• E-mail
• Print
• RSS

When patients’ pain doesn’t call it a day at quitting time

Ambulatory Safety Monitor, September 30, 2004

Want to receive articles like this one in your inbox? Subscribe to Ambulatory Safety Monitor!

Although an accredited ambulatory surgery center may list its business hours as 9 a.m. to 5 p.m., Monday-Friday, that's not exactly accurate. Patients who have undergone surgery may find that once they go home, their pain worsens or they experience symptoms they aren't sure how to handle. The surgery center must have a policy in place to tend to after-hours needs.

The AAAHC standard 1.F.4 says information must be available to patients and staff concerning provisions for after hours and emergency care. Similarly, the JCAHO says when choosing an ambulatory center, patients should ask whether the organization has a 24-hour telephone number to call if complications arise after a procedure. ASCs should consider who will answer that call and how to deal with after-hours emergencies. The JCAHO standard PC.5.10 also says the organization shall provide care, treatment, and services individualized and appropriate to the patient's needs, strengths, limitations, and goals. 

Prevent problems with postoperative information
Arm your patients with explicit information on what they should do after surgery. "There shouldn't be much of a problem after hours if your physicians and nurses do a good job with postoperative training for patients," says Pat Jepsen, RN, BS, CCM, administrator at the Surgery Center of Des Moines West in Iowa.

Although postoperative information will vary depending on the surgery, Jepsen suggests facilities give all patients the following instructions:

*  If given medication for pain, take it so your pain isn't overwhelming 

*  Rest if you've had anesthesia 

*  Don't drive if you've had anesthesia

*  Avoid signing important documents following anesthesia

*  Refrain from making important decisions after you've had anesthesia 

If your patient has had anesthesia, talk to a family member or a responsible party about the postoperative information and have the nonanesthetized person sign off on the instructions.

What message are you sending?

Patients may still have questions after reading their postoperative information. The AAAHC and the JCAHO don't define exactly what ASCs should do after hours, so each facility must establish a policy that serves its needs. 

For some, it's a recorded message. Regardless of what information you leave on a machine, the first instruction should be that if the patient is having an emergency, he or she should hang up and dial 911. 

Other facilities, such as Healthsouth SurgiCenter at Woodward Park in Fresno, CA, where Dee Patrick, RN, BHA, is the administrator, use answering services with a live operator to direct patients. According to Patrick, the service provider also tells patients to dial 911 for emergencies, call their physician, or have the service contact the administrator or director of nursing. Remember to list the phone number in the patients' postoperative instructions.

Want to receive articles like this one in your inbox? Subscribe to Ambulatory Safety Monitor!

• E-mail to a Colleague
• Print
• RSS
• Archive