PACU Nurse Staffing and Patient Outcomes: The Evidence Is Still Missing

Developing a model for quantifying staffing requirements in the post-anaesthesia care unit

Nurse managers in charge of a post-anaesthesia care unit (PACU) face the task of optimising staffing levels and must be able to justify staffing needs to the wider operational team. The high variability in patient numbers and acuity that characterises the PACU, as well as the broader factors that affect patient flow to and from the PACU, make it challenging to quantify staffing requirements. Staffing models often fail to reflect accurately the needs of patients and therefore the needs of the unit and there is no recommended model for quantifying PACU staffing requirements. In this article, the author describes the challenges of quantifying PACU staffing requirements and the suitability of different types of data. The author also discusses factors to consider when developing model for quantifying PACU staffing requirements.

Clinical practice and procedures for postoperative care in Sweden: Results from a nationwide survey

A nationwide survey describing Swedish post-anaesthesia care units (PACUs), n = 75 was undertaken. The patients most commonly cared for at PACUs were patients who had undergone laparoscopic surgery, 69.3%, followed by patients who had undergone minor orthopaedic surgery, 68%. At the majority of the PACUs, 86.7%, the staff cared for emergency surgery patients and 48% for day surgery patients. In 31% of the PACUs, a pain relief service was offered through a specific pain service team. During the daytime, the anaesthetist in charge most frequently worked in the operating room 42.7%, and on call in the intensive care unit, 37.3% of the time. In 88% of the PACUs, either all or most registered nurses had a specialist education at an advanced level. The most frequent ratio of registered nurses to patients was 1 to 4, 37.3%. However, Swedish PACUS are also staffed by assistant nurses and the most frequent ratio of registered nurse to assistant nurse was 1:1. Thirty-three (44%) of the PACUs had access to a physiotherapist during the daytime. Almost all PACUs (93.3%) had predetermined discharge criteria but in the majority of PACUs' high-risk patients (68%) were not followed up by an anaesthetist after discharge from the PACU.