Lumbar discectomy: developing and implementing a day surgery protocol.
In some centres, patients who require a lumbar discectomy are successfully discharged the day of surgery. With the ongoing pressure to provide safe care for patients within certain bed limitations, this option was considered. Using a continuous quality improvement method, a prospective review of patients undergoing a single-level lumbar discectomy was monitored. Based on pre-set criteria, patients were included or excluded in the day surgery protocol and both groups were monitored. A large component of nursing education was provided for all patients, and will be highlighted. Data retrieved for both groups included demographics, length of operation, length in recovery room, length of hospital stay required, and the re-admission rate. There were 47 patients monitored over 11 months. Of the 34 patients entered in the protocol, seven required an overnight length of stay. The reasons for the extended length admission will be described. Of the 13 patients excluded from the protocol, one did not require an overnight stay. Following review of the data, the criteria for inclusion of patients into the protocol has been altered and patients can safely proceed with day surgery for lumbar discectomy.
Doerksen
Kathy
K
Health Sciences Centre, Winnipeg, Manitoba. kdoerksen@exchange.hsc.mb.ca
Dusik-Sharpe
Jodi
J
D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000451:nursing / Q000592:standards* / Q000706:statistics & numerical data; D001509:Bed Occupancy / Q000706:statistics & numerical data; D002985:Clinical Protocols / Q000592:standards; D017586:Diskectomy / Q000451:nursing / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008866:Microsurgery / Q000451:nursing / Q000592:standards / Q000706:statistics & numerical data; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D018579:Patient Selection; D019990:Perioperative Care / Q000451:nursing / Q000592:standards* / Q000706:statistics & numerical data; D016730:Program Development; D011446:Prospective Studies; D017751:Safety Management; D013997:Time Factors; D017749:Total Quality Management / Q000458:organization & administration*