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Lumbar discectomy: developing and implementing a day surgery protocol
Kathy Doerksen1, Jodi Dusik-Sharpe
1Health Sciences Centre, Winnipeg, Manitoba. kdoerksen@exchange.hsc.mb.ca
Axone (Dartmouth, N.S.)
|November 19, 2003
Summary
Day surgery for lumbar discectomy is safe and effective. A quality improvement study found that most patients undergoing this procedure could be discharged the same day, with revised criteria enhancing patient selection for this successful approach.
Area of Science:
- Neurosurgery
- Quality Improvement
- Patient Care Management
Background:
- Lumbar discectomy patients are sometimes discharged same-day in some centers.
- Healthcare systems face pressure to optimize bed utilization while ensuring patient safety.
Purpose of the Study:
- To evaluate the safety and feasibility of a day surgery protocol for single-level lumbar discectomy.
- To identify criteria for patient selection for same-day discharge after lumbar discectomy.
Main Methods:
- Prospective review using a continuous quality improvement methodology.
- Monitoring of patients undergoing single-level lumbar discectomy, divided into day surgery protocol and control groups.
- Data collection included demographics, operative time, recovery room stay, hospital length of stay, and readmission rates.
Main Results:
- Out of 47 patients monitored, 34 were in the day surgery protocol. Seven patients in the protocol required an overnight stay, with reasons to be detailed.
- One of the 13 excluded patients did not require an overnight stay.
- The study highlights the importance of nursing education in patient preparation.
Conclusions:
- The established criteria for day surgery lumbar discectomy were effective.
- Adjustments to the inclusion criteria allow for safe and effective same-day discharge for lumbar discectomy patients.