Evaluation of the length of stay of patients at the Kenyatta National Hospital Theatres Post-Anaesthesia care unit

Abstract

Background- Prolonged length of stay in P ACU leads to patient congestion in the unit; this has been linked to delay in the handing over of new admissions to the P ACU nurses and delay of the anaesthesia team in starting the next case resulting in under-utilization of the allocated theatre time Objective- To determine the length of stay of post-operative patients at the Kenyatta National Hospital main theatres' Post Anaesthesia Care Unit. Methodology - This was a cross-sectional observational descriptive study that involved 175 ASA I II and III category of post-operative adult patients who had been admitted to PACU following emergency or elective surgery. Following PACU admission the patients were monitored and nursed until found fit for discharge to the post-surgical wards, upon being found fit for discharge the relevant wards were informed so that they could pick up these patients. The time taken to achieve fitness for discharge was noted and the time taken to leave P ACU was also noted. A cutoff of up to 2 hours was used as the appropriate duration of stay in P ACU to achieve clinical fitness for discharge to the wards; those in the unit for > 2hours were grouped as having been delayed in discharge fromPACU. Results- The study participants were 175 in total. The average length of PACU stay was 124.5 minutes while the incidence of delayed discharge from the unit was found to be 44%. The factors associated with delayed discharge from P ACU were mainly logistical with 81.8 % being due to non-availability of ward staff and 18.2% being due to nonavailability of lifts for patients transport. A patient's age > 35 years was noted to be associated with delay in discharge from PACU. Conclusion- This study found out that the average length of stay at the Kenyatta National Hospital theatre PACU is 124.5 minutes and that the incidence of delay in discharge from PACU was 44%. Logistical factors were the major contributors to this delay while age was the only patient variable that contributed to delay in PACU.