Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.
BMJ Open. 2020 Mar 4;10(3):e027262. doi: 10.1136/bmjopen-2018-027262.
Postoperative recovery rooms have existed since 1847, however, there is sparse literature investigating interventions undertaken in recovery, and their impact on patients after recovery room discharge.
This review aimed to investigate the organisation of care delivery in postoperative recovery rooms; and its effect on patient outcomes; including mortality, morbidity, unplanned intensive care unit (ICU) admission and length of hospital stay.
NCBI PubMed, EMBASE and Cumulative Index to Nursing and Allied Health Literature.
Studies published since 1990, investigating health system initiatives undertaken in postoperative recovery rooms. One author screened titles and abstracts, with two authors completing full-text reviews to determine inclusion based on predetermined criteria. A total of 3288 unique studies were identified, with 14 selected for full-text reviews, and 8 included in the review.
EndNote V.8 (Clarivate Analytics) was used to manage references. One author extracted data from each study using a data extraction form adapted from the Cochrane Data Extraction Template, with all data checked by a second author.
Narrative synthesis of data was the primary outcome measure, with all data of individual studies also presented in the summary results table.
Four studies investigated the use of the postanaesthesia care unit (PACU) as a non-ICU pathway for postoperative patients. Two investigated the implementation of physiotherapy in PACU, one evaluated the use of a new nursing scoring tool for detecting patient deterioration, and one evaluated the implementation of a two-track clinical pathway in PACU.
Managing selected postoperative patients in a PACU, instead of ICU, does not appear to be associated with worse patient outcomes, however, due to the high risk of bias within studies, the strength of evidence is only moderate. Four of eight studies also examined hospital length of stay; two found the intervention was associated with decreased length of stay and two found no association.
This protocol is registered on the International Prospective Register of Systematic Reviews (PROSPERO) database, registration number CRD42018106093.
自 1847 年以来，术后恢复室就已经存在，然而，关于恢复室内所采取的干预措施及其对恢复室出院后患者的影响的文献却很少。
本综述旨在研究术后恢复室的护理服务组织情况；并评估其对患者结局的影响，包括死亡率、发病率、非计划性重症监护病房（ICU）入院和住院时间。
NCBI PubMed、EMBASE 和 Cumulative Index to Nursing and Allied Health Literature。
自 1990 年以来发表的研究，调查术后恢复室中开展的卫生系统举措。一名作者筛选标题和摘要，两名作者根据预先确定的标准完成全文审查以确定纳入标准。共确定了 3288 项独特的研究，其中有 14 项进行了全文审查，8 项纳入了综述。
使用 EndNote V.8（Clarivate Analytics）管理参考文献。一名作者使用从 Cochrane 数据提取模板改编的表格从每项研究中提取数据，所有数据均由第二名作者检查。
主要结局评估为数据的叙述性综合，所有研究的数据也在总结结果表中呈现。
四项研究调查了将麻醉后护理单元（PACU）作为术后患者的非 ICU 通道的使用情况。两项研究调查了在 PACU 中实施物理疗法的情况，一项研究评估了使用新的护理评分工具检测患者病情恶化的情况，一项研究评估了在 PACU 中实施双轨临床路径的情况。
将选定的术后患者在 PACU 中进行管理，而不是在 ICU 中进行管理，似乎不会导致患者结局恶化，但是由于研究中存在高度偏倚风险，证据强度仅为中等。八项研究中有四项还研究了住院时间长短；其中两项研究发现干预措施与住院时间缩短相关，两项研究则未发现相关性。
本方案在国际前瞻性系统评价注册库（PROSPERO）数据库注册，注册号为 CRD42018106093。
