Introduction: The nurse in the Post Anaesthetic Care Unit (PACU) is required to assess, and make clinical judgements about the patient’s recovery and his or her readiness to be transferred out of the PACU to the usually higher patient to staff ratio surgical ward. Background: A literature review was conducted with the focus of uncovering how registered nurses assess patients and make clinical judgements about patients’ readiness for transfer out of a PACU, and to what extent they are influenced by currently available evidence and other factors. Method: Literature searches were conducted on the NEWCAT, Proquest, Ovid and CINHAL databases using the search terms of recovery room nursing, nursing assessment in PACU, PACU discharge criteria and post anaesthetic assessment for discharge. Findings: The findings consisted of primary research (usually journal) publications, and secondary textbook publications. The date of publication was limited from 1983 to 2008 to provide an overview of the topic. Articles that were not available in full text or from unconfirmed authors were discarded. The large amount of research available on ambulatory (day only/outpatient) peri-operative nursing care was not included as the primary focus of this literature review centred on the assessment of patients that return to a surgical ward. Discussion: The main areas of discussion within the literature focus on the role of a PACU nurse, the assessment criteria, length of stay and the nurse’s responsibility for discharge back to a surgical ward. No published papers could be located that reported the use of qualitative research methods to explore how PACU nurses assess a patient’s readiness to return to the surgical ward. The literature shows a pattern that has changed little over the years. The literature search conducted for this study failed to produce evidence that PACU nurses are questioning the practices within their specialty area. Conclusion: This study concludes that qualitative research is required to explore how PACU nurses assess a patient’s readiness to return to the surgical ward. There is an identified gap in the literature that is currently available. There is a need to focus on this area of nursing practice. To build on the foundations that have been established by this research will move the profession towards best practice, evidence based post anaesthetic nursing care.
HNE Handover for Nurses and Midwives Vol. 1, Issue 2, p. 25-28