The Significance of Nursing Care in the Post-anesthesia Care Unit and Barriers to Care

Abstract

The post-anesthesia care unit (PACU) is the section where the effects of anesthesia are expected to pass following surgery, the patient's vital signs are aimed to be stable, and the prevention of possible complications is aimed. In PACU, patients may encounter many complications after surgery and anesthesia. The most common complications include acute pain, hypoxemia, nausea, vomiting, delirium, hypothermia, etc. It is stated that most of the complications in the post-anesthesia care phase are seen between the first 1 and 5 h. Nursing care is significant in PACU to improve the quality of recovery of patients and to prevent complications that may occur. Nurses must be highly qualified and have knowledge and skills in the treatment and care of patients from different surgeries of varying complexity that require specialized and individualized care. Complications and side effects can be detected early with adequate nursing observation, care, and treatment in PACU, and the incidence of complications, mortality rates, and length of hospital stay can be reduced with timely intervention. However, unexpected increases in patient volume or acuity, prolonged patient stay in the unit, nurses' lack of knowledge and skills in some subjects, lack of staff, excessive workload, communication barriers between surgeons, anesthesiologists, and nurses, the absence of structured information reporting systems, lack of a standard PACU transfer checklist, and inability to allocate sufficient time for nursing care due to heavy administrative burden in addition to psychosocial factors such as high stress, insufficient sleep, and lack of active rest intervals, prevent adequate nursing care in PACU. The existing literature does not offer a comprehensive examination of nursing care in the PACU, the complications arising therein, impediments to nursing care, or recommendations to address these challenges. This review, seeking to elucidate the methodologies of nursing care within the PACU, highlighting its significance, identifying challenges, and proposing solutions, is anticipated to act as a foundational guide for practitioners, administrators, and scholars in the domain, facilitating the resolution of nursing care barriers and enhancing the body of knowledge on this topic.