Discharge criteria in day surgery

Abstract

Criteria are necessary to guide the nurse's clinical decision in determining when a patient is ready for discharge following day surgery. On the basis of a literature search and a descriptive research study of the recovery and welfare of patients following day surgery, seven categories are proposed for guiding the nurse's decision making. The seven categories are mental state, mobility, pain, eating and drinking, elimination, information and social factors. Mental state examines recovery from the effects of the premedication (if used) and anaesthetic on mental abilities, and the related problems of headache and muzzyheadedness. Mobility examines mobilization and the related problems of dizziness or faintness. Pain considers postoperative pain. Eating and drinking considers oral intake and the related problems of nausea and vomiting. Elimination considers voiding and the related problem of urine retention. Educational factors relate to the patient's need for predischarge information. Lastly, social factors consider the need for transportation and support within the home. Although there is not a proposed category for wound and cardiovascular complications, the literature review in this area is included in order to support this decision. The seven categories are subdivided into those criteria which are essential and those which are desirable. Meeting the essential criteria ensures patient safety. The desirable factors provide guidance for the nurse on additional factors which should be considered in relation to the quality of the patient's recovery and welfare. With these factors the nurse exercises his or her judgement in relation to the individual patient.