Post Anesthesia Care Unit Patient Classification System: The Direct Care NursingTime Component. Executive Summary

摘要

The intent of the study was to quantify the time Post Anesthesia Care Unit (PACU)nurses spend in direct patient care (i.e., that care provided in the presence of the patient). The quantified PACU direct care time would provide one critical component necessary for the development of an acuity based Patient Classification System (PCS). The study was conducted in three broad phases over a period of two years. Phase I, a panel of clinical nursing experts identified 62 direct care nursing tasks that reflected the full range of PACU nursing. The average time (mean time) to complete each of the 62 direct care tasks was established by actual stopwatch timed measurements. In Phase II a PACU data collection instrument was developed that contained the 62 PACU direct care tasks. A pilot test of this 62 task instrument revealed a reliability of r .93 and a validity of r .82. A field study was initiated at six Army Medical Treatment Facilities (MTFs) with 4018 data collection instruments completed over a period of 14 weeks. Analysis of the data revealed three naturally occurring patient acuity categories (category I 0-29 min, category II 30-69 min, and category III 70 min or greater). Regression analysis identified 25 tasks as the fewest best set of direct care predictor tasks.