Date of Award

Fall 2015

Project Type


College or School




Program or Major


Degree Name

Master of Science

First Advisor

Joanne Samuels


Background: Advances in anesthesia and surgical techniques, along with an increase in managed care, have led to an increase in ambulatory surgeries. The post-anesthesia discharge criteria used for inpatient care may not be appropriate for ambulatory care patients

Aim: This quality improvement project was aimed at examining whether or not the patient length of stay (LOS) in Phase I of post anesthesia care was appropriate. The global aim was to right-size post anesthesia care Phase I length of stay for adult upper extremity surgical patients.The first step was to assess the effectiveness of the PACU discharge criteria. The specific aim was to determine the effectiveness of the Aldrete scoring tool at this facility.

Methods: After study approval from the hospital’s clinical inquiry committee, data from existing records of 60 adult upper-extremity surgical patients were used to compare LOS in Phase I of post-anesthesia care in relation to achieving a score of 8-10 on the Aldrete tool. A survey was given to PACU nurses to assess their understanding of discharge criteria.

Results: An education seminar was conducted for PACU nurses as the survey revealed lack of knowledge of the hospital discharge protocol and lack of understanding of the steps and purpose of Aldrete scoring. A comparison of ASPAN approved discharge tools was completed to ascertain if a change in discharge protocol was warranted.

Conclusion: It is anticipated that a new scoring tool will be instituted as the discharge protocol for Phase I PACU. Using a standardized tool provides consistency of care, reduces errors,promotes efficient use of resources, meets Joint Commission requirements, and meets ASPAN recommended standards. Use of the scoring tool should be taught as part of orientation to the unit.

Implications for CNL practice: The CNL will take charge of this policy change process.

Included in

Nursing Commons