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that procedures that are delayed and performed in the late afternoon frequently result in extended recovery times due to fluid deficits, nausea and fatigue.
"We have an exceptional anesthesia staff that proactively works to prevent PONV or uncontrolled pain," says Brenda Vahle, RN, CAPA, clinical director of the Beaver Sports Medicine Surgery Center in Corvallis, Ore. "We are lucky that extended recoveries are kept to a minimum."
Only 7.4% of our survey respondents assign an additional nurse to give discharge instructions. "It lets the PACU nurse concentrate on the
patient and a discharge nurse to assist the family," says Ms. Butts. At the Beaver Sports Medicine Surgery Center, a certified athletic trainer gives exercise instructions to the patient and their family. These include a personal sign-on to a web page where exercises are patient-specific," says Ms. Vahle.
"The same nurse prepares the patient for surgery and cares for the patient through recovery also gives all discharge instruction and routinely makes follow-up calls to the same patient," says anesthesiologist
W. Bradley Worthington, MD, of the Hospital for Spinal Surgery in Nashville, Tenn.
Agents for post-op pain control
We asked respondents which agent they you use primarily for post-op pain control. Nearly two-thirds (63.5%) use fentanyl, about one-fourth (24.5%) use morphine and 11.9% use Demerol. Several respondents use dilaudid and such oral pain medications as Vicodin (acetaminophen and hydrocodone), Nucynta (tapentadol), Toradol (ketorolac) and extra-strength Tylenol.
"It depends on the surgeon and the type of surgery done," says a hospital administrator. "For fast short-term relief, we use fentanyl.
