Nurses' Recognition and Care of Thirst in Perioperative Patients in Japan

Postoperative thirst is common and distressing to patients, as is pain and nausea. The causes of postoperative thirst are complex and include factors like preoperative fasting, perioperative fluid loss, and certain anesthesia medications. Effective care for postoperative thirst has been shown in post-anesthesia care units (PACUs), but many Japanese hospitals lack PACUs or do not address thirst in their PACUs. Therefore, cooperation between the operating room and ward nurses is crucial for providing proper care for postoperative thirst. The purpose of this study was to clarify the actual situation of ward nurses' and operating room nurses' recognition and care of thirst in postoperative patients.

The study was a cross-sectional survey conducted using a self-administered questionnaire based on previous research. Study participants were nurses working in surgical wards and operating rooms of two university-affiliated hospitals. The survey items included (1) participants' characteristics, (2) recognition of thirst in perioperative patients, and (3) actual care provided to perioperative patients for thirst. Data were collected between September and October 2022 and subjected to descriptive and bivariate analysis.

A total of 298 ward nurses and 43 operating room nurses were included in the study. Among the observation items, thirst was observed least frequently. Both ward nurses and operating room nurses recognized patient thirst based on complaints rather than physical observations. Sharing of information about patient thirst differed between ward nurses and operating room nurses. None of the participants used scales or scores to evaluate thirst. The most common postoperative care in the ward was "They were asked to do a mouthwash with water," while in the operating room, it was "Placed a moistened gauze against the mouth." The reasons for selecting a particular type of care were primarily based on "Because of the patient's wishes" and "I think it is effective," while the reasons for not providing care included "Because there is an instruction not to drink water," "Due to the possibility of aspiration," "I don't have the knowledge and don't know how," and "I'm busy with other work."

Regarding the recognition of thirst, both ward nurses and operating room nurses recognized patient thirst most often when the patient directly reported feeling thirsty. They relied more on patients' verbal complaints than physical observations to recognize thirst. Both surgical ward nurses and operating room nurses provided care based on their experience.