Nursing workload associated with adverse events in the postanesthesia care unit

Area of Science:

• Anesthesiology
• Nursing Resource Management
• Patient Safety

Background:

• Assessed nursing resources in the postanesthesia care unit (PACU) using a nursing task inventory system.
• Compared resource needs for patients with and without adverse postoperative events.

Purpose of the Study:

• To quantify the impact of adverse postoperative events on nursing workload in the PACU.
• To develop models for predicting nursing personnel requirements based on event rates.

Main Methods:

• Utilized the Project Research in Nursing (PRN) workload system to record direct patient care tasks for 2,031 patients over 3 months.
• Merged PRN data with anesthesia database information, including demographics and adverse events.
• Developed theoretical models to assess the relationship between adverse event rates and nursing resource needs.

Main Results:

• Median nursing workload (PRN points) was significantly higher for patients with adverse events (155) compared to those without (26).
• Specific events like ICU admission (95 PRN) and critical respiratory events (54 PRN) substantially increased workload.
• Modeling confirmed that adverse events necessitate increased nursing personnel in the PACU.

Conclusions:

• Patient-specific nursing care documentation reveals that the incidence of postoperative adverse events directly influences the demand for nursing resources in the PACU.
• Accurate assessment of nursing requirements must consider the complexity introduced by adverse events.