaluar el dolor. Conclusión. En el Hospital Nacional Rosales no se están siguiendo los principios analgésicos de la OMS en el manejo del dolor post quirúrgico.

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A prospective observational study comparing a physiological scoring system with time-based discharge criteria in pediatric ambulatory surgical patients

Cited by 18 publications

References 22 publications

Monitoring of home recovery using the 317-nursing mobile application following day-case surgery in children

Monitoring of home recovery using the 317-nursing mobile application following day-case surgery in children

Adverse Events in Infants Less Than 6 Months of Age After Ambulatory Surgery and Diagnostic Imaging Requiring Anesthesia

Adherencia a principios del manejo del dolor establecidos por la OMS en cirugía mayor electiva.

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