Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.07.004
Brazilian Journal of Anesthesiology
Clinical Research

Development of a recovery-room discharge checklist (SAMPE checklist) for safe handover and its comparison with Aldrete and White scoring systems

Antônio Prates; Bruno Colognese; Wolnei Caumo; Luciana Cadore Stefani

Downloads: 0
Views: 17

Abstract

Background
The postoperative care transition from the postanesthetic recovery room (PACU) to the common ward or even home discharge represents a critical step of the surgical patients’ handover. Although some systems have been proposed to measure the ability to discharge after an anesthetic-surgical procedure effectively, there is no consensus defining which variables should necessarily be evaluated by these instruments. The instruments routinely used do not evaluate important domains for discharge and are laborious to fill, which compromises the professionals’ adhesion. The objectives are to describe the creation of a new recovery room discharge tool (SAMPE checklist) and determine the degree of agreement of the new tool with two classical scales.

Methods
In a cross-sectional observational study, 997 patients were selected from the general population undergoing a wide range of surgical procedures in a quaternary care hospital. At 90 minutes after leaving the operating room (OR), patients were evaluated and information was collected to fill out the new SAMPE checklist and two other scores (Aldrete and White) to examine the degree of agreement between them.

Results
SAMPE checklist has presented a satisfactory agreement with the White score and lower agreement with Aldrete modified score.

Conclusion
This new instrument, as demonstrated in this study with nearly 1000 patients from different contexts, is easy to apply, has high adhesion potential, and can be considered a new option to formalize the discharge from the recovery room.

Keywords

Anesthesia recovery period;  Recovery room;  Models;  Statistical

References

1 R. Advani, N.M. Stobbs, N. Killick, et al. “Safe handover saves lives”: results from clinical audit Clin Gov, 20 (2015), pp. 21-32

2 S.I. Marshall, F. Chung Discharge criteria and complications after ambulatory surgery Anesth Analg, 88 (1999), pp. 508-517

3 R. Merchant, D. Chartrand, S. Dain, et al. Guidelines to the practice of anesthesia — revised edition 2016 Can J Anaesth, 63 (2016), pp. 86-112

4 A.M. Scott, J. Li, S. Oyewole-Eletu, et al. Understanding facilitators and barriers to care transitions: insights from Project ACHIEVE Site Visits Jt Comm J Qual Patient Saf, 43 (2017), pp. 433-447

5 I.T. Awad, F. Chung Factors affecting recovery and discharge following ambulatory surgery Can J Anaesth, 53 (2006), pp. 858-872

6 J.A. Aldrete, D. Kroulik A postanesthetic recovery score Anesth Analg Curr Res, 49 (1970), pp. 924-934

7 P.F. White, D. Song New criteria for fast-tracking after outpatient anesthesia Anesth Analg, 88 (1999), pp. 1069-1072

8 M. Massoud, G. Nielsen, K. Nolan, et al. A framework for spread: from local improvements to system-wide change Institute for Healthcare Improvement, Cambridge (2006)

9 P.F. White, D. Song New criteria for fast-tracking after outpatient anesthesia: a comparison with the modified Aldrete’s scoring system Anesth Analg, 88 (1999), pp. 1069-1072

10 E.M. Bennett, R. Alpert, A.C. Goldstein Communications through limited response questioning Public Opin Q, 18 (1954), pp. 303-308

11 J.R. Landis, G.G. Koch The measurement of observer agreement for categorical data Biometrics, 33 (1977), pp. 159-174

12 J. Fortier, F. Chung, J. Su Unanticipated admission after ambulatory surgery — a prospective study Can J Anaesth, 45 (1998), pp. 612-619

13 R. Gärtner, T. Callesen, N. Kroman, et al. Recovery at the post anaesthetic care unit after breast cancer surgery Dan Med Bull, 57 (2010), p. A4137

14 D. Song, F. Chung, M. Ronayne, et al. Fast-tracking (bypassing the PACU) does not reduce nursing workload after ambulatory surgery Br J Anaesth, 93 (2004), pp. 768-774

15 V. Salmasi, K. Maheshwari, D. Yang, et al. Relationship between intraoperative hypotension, defined by either reduction from baseline or absolute thresholds, and acute kidney and myocardial injury after noncardiac surgery Anesthesiology, 126 (2017), pp. 47-65

16 E. Futier, J.Y. Lefrant, P.G. Guinot, et al. Effect of individualized vs standard blood pressure management strategies on postoperative organ dysfunction 6among high-risk patients undergoing major surgery: a randomized clinical trial JAMA, 318 (2017), pp. 1346-1357

17 D.I. Sessler, C.S. Meyhoff, N.M. Zimmerman, et al. Period-dependent associations between hypotension during and for four days after noncardiac surgery and a composite of myocardial infarction and death: a substudy of the POISE-2 trial Anesthesiology, 128 (2018), pp. 317-327

18 M.D. McEvoy, R. Gupta, E.J. Koepke, et al. Perioperative quality initiative consensus statement on postoperative blood pressure, risk and outcomes for elective surgery Br J Anaesth, 122 (2019), pp. 575-586

19 R.H. Hollis, L.A. Graham, J.P. Lazenby, et al. A role for the early warning score in early identification of critical postoperative complications Ann Surg, 263 (2016), pp. 918-923

20 P.S. Roshanov, T. Sheth, E. Duceppe, et al. Relationship between perioperative hypotension and perioperative cardiovascular events in patients with coronary artery disease undergoing major noncardiac surgery Anesthesiology, 130 (2019), pp. 756-766

21 M.E. Stephenson Discharge criteria in day surgery J Adv Nurs, 15 (1990), pp. 601-613

22 J.G. Hannington-Kiff Measurement of recovery from outpatient general anaesthesia with a simple ocular test Br Med J, 3 (1970), pp. 132-135

23 A.E. Pflug, G.M. Aasheim, C. Foster Sequence of return of neurological function and criteria for safe ambulation following subarachnoid block (Spinal anaesthesic) Can Anaesth Soc J, 25 (1978), pp. 133-139

24 Conselho Federal de Medicina Resolução CFM no 2174, de 14 de dezembre de 2017 Diário Oficial da União, 39 (Seção 1) (2017), pp. 75-84

6107fd9da953954356282ee3 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections