Anaesthesiology, Intensive Care and perioperative medicine, Hamad Medical Corporation, Doha, Qatar.
Ambulatory Care Center, Hamad Medical Corporation, Doha, Qatar.
BMJ Open Qual. 2021 Dec;10(4). doi: 10.1136/bmjoq-2020-001066.
Nurse-run preanaesthesia assessment is well established in ambulatory surgery. However, in the Middle East the implementation of such a service is new and needed careful preparation. Aim of this audit is to assess the feasibility and the quality of preoperative assessments by the specially trained nurses, patient and nurse satisfaction and overall perioperative quality of recovery.
The nurses were selected and trained first in an accredited programme. Then an implementation period of 3 month was used for them to gain experience. Hereafter, we performed a four-step audit on the quality of preassessment, the patient's satisfaction, the quality of recovery and adverse events if any. Finally, we also monitored the nurse's satisfaction of their new advanced role.
The quality of preanaesthesia assessment was high as with 95% compliance to the accepted standards. In the patient satisfaction survey, all 152 patients were either highly satisfied or satisfied with the nurse-run service. The nurses were also highly satisfied and felt that they were either highly or moderately valued. All the patients who were operated at the ambulatory care services were followed up postoperatively by telephone calls which revealed that most of them were highly satisfied. No major or minor adverse events occurred.
Our specially trained nurses perform preoperative assessments on high standard without adverse events, while patient and staff satisfaction is very high. Future projects will focus on reducing the rate of cancellation of surgeries, investigating the cost-effectiveness of this approach as well as training the specialised nurses for paediatric preoperative anaesthesia assessments. This model of care could induce further nurse-run models of care in the Middle East.
在日间手术中，由护士主导的术前评估已得到广泛应用。然而，在中东地区，这种服务的实施尚属新生事物，需要精心准备。本审计旨在评估经过专门培训的护士进行术前评估的可行性和质量、患者和护士的满意度以及整体围手术期恢复质量。
首先，对护士进行选拔和认证培训。然后，他们有 3 个月的时间积累经验。此后，我们对术前评估质量、患者满意度、恢复质量和任何不良事件进行了四步审计。最后，我们还监测了护士对其新的高级角色的满意度。
术前评估质量很高，符合 95%的可接受标准。在患者满意度调查中，152 名患者均对护士主导的服务表示非常满意或满意。护士也非常满意，并认为他们受到高度或中度重视。所有在日间护理服务接受手术的患者都接受了术后电话随访，结果显示大多数患者非常满意。未发生重大或轻微不良事件。
我们经过专门培训的护士以高标准进行术前评估，无不良事件发生，同时患者和医护人员的满意度非常高。未来的项目将侧重于降低手术取消率，研究这种方法的成本效益，并对专门的护士进行儿科术前麻醉评估培训。这种护理模式可能会在中东地区进一步推广护士主导的护理模式。
