Development and Validation of a Discharge Assessment Scale for Outpatients Undergoing Sedative Anesthesia in the Ambulatory Postanesthesia Care Unit: A Comprehensive Delphi Study

Liangyu Fang; Bingbing Wu; Meifeng Wu; Yongli Ye; Lina Chen; Yinchuan Xu

doi:10.1016/j.jopan.2024.01.006

Development and Validation of a Discharge Assessment Scale for Outpatients Undergoing Sedative Anesthesia in the Ambulatory Postanesthesia Care Unit: A Comprehensive Delphi Study

J Perianesth Nurs. 2024 May 8:S1089-9472(24)00010-8. doi: 10.1016/j.jopan.2024.01.006. Online ahead of print.

Authors

Liangyu Fang¹, Bingbing Wu², Meifeng Wu², Yongli Ye², Lina Chen², Yinchuan Xu³

Affiliations

¹ Nursing Department, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China. Electronic address: 2511066@zju.edu.cn.
² Nursing Department, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
³ Department of Cardiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.

PMID: 38727655
DOI: 10.1016/j.jopan.2024.01.006

Abstract

Purpose: The purpose of this study was to develop a discharge assessment scale tailored for outpatients undergoing sedative anesthesia treatment in the ambulatory postanesthesia care unit and validate its agreement with the Post-Anesthetic Discharge Scoring System.

Design: The Delphi method.

Methods: A Delphi survey was conducted with 30 experts focusing on the evaluation of outpatient discharges following treatment under ambulatory anesthesia. Subsequently, a cross-sectional observational study employing convenience sampling selected 2,579 outpatients who had undergone painless ambulatory gastrointestinal endoscopy at a tertiary hospital to analyze the level of agreement with the Post-Anesthesia Discharge Scoring System.

Findings: The study conducted three rounds of expert consultations to create the ambulatory discharge assessment scale. Twenty-five experts from 12 provinces and municipalities in our country were interviewed. The discharge assessment form encompassed five aspects: consciousness level, vital signs, directional stability, mobility, and adverse reactions. According to the scale, if the total score exceeded 9 points, with none of the items scoring 0 points, the ambulatory patient could be discharged from the hospital with the accompaniment of family members. Patients assessed using this newly constructed scale were able to leave the hospital earlier compared to those assessed using the comparative scale. No significant differences were observed in vital signs at the time of discharge or the occurrence of adverse events within 24 hours after the procedure.

Conclusions: This assessment tool for discharging ambulatory patients after the ambulatory anesthesia from the postanesthesia outpatient care unit can be considered a valuable addition to formalize the discharge process in outpatient services.

Keywords: Delphi technique; ambulatory discharge planning; ambulatory patient; pain-free diagnosis and treatment; postanesthesia outpatient care unit.