Development and Evaluation of the Pediatric Readiness for Discharge (P-REDI) Tool

Abstract

PurposeThe purpose of this study was to evaluate the P-REDI discharge tool for safe discharge to home following ambulatory surgery. DesignA quasi-experimental, mixed methods with pre/post nurse surveys and retrospective chart review comparing pre-, interim- and post-implementation of P-REDI on unscheduled clinic visits, Emergency Department visits, hospital readmission, and length of stay. MethodsThe P-REDI tool was developed in collaboration with anesthesia and based upon an extensive review of the literature on safe discharge from the Phase II Postanesthesia Care Unit (PACU). Nurse surveys and patient data extracted from the electronic health record through the computer-assisted reporting system were analyzed using descriptive statistics, bivariate statistics, and correlations to assess outcomes and relationships between variables. FindingsNurses’ perceptions of discharge criteria improved after implementation of P-REDI. There were no differences in adverse events before, during, and after the implementation of the P-REDI instrument. There was a significant decrease in Phase II time after implementation of the tool. There were also significant correlations with the P-REDI score and related variables such as length of surgical procedure time and length of stay. ConclusionsThe P-REDI tool was developed to provide nurses a concrete, objective tool to increase their level of comfort with discharging patients from the Phase II PACU. The tool significantly decreased length of stay in Phase II without any change in adverse events. The cost savings to the institution needs to be examined in future studies.