Implementation of a nursing assessment framework in the postanesthesia care unit: a pre-post implementation design

Structured nursing assessment during the postanesthesia period is critical for patient safety, yet assessment practices in the postanesthesia care unit (PACU) often remain inconsistent. The Nursing Assessment Framework for Patients in the Anesthesia Recovery Period (NAF-PARP) was previously developed, but its implementation and impact have not been evaluated. This study aimed to implement NAF-PARP in a PACU and assess its effects on nursing assessment quality and the incidence of nursing defects.

This study used a pre- and post-intervention quality improvement design. A total of 90 patients admitted between September and December 2024 were assessed using the existing model (control group). After a 2-month training program for nurses (January-February 2025), a second group of 90 patients admitted between March and June 2025 was assessed using NAF-PARP (intervention group). Outcome measures included scores for different assessment domains and the incidence of nursing defects.

Improvements were observed in physical assessment, clinical judgment, and organizational efficiency in the intervention group. However, there was no significant difference in the incidence of nursing defects between the two groups.

Implementation of NAF-PARP was associated with improvements in key domains of nursing assessment quality but did not reduce nursing defects. These findings support the value of structured assessment frameworks in postanesthesia nursing while highlighting the complexity of translating process improvements into patient safety outcomes. Further research is warranted to explore longer-term effects and system-level strategies.