Norinkavich K M, Howie G, Cariofiles P
Pediatr Nurs. 1995 Jul-Aug;21(4):341-4.
Ongoing efforts to contain costs in health care have had an impact on the delivery of care in the ambulatory setting. Many patients previously admitted to the hospital for an overnight stay are now discharged home within hours of surgery. In response to concerns raised by nursing staff about same-day discharge of patients undergoing tonsillectomy and adenoidectomy (T&A), a quality improvement (QI) study was conducted. Data from more than 150 families over a 2-year period were collected, using the clinical indicator of safe discharge. The data were obtained during the patient's recovery room stay, the first post-operative day, and 2 weeks after surgery. Findings suggested that some of the teaching done by nurses was useful and some needed revision to meet patients' needs. Changes regarding pain management, fluid management, and post-operative bleeding were addressed.
当前控制医疗保健成本的努力已经对门诊环境中的医疗服务提供产生了影响。许多以前需要住院过夜的患者现在在手术后数小时内就被送回家中。针对护理人员对扁桃体切除术和腺样体切除术（T&A）患者当日出院的担忧，开展了一项质量改进（QI）研究。在两年时间里收集了150多个家庭的数据，采用安全出院这一临床指标。这些数据是在患者在恢复室停留期间、术后第一天以及手术后两周获得的。结果表明，护士所做的一些指导是有用的，而有些则需要修订以满足患者的需求。针对疼痛管理、液体管理和术后出血方面的问题进行了改进。
