Determining criteria to assess patient readiness for discharge from postanaesthetic care: an international Delphi study
Article first published online: 20 MAR 2014
© 2014 John Wiley & Sons Ltd
Journal of Clinical Nursing
Volume 23, Issue 23-24, pages 3345–3355, December 2014
How to Cite
Phillips, N. M., Street, M., Kent, B. and Cadeddu, M. (2014), Determining criteria to assess patient readiness for discharge from postanaesthetic care: an international Delphi study. Journal of Clinical Nursing, 23: 3345–3355. doi: 10.1111/jocn.12576
- Issue published online: 17 NOV 2014
- Article first published online: 20 MAR 2014
- Manuscript Accepted: 29 JAN 2014
- Deakin University's Strategic Research Centre for Quality, and Patient Safety
- QPS – Research Grants Scheme
- Delphi study;
- nursing assessment;
- patient discharge;
- postanaesthetic care unit;
Aims and objectives
To obtain expert consensus on essential criteria required to assess patient readiness for discharge from the postanaesthetic care unit.
A patient's condition can deteriorate after surgery, and the immediate postoperative period is recognised internationally as a time of increased risk to patient safety. A recent systematic review identified evidence-based assessment criteria for the safe discharge of patients from the postanaesthetic care unit and identified gaps in the evidence.
Descriptive consensus study using the Delphi method.
Members of international clinical specialist groups with expertise in anaesthesia or postanaesthetic care participated in three consultation rounds. Online surveys were used to determine expert consensus with regard to aspects of postanaesthetic care and specific criteria for assessing patient readiness for discharge. Three rounds of surveys were conducted from May 2011–September 2012.
Twenty-three experts contributed to the panel. Consensus, that is, at least 75% agreement, was reached in regard to 24 criteria considered essential (e.g. respiratory rate 100%; pain 100%; heart rate 95%; temperature 91%). Consensus was also reached for 15 criteria not considered essential (e.g. appetite 96%; headache 76%). Consensus was not obtained for a further 10 criteria. Participants (95%) agreed that a discharge tool was important to ensure safe patient discharge.
Consensus was achieved by a panel of international experts on the use of a tool to assess patient readiness for discharge from postanaesthesia care unit and specific variables to be included or excluded from the tool. Further work is required to develop a tool and test its reliability and validity.
Relevance to clinical practice
The findings of this study have informed the development of an evidence-based tool to be piloted in a subsequent funded study of nursing assessment of patient readiness for discharge from the postanaesthetic care unit.