Discharge delay from the Post Anaesthesia Care Unit: A nursing perspective

Abstract

Background: The Post Anaesthesia Care Unit (PACU) is a critical junction between the operating theatre and the wards. It is essential for the close monitoring of patients before they are discharged to their destination wards for recovery. Many clinical and non-clinical factors influence the flow of patient discharge from the PACU to the wards. This study explores PACU nurses’ perceptions of non-clinical factors causing discharge delays and how these impact the work of nurses. Method: In this study, a descriptive qualitative methodology was implemented. This methodology is widely used in nursing and health care research as it provides a descriptive analysis of a phenomenon with straightforward descriptions of experience and perceptions. Data were collected from ten PACU nurses via in-depth, semi-structured, recorded, individual interviews. Thematic analysis using the work of Braun and Clarke was applied to gain rich insight into PACU nurses’ views, values and experiences concerning discharge delay influenced by non-clinical factors. Findings: Four themes related to discharge delay were identified: ‘accepted as part of the day’, ‘wards are never ready’, ‘feeling frustrated, powerless and stressed’ and ‘empathy for patients’. The analysis of interview transcripts demonstrated that PACU nurses constantly experienced discharge delays because ward beds or ward nurses were not readily available for admitting post-operative patients from the PACU. The findings also revealed PACU nurses’ perceptions of non-clinical discharge delay and how this event may induce stress, frustration and feelings of hopelessness at work. Participants expressed that discharge delay caused them stress and negative emotions or ‘bad feelings’ and challenged their ability to show compassion for patients. Conclusion: PACU nurses perceive discharge delays due to non-clinical factors as compromising their work. Their perspective on discharge delay indicates the need to improve relevant non-clinical factors to minimise PACU nurses’ work stress and to help facilitate the discharge experience of patients and nurses.