To determine the nonclinical causes of delayed discharge from the postanesthesia care unit (PACU)... more To determine the nonclinical causes of delayed discharge from the postanesthesia care unit (PACU). Design: A prospective observational study. Methods: Over a 2-month period, data were collected on 576 patients who were transferred to the clinical areas from PACU after surgery. Patients were considered ready for discharge after they had achieved a satisfactory discharge score. Findings: The most common documented reason for nonclinical delayed discharge was lack of available transport (45.5%; n 5 310) followed by bed availability (13%; n 5 89) and the receiving registered nurse's readiness to accept a transfer from PACU (7.3%; n 5 50). Conclusions: Nonclinical delays account for a considerable extension of a patient's time in PACU. The findings of this study suggest that understanding and addressing the causes of delayed discharge in PACU may help to improve patient flow and reduce discharge times. Future research should include the cost associated with these delays and assess the effectiveness of interventions introduced to eliminate such delays.
Magnet designation is the'gold standard'recognising excellence in nursing care and outc... more Magnet designation is the'gold standard'recognising excellence in nursing care and outcomes. It is granted on the basis of empirical evidence across 88 criteria organised into four model components, namely: Transformational Leadership; Structural Empowerment; ...
Background: Patients having arthroscopic shoulder surgery frequently experience periods of inadve... more Background: Patients having arthroscopic shoulder surgery frequently experience periods of inadvertent hypothermia. This common perioperative problem has been linked to adverse patient outcomes such as myocardial ischaemia, surgical site infection and coagulopathy. International perioperative guidelines recommend patient warming, using a forced air warming device, and the use of warmed intraoperative irrigation solutions for the prevention of hypothermia in at-risk patient groups. This trial will investigate the effect of these interventions on patients' temperature, thermal comfort, and total recovery time. Method/Design: The trial will employ a randomised 2 x 2 factorial design. Eligible patients will be stratified by anaesthetist and block randomised into one of four groups: Group one will receive preoperative warming with a forced air warming device; group two will receive warmed intraoperative irrigation solutions; group three will receive both preoperative warming and warmed intraoperative irrigation solutions; and group four will receive neither intervention. Participants in all four groups will receive active intraoperative warming with a forced air warming device. The primary outcome measures are postoperative temperature, thermal comfort, and total recovery time. Primary outcomes will undergo a two-way analysis of variance controlling for covariants such as operating room ambient temperature and volume of intraoperative irrigation solution. Discussion: This trial is designed to confirm the effectiveness of these interventions at maintaining perioperative normothermia and to evaluate if this translates into improved patient outcomes.
To determine the nonclinical causes of delayed discharge from the postanesthesia care unit (PACU)... more To determine the nonclinical causes of delayed discharge from the postanesthesia care unit (PACU). Design: A prospective observational study. Methods: Over a 2-month period, data were collected on 576 patients who were transferred to the clinical areas from PACU after surgery. Patients were considered ready for discharge after they had achieved a satisfactory discharge score. Findings: The most common documented reason for nonclinical delayed discharge was lack of available transport (45.5%; n 5 310) followed by bed availability (13%; n 5 89) and the receiving registered nurse's readiness to accept a transfer from PACU (7.3%; n 5 50). Conclusions: Nonclinical delays account for a considerable extension of a patient's time in PACU. The findings of this study suggest that understanding and addressing the causes of delayed discharge in PACU may help to improve patient flow and reduce discharge times. Future research should include the cost associated with these delays and assess the effectiveness of interventions introduced to eliminate such delays.
Magnet designation is the'gold standard'recognising excellence in nursing care and outc... more Magnet designation is the'gold standard'recognising excellence in nursing care and outcomes. It is granted on the basis of empirical evidence across 88 criteria organised into four model components, namely: Transformational Leadership; Structural Empowerment; ...
Background: Patients having arthroscopic shoulder surgery frequently experience periods of inadve... more Background: Patients having arthroscopic shoulder surgery frequently experience periods of inadvertent hypothermia. This common perioperative problem has been linked to adverse patient outcomes such as myocardial ischaemia, surgical site infection and coagulopathy. International perioperative guidelines recommend patient warming, using a forced air warming device, and the use of warmed intraoperative irrigation solutions for the prevention of hypothermia in at-risk patient groups. This trial will investigate the effect of these interventions on patients' temperature, thermal comfort, and total recovery time. Method/Design: The trial will employ a randomised 2 x 2 factorial design. Eligible patients will be stratified by anaesthetist and block randomised into one of four groups: Group one will receive preoperative warming with a forced air warming device; group two will receive warmed intraoperative irrigation solutions; group three will receive both preoperative warming and warmed intraoperative irrigation solutions; and group four will receive neither intervention. Participants in all four groups will receive active intraoperative warming with a forced air warming device. The primary outcome measures are postoperative temperature, thermal comfort, and total recovery time. Primary outcomes will undergo a two-way analysis of variance controlling for covariants such as operating room ambient temperature and volume of intraoperative irrigation solution. Discussion: This trial is designed to confirm the effectiveness of these interventions at maintaining perioperative normothermia and to evaluate if this translates into improved patient outcomes.
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Papers by Kerry Cobbe