POST ANESTHESIA CARE UNIT

September 08, 2013 INSIGHTS Patients are brought to the Post-Anesthetic Care Unit (PACU) to recover from anesthesia after a surgical procedure. The type of anesthetic (general, regional, local or sedation), duration and type of surgery and other patient factors are taken in to consideration to determine the length of stay in PACU. Once the patient is ready to be transferred from PACU they are admitted to the ward or are admitted to an assigned hospital room. In the PACU, specially trained nurses provide care for the patients. The focus of care in the early postoperative period is on close monitoring of vital signs and pain management. Assessments of the surgical site for excessive bleeding, discharge, swelling, hematoma, redness etc are also done. Nurses must always watch out for nausea, vomiting, sedation, anxiety amongst others. In the PACU, patients with specialized venous access catheters, central lines, arterial lines, ventricular and subarachnoid drains, stomas and feeding tubes are also cared for, just like my patient in PICU who underwent an open-heart surgery, has a femoral arterial line and a femoral venous catheter access. The PACU serves as the point of initiation of pain management strategies. I think preparation, education and establishment of Patient Controlled Analgesia (PCA) are all often done in the PACU. Patients with continuous regional analgesia techniques such as epidural and perineural catheters are also closely monitored and prepared for transfer to the ward or hospital room. Occasionally patients may remain monitored in PACU for extended periods of time, while others for short periods of time. The PACU staff closely works with the Intensive Care Unit (ICU) for the care of critically ill patients and with the Ward for the care of patients who dont necessarily need care classified for the ICU setting. PACU nurses are the ones who are going to arrange for the transfer of such patients to the ICU, to the ward, or to the hospital room.

HIGHLIGHTS In the PACU, I expect to learn about the critical stage of recovery after surgery. In the PACU, recovery from anesthesia of the patients can vary. Some maybe uncomplicated and some may be life threatening. These patients must be managed by competent and skilled nurses and other members of the health care team. In this duty, we will be trained to be competent and excellent Post Anesthesia Nurses. It is important that health care professionals collaborate in the care of the client, that is why, I expect to work with OR nurses and the anesthesiologists. I expect to also receive endorsements from the nurses from the operating room. During this endorsements, I will make sure that what they say are true in order to maintain and protect patient safety. It is important that we also know the baseline assessment when the client comes in, so that, we will know the development of the client. We must be aware of the changes happening to the client, in order to be able to promote his/her well-being and prevent any complication. Assessment during the entire stay of the client, in the unit is critical. It must always be accurate and must be done as ordered. Assessment is an important stage in knowing and caring for the client. Once the client is ready to be transferred, it is our role as PACU nurses to endorse them to the ward, ICU, or hospital room. NURSE-CENTERED OBJECTIVES Receive patient from the OR setting and assess client while being endorsed by the OR nurse Provide transition for the patient from a status from the operating room to a status that can be transferred to the ward/ ICU/ hospital room Assess the client accurately and adequately Provide interventions which will prevent complications and promote welfare of the client Collaborate with other members of the health team Improve skills and knowledge in assessment and providing interventions for post-operated patients Prioritize problems based on immediate need of client

Time and Activity Plan Time 7:00 am 7:30 am 8:00 am 8:30 am 9:00 am 9:30 am 10:00 am 10:30 am 11:00 Activity Pre-conference Tour and Orientation of the Post Anesthesia Care Unit Training on how to utilize and troubleshoot machines Orientation on how to receive clients from OR nurses Orientation on how to assess clients Orientation on how to fill up the forms Orientation on how to collaborate with transfer Orientation on how to do the transfer of the client Post-conference