Developing and Implementing an Ambulatory Postanesthesia Care Unit Hand-Off Tool

Author(s):  
Claire Cyriax ◽  
Eunhea You
Author(s):  
Lindsey Van Drunen ◽  
Sanjay Dwarakanath

This chapter presents key aspects to help those early in their anesthesia career to provide safe and efficient care to patients. It includes tips for safe transport of patients after surgery, effective hand-off reporting to the next level of care, and criteria to assess readiness of a patient to be discharged from the postanesthesia care unit (PACU). It also discusses common PACU complications such as pain and postoperative nausea and vomiting and approaches to treating them. Finally, it discusses PACU discharge instructions for patients after ambulatory surgery, with special attention paid for elderly patients or those with obstructive sleep apnea.


2012 ◽  
Vol 5 (5) ◽  
pp. 17
Author(s):  
MARY ELLEN SCHNEIDER
Keyword(s):  

2005 ◽  
Vol 6 (7) ◽  
pp. 749-754 ◽  
Author(s):  
P. Pandharipande ◽  
E. Ely ◽  
M. Maze

2014 ◽  
Vol 29 (4) ◽  
pp. 298-312 ◽  
Author(s):  
James D. McGlothlin ◽  
John E. Moenning ◽  
Sandra S. Cole

2021 ◽  
pp. 073346482199292
Author(s):  
Fayron Epps ◽  
Glenna Brewster ◽  
Judy S. Phillips ◽  
Rachel Nash ◽  
Raj C. Shah ◽  
...  

“Testing Tele-Savvy” was a three-arm randomized controlled trial that recruited participants from four National Institute on Aging (NIA)–funded Alzheimer’s Disease Centers with Emory University serving as the coordinating center. The enrollment process involved each center providing a list of eligible caregivers to the coordinating center to consent. Initially, the site proposed to recruit primarily African American caregivers generated a significant amount of referrals to the coordinating center, but a gap occurred in translating them into enrolled participants. To increase the enrollment rate, a “Handshake Protocol” was established, which included a warm handoff approach. During preset phone calls each week, the research site coordinator introduced potential participants to a culturally congruent co-investigator from the coordinating center who then completed the consent process. Within the first month of implementation, the team was 97% effective in meeting its goals. This protocol is an example of a successful, innovative approach to enrolling minority participants in multi-site clinical trials.


Hand ◽  
2021 ◽  
pp. 155894472110031
Author(s):  
Ian Wellington ◽  
Antonio Cusano ◽  
Joel V. Ferreira ◽  
Anthony Parrino

Background This study sought to investigate complication rates/perioperative metrics after endoscopic carpal tunnel release (eCTR) via wide-awake, local anesthesia, no tourniquet (WALANT) versus sedation or local anesthesia with a tourniquet. Methods Patients aged 18 years or older who underwent an eCTR between April 28, 2018, and December 31, 2019, by 1 of 2 fellowship-trained surgeons at our single institution were retrospectively reviewed. Patients were divided into 3 groups: monitored anesthesia care with tourniquet (MT), local anesthesia with tourniquet (LT), and WALANT. Results Inclusion criteria were met by 156 cases; 53 (34%) were performed under MT, 25 (16%) under LT, and 78 (50%) under WALANT. The MT group (46.1 ± 9.7) was statistically younger compared with LT (56.3 ± 14.1, P = .007) and WALANT groups (53.5 ± 15.8, P = .008), F(2, 153) = 6.465, P = .002. Wide-awake, local anesthesia, no tourniquet had decreased procedural times (10 minutes, SD: 2) compared with MT (11 minutes, SD: 2) and LT (11 minutes, SD: 2), F(2, 153) = 5.732, P = .004). Trends favored WALANT over MT and LT for average operating room time (20 minutes, SD: 3 vs 32 minutes, SD: 6 vs 23 minutes, SD: 3, respectively, F(2, 153) = 101.1, P < .001), postanesthesia care unit time (12 minutes, SD: 7 vs 1:12 minutes, SD: 26 vs 20 minutes, SD: 22, respectively, F(2, 153) =171.1, P < .001), and door-to-door time (1:37 minutes, SD: 21 vs 2:51 minutes, SD: 40 vs 1:46 minutes, SD: 33, respectively, F(2, 153) = 109.3, P < .001). There were no differences in complication rates. Conclusions Our data suggest favorable trends for patients undergoing eCTR via WALANT versus MT versus LT.


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