Development of a same day laminectomy program.
Historically, patients undergoing a lumbar laminectomy for discectomy (LLD) have been admitted to the hospital for 1 to 3 days. Because a patient undergoing a surgical procedure is not necessarily medically ill, many surgical procedures are now performed on an outpatient basis. A multidisciplinary nursing team proposed that some patients scheduled to undergo an LLD would be able to have this surgery as an outpatient. A 6-month research project was developed to study outcomes of patients undergoing LLD who were discharged after 4 to 6 hours of postoperative care in the PACU. Guidelines were established to define the candidates for enrollment in the same day LLD. A patient clinical pathway was established, and outcome monitors were selected. Twenty-seven patients were enrolled in this study. This article describes the process of development, application, and future implications of this study.
Scanlon
Jeanne
J
Kaiser Permanente Medical Center, Sacramento, CA 95864, USA.
Richards
Becky
B
D000556:Ambulatory Surgical Procedures / Q000451:nursing / Q000523:psychology; D002140:California; D019091:Critical Pathways / Q000458:organization & administration; D006279:Health Maintenance Organizations; D006801:Humans; D007796:Laminectomy / Q000451:nursing / Q000523:psychology; D007902:Length of Stay / Q000706:statistics & numerical data; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration; D010351:Patient Discharge; D017060:Patient Satisfaction; D018579:Patient Selection; D019990:Perioperative Care / Q000451:nursing / Q000458:organization & administration* / Q000523:psychology; D010687:Philosophy, Nursing; D016528:Postanesthesia Nursing / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D016730:Program Development / Q000379:methods; D015397:Program Evaluation