Reasons for delayed patient discharge following day surgery: a literature review
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Reasons for delayed patient discharge following day surgery: a literature review

Alison Rae Senior lecturer, Adult Nursing and Paramedic Science, University of Greenwich, London, England
Aim

The aim of this literature review was to explore the reasons why some patients are not suitable for discharge following day surgery.

Method

A pragmatic, mixed-methods approach was used to undertake a critical evaluation of the literature and current practice to determine what is already known about discharge following day surgery. Thematic analysis was used to identify the main themes and issues, enabling recommendations to be made to reduce the incidence of patients unable to be discharged following day surgery.

Findings

The main themes or reasons for delayed discharge following day surgery identified from the literature review were: post-operative nausea and vomiting, post-operative pain, going late to theatre and social factors. These themes were supported by the findings of an unpublished audit carried out in a day surgery unit in one NHS healthcare organisation in the south of England between June and August 2014, which indicated that 54 out of 1,180 day surgery patients required an overnight stay during this 12-week period. The audit also showed that a patient going late to theatre had the greatest effect on discharge outcomes.

Conclusion

Recommendations for practice include: the introduction of post-operative nausea and vomiting risk scoring and prophylactic protocols; reorganisation of theatre lists to ensure patients have enough time to recover; and provision of information during the pre-assessment process about the requirement for a responsible adult escort to take patients home and stay with them for the first 24 hours. These changes may help NHS organisations to improve discharge outcomes for day surgery patients and reduce unplanned costs.

Nursing Standard. 31, 11, 42-51. doi: 10.7748/ns.2016.e10292

Correspondence

a.rae@gre.ac.uk

Peer review

This article has been subject to external double-blind peer review and checked for plagiarism using automated software

Conflict of interest

None declared

Received: 30 September 2015

Accepted: 15 December 2015