title: Determining criteria to assess patient readiness for discharge from postanaesthetic care: an international Delphi study.
abstract: OBJECTIVE
  To obtain expert consensus on essential criteria required to assess patient readiness for discharge from the postanaesthetic care unit.
  
  
  BACKGROUND
  A patient's condition can deteriorate after surgery, and the immediate postoperative period is recognised internationally as a time of increased risk to patient safety. A recent systematic review identified evidence-based assessment criteria for the safe discharge of patients from the postanaesthetic care unit and identified gaps in the evidence.
  
  
  METHODS
  Descriptive consensus study using the Delphi method.
  
  
  METHODS
  Members of international clinical specialist groups with expertise in anaesthesia or postanaesthetic care participated in three consultation rounds. Online surveys were used to determine expert consensus with regard to aspects of postanaesthetic care and specific criteria for assessing patient readiness for discharge. Three rounds of surveys were conducted from May 2011-September 2012.
  
  
  RESULTS
  Twenty-three experts contributed to the panel. Consensus, that is, at least 75% agreement, was reached in regard to 24 criteria considered essential (e.g. respiratory rate 100%; pain 100%; heart rate 95%; temperature 91%). Consensus was also reached for 15 criteria not considered essential (e.g. appetite 96%; headache 76%). Consensus was not obtained for a further 10 criteria. Participants (95%) agreed that a discharge tool was important to ensure safe patient discharge.
  
  
  CONCLUSIONS
  Consensus was achieved by a panel of international experts on the use of a tool to assess patient readiness for discharge from postanaesthesia care unit and specific variables to be included or excluded from the tool. Further work is required to develop a tool and test its reliability and validity.
  
  
  CONCLUSIONS
  The findings of this study have informed the development of an evidence-based tool to be piloted in a subsequent funded study of nursing assessment of patient readiness for discharge from the postanaesthetic care unit.
authors.affiliation: School of Nursing and Midwifery, Deakin University, Burwood, Melbourne, Vic., Australia.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Phillips
authors.forename: Maryann
authors.initials: M
authors.lastname: Street
authors.forename: Bridie
authors.initials: B
authors.lastname: Kent
authors.forename: Mary
authors.initials: M
authors.lastname: Cadeddu
mesh_terms: D000328:Adult; D032921:Consensus; D003697:Delphi Technique; D005260:Female; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D009736:Nursing Process; D010351:Patient Discharge / Q000592:standards*; D016528:Postanesthesia Nursing; D011184:Postoperative Period; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: Delphi study; consensus; nursing assessment; patient discharge; postanaesthetic care unit; postoperative