Nursing Department, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
Nursing Department, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
J Perianesth Nurs. 2023 Aug;38(4):642-649.e1. doi: 10.1016/j.jopan.2022.11.008. Epub 2023 Jan 18.
The aim of this review was to explore the existing literature on discharge criteria, tools and strategies used in the postanesthesia care unit (PACU) after ambulatory surgery and to identify the essential components of an effective and feasible scoring system based on applicable criteria for the three phases of anesthesia recovery to assess patient discharge after outpatient anesthesia.
A review of the literature.
In this study, a review of sixteen articles was conducted to analyze the affecting factors, evaluation tools, and the current research status of patients discharge after outpatient anesthesia.
The main factors affecting the discharge after diagnostic or therapeutic procedures under outpatient anesthesia were hospital management, medical treatment and patients themselves. Physiological systems-based discharge assessment had several advantages over traditional time-based discharge assessment. The Aldrete scoring scale was often used for patients in the first stage of anesthesia recovery to leave the PACU, and the Chung's scoring scale was often used to evaluate patients in the second stage of recovery until they leave the hospital. These two scales were often used in combination for outpatient anesthesia. The Fast-tracking assessment tool was used in patients who directly returned to the ward or discharge of patients after ambulatory surgery. There is currently no uniform standard or tool for assessing patients discharge after diagnostic or therapeutic procedures under the outpatient anesthesia.
Optimal care under anesthesia should allow the patient to recover from anesthesia smoothly and quickly and leave the hospital safely. When the patients can safely leave the hospital after outpatient anesthesia is still a problem that needs to be solved in the nursing field. Various existing scoring systems have their historical advancements, but we need to formulate more in line with the current status of postoperative patients discharge standards.
本综述旨在探讨术后恢复室（PACU）中用于门诊手术患者的出院标准、工具和策略，并基于麻醉恢复的三个阶段的适用标准，确定有效的、可行的评分系统的基本组成部分，从而确定门诊麻醉后患者出院的标准。
文献综述。
本研究通过回顾 16 篇文章，分析了门诊麻醉后患者出院的影响因素、评估工具和当前研究现状。
影响门诊诊断或治疗程序后患者出院的主要因素包括医院管理、医疗和患者自身。基于生理系统的出院评估与传统的基于时间的出院评估相比具有几个优势。Aldrete 评分量表常用于评估患者离开 PACU 的第一阶段麻醉恢复情况，Chung 评分量表常用于评估患者第二阶段恢复情况直至出院。这两个量表通常联合用于门诊麻醉。Fast-tracking 评估工具用于直接返回病房的患者或门诊手术后出院的患者。目前，尚无用于评估门诊诊断或治疗程序后患者出院的统一标准或工具。
最佳的麻醉护理应使患者平稳、快速地从麻醉中恢复，并安全地离开医院。当患者可以安全地离开医院时，这仍然是护理领域需要解决的问题。各种现有的评分系统都有其历史进步，但我们需要制定更符合术后患者出院标准的新的评分系统。
