Integrative Literature Review: Ascertaining Discharge Readiness for Pediatrics After Anesthesia

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• 作者：Deborah R. Whitley ; MSN ; RN ; ^{renee.whitley@carolinashealthcare.org" class="auth_mail" title="E-mail the corresponding author}Author Vitae
• 关键词：pediatric ; postanesthesia ; discharge ; criteria ; ambulatory
• 刊名：Journal of PeriAnesthesia Nursing
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：31
• 期：1
• 页码：23-35
• 全文大小：143 K

文摘

Unplanned hospital readmissions after the administration of general anesthesia for ambulatory procedures may contribute to loss of reimbursement and assessment of financial penalties. Pediatric patients represent a unique anesthetic risk. The purpose of this integrative literature review was to ascertain specific criteria used to evaluate discharge readiness for pediatric patients after anesthesia.

Design

This study is an integrative review of literature.

Methods

An integrative literature search was conducted and included literature sources dated January 2008 to November 2013. Key words included pediatric, anesthesia, discharge, criteria, standards, assessment, recovery, postoperative, postanesthesia, scale, score, outpatient, and ambulatory.

Finding

Eleven literature sources that contributed significantly to the research question were identified. Levels of evidence included three systematic reviews, one randomized controlled trial, three cohort studies, two case series, and two expert opinions.

Conclusions and Implications

This integrative literature review revealed evidence-based discharge criteria endorsing home readiness for postanesthesia pediatric patients should incorporate consideration for physiological baselines, professional judgment with regard to infant consciousness, and professional practice standards/guidelines. Additionally, identifying and ensuring discharge to a competent adult was considered imperative. Nurses should be aware that frequently used anesthesia scoring systems originated in the 1970s, and this review was unable to locate current literature examining the reliability and validity of their use in conjunction with modern anesthesia-related health care practices.