Design. This study was a retrospective chart review.

Population, Sample, Setting, & Years. The charts of children (birth to age 18) classified as same-day-surgery patients from one southwestern Gulf coast children’s burn hospital were reviewed from January 1, 2002 until April 30, 2003. A total of seven hundred and eighty-six charts were reviewed.

Findings. Admissions occurred for 181 children of the 768 (24%) children’s charts reviewed. Of those admitted, multiple categories were identified as the reason for one admission for a total of 256 complications. The three main reasons for admission were: being too sedated for safe discharge to home without admission (n = 58 or 23%), pain (n = 45 or 18%), or nausea and vomiting (n = 38 or 15%). These three reasons accounted for 55% of the admissions, with some children’s admissions due to more than one of these three major reasons.

Conclusions. The classification of same-day-surgery post procedure needs to be reviewed with an explanation of criteria. Further study of the category “being to sedated,” and better understanding of medications effective in preventing postoperative pain and nausea and vomiting is indicated.

Implications. Mislabeling a patient admission can lead to inadequate family preparation, expectations, and ambiguous outcomes. Contributing factors that lengthen effects of sedation and increase potential for admission, as well as increase number of procedures with subsequent, lengthening of time under anesthesia, need assessment during the pre-surgery interval. Improved clinical understanding of which medications, dosages, and frequencies work best with children to prevent post-operative pain and nausea and vomiting is an important patient outcome. As the same-day-surgery population is constantly changing, ongoing monitoring of procedures and outcomes becomes essential.

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Back to 15th International Nursing Research Congress
Sigma Theta Tau International
July 22-24, 2004