Nursing Workload Associated with Adverse Events in the Postanesthesia Care Unit

Cohen, Marsha M.; O’Brien‐Pallas, Linda; Copplestone, Christine; Wall, Ron; Porter, Joan; Rose, Keith

doi:10.1097/00000542-199912000-00043

Cited by 72 publications

(42 citation statements)

References 14 publications

(8 reference statements)

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“…In addition, the rate of postoperative adverse events proportionally increases the nursing resources needed in PACU. 73 Therefore, the speed to suitability for PACU discharge, including the absence of PONV, is a relevant factor in considering PACU costs.…”

Section: Discussionmentioning

confidence: 99%

A Cost-Benefit Analysis of the ENIGMA Trial

et al. 2011

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Background:The ENIGMA trial was a prospective, randomized, multicenter study that evaluated the clinical consequences of including N 2 O in general anesthesia. Patients who were given a N 2 O-free anesthetic when undergoing major surgery for which the expected hospital stay was at least 3 days had lower rates of some postoperative complications. This suggests that, despite a higher consumption of potent inhalational agent, there could be a financial benefit when N 2 O is avoided in such settings. Methods: A retrospective cost analysis of the 2,050 patients recruited to the ENIGMA trial was performed. We measured costs from the perspective of an implementing hospital. Direct health care costs include the costs for maintaining anesthesia, daily medications, hospitalization, and complications. The primary outcome was the net financial savings from avoiding N 2 O in major noncardiac surgery. Comparisons between groups were analyzed using Student t test and bootstrap methods. Sensitivity analyses were also performed. Results:Rates of some serious complications were higher in the N 2 O group. Total costs in the N 2 O group were $16,203 and in the N 2 O-free group $13,837, mean difference of $2,366 (95% CI: 841-3,891); P ϭ 0.002. All sensitivity analyses retained a significant difference in favor of the N 2 Ofree group (all P Յ 0.005). Conclusions: Despite N 2 O reducing the consumption of more expensive potent inhalational agent, there were marked additional costs associated with its use in adult patients undergoing major surgery because of an increased rate of complications. There is no cogent argument to continue using N 2 O on the basis that it is an inexpensive drug.

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Section: Discussionmentioning

confidence: 99%

A Cost-Benefit Analysis of the ENIGMA Trial

et al. 2011

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“…The results of this study highlight the importance of the nursing team in the prevention and management of postoperative complications and provides insight into the nursing activities carried out in the post-anesthesia recovery setting. (1) Surgical complications may be associated with clinical variables, the complexity of surgery, or operative time; (1)(2)(3) these aspects may, in turn, lead to an increase in nursing workload. Studies confirm that the nursing workload in the post-anesthesia care unit is greater when more severely ill patients are present and when the number of adverse events is higher.…”

Section: Introductionmentioning

confidence: 99%

“…Studies confirm that the nursing workload in the post-anesthesia care unit is greater when more severely ill patients are present and when the number of adverse events is higher. (2,3) Although the postoperative needs of surgical patients are well known, there has been little research into the time spent on provision of postoperative care. In the Brazilian context, knowledge of the adequacy of nursing workload as a function of patient needs in the post-anesthesia care unit is still incipient.…”

Section: Introductionmentioning

confidence: 99%

Carga de trabalho de enfermagem em unidade de recuperação pós-anestésica

Lima¹,

Rabelo²

2013

Acta paul. enferm.

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Objectives: To assess nursing workload in the post-anesthesia care unit and its potential correlations with a surgical severity index, length of stay, magnitude of surgery, and patient age. Methods: Cross-sectional study conducted at a university hospital. Workload was assessed by the Nursing Activities Score, and severity of illness, by the Simplified Acute Physiology Score II. Both were assessed at the time of discharge from the unit. Results: The study sample comprised 160 patients (mean age, 57 ± 15 years). The median nursing workload was 45.6 minutes per hour, i.e. 50% of patients required 45.6 minutes of nursing care per hour spent in the post-anesthesia care unit. There was no association between workload and severity index. However, there were positive correlations among workload, length of stay, and magnitude of surgery. The severity of illness was correlated with age. Conclusion: Nursing workload in the post-anesthesia care unit is influenced by length of stay and magnitude of surgery. ResumoObjetivos: Avaliar a carga de trabalho de enfermagem em unidade de recuperação pós-anestésica e relacionar com o índice de gravidade cirúrgico, tempo de permanência, porte cirúrgico e idade. Métodos: Estudo transversal conduzido em hospital universitário. A carga de trabalho foi avaliada pelo Nursing Activities Score e o índice de gravidade pelo Simplified Acute Physiology Score II aplicados na alta da unidade de recuperação. Resultados: Foram incluídos 160 pacientes, idade média 57±15 anos. A carga de trabalho para 50% dos pacientes foi de 45,6 minutos a cada hora de permanência na unidade. Não houve relação entre carga de trabalho e índice de gravidade. Contudo, houve correlações positivas entre carga de trabalho, tempo de permanência e porte cirúrgico. O índice de gravidade apresentou correlação com a idade. Conclusão: A carga de trabalho de enfermagem em unidade de recuperação pós-anestésica sofre influência do tempo de permanência e do porte cirúrgico.

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“…(152) . Além disso, a presença de burnout e eventos adversos também foi associada com alta demanda de cuidados requerida pelos pacientes (35,153) .…”

Section: % Esses Resultados Validam O Uso Desses íNdices Em Vítimaunclassified

Vítimas de trauma admitidas em unidade de terapia intensiva: características e fatores associados à carga de trabalho de enfermagem

Nogueira¹

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Nursing Workload Associated with Adverse Events in the Postanesthesia Care Unit

Abstract: Nursing care documentation based on requirements for individual patients demonstrates that the rate of postoperative adverse events affects the amount of nursing resources needed in the PACU.

Cited by 72 publications

References 14 publications

A Cost-Benefit Analysis of the ENIGMA Trial

A Cost-Benefit Analysis of the ENIGMA Trial

Carga de trabalho de enfermagem em unidade de recuperação pós-anestésica

Vítimas de trauma admitidas em unidade de terapia intensiva: características e fatores associados à carga de trabalho de enfermagem

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