Nursing observations during the first 24 hours after a surgical procedure: what do we do?

Abstract

The purpose of the study was to describe what constitutes postoperative nursing monitoring during the initial 24 hours on the ward including the components of observation, frequency and time spent with patients. The literature provides little guidance as to the best practice of postoperative surveillance. To understand the practice of monitoring patients after returning to the ward from a surgical procedure it is important to describe the current practice. The study involved a non-participant observation of nursing practice. Data were generated via observation of postoperative patients in the first 24 hours after returning to the ward. This occurred in the general surgical units of two different South Australian hospitals over an 8-week period. A total of 81 patients were observed for 282 patient hours. Vital sign collection generally reflected a traditional pattern of hourly for the first four hours, reducing to four hourly across the 12- to 24-hour period. The frequency and duration of patient-nurse interactions, observations recorded and the collection of other clinical data such as pain, oxygen saturations and nausea are also discussed. The findings presented here depict the current nursing practice of postoperative monitoring in two different settings, providing insight into what constitutes contemporary postoperative surveillance. Before inroads can be made to identify the best practice of postoperative patient surveillance a clear cognisance of practice needs to be identified.