A preoperative scoring system to identify patients requiring postoperative high dependency care.
BACKGROUND
The incidence of postoperative complications is reduced with early identification of at risk patients and improved postoperative monitoring.


OBJECTIVE
A nursing preoperative assessment tool was developed to identify patients at risk of postoperative complications and to reduce the number of acute admissions to ICU/HDU.


METHODS
All surgical patients admitted to a surgical ward for an elective surgical procedure (n=7832) over a 23-month period were concurrently scored on admission using the preoperative assessment tool.


RESULTS
During the time period studied, acute admissions to ICU/HDU reduced from 40.37 to 19.11%.


CONCLUSIONS
Only 24.04% of patients who had a PAS >4 were identified by the surgeon and/or anesthetist as being at risk of a postoperative complication, or if identified, no provision was made for improved postoperative monitoring. This supports the need for nurses to be involved in identifying preoperatively patients at risk of a postoperative complication and in need of improved postoperative monitoring. The postoperative monitoring requirements for the PAS >4 patients were relatively low technology interventions.


CONCLUSIONS
The preoperative assessment tool is a simple and effective tool for nurses to identify patients at risk of postoperative complications and reduces the number of acute admissions to ICU/HDU.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007362:Intensive Care Units; D008875:Middle Aged; D010343:Patient Admission; D011182:Postoperative Care / Q000451:nursing*; D011183:Postoperative Complications / Q000451:nursing*; D011300:Preoperative Care; D018570:Risk Assessment