PACU NURSING MANAGER

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REQUIRED QUESTIONS

Shortcut to Optional

1. Is safety the top priority in the anesthesia department?
2. Is there open and effective collegial communication between your service and the anesthesia department?
3. Do all patients who have received GA, regional anesthesia, or monitored anesthesia care receive appropriate post-anesthesia management.
4. Are patients transported to the PACU accompanied by a member of the anesthesia care team who is knowledgeable about the patient's condition? Are patients continually evaluated and treated (as necessary) during transport with monitoring and is support appropriate to the patient's condition?
5. Upon arrival in the PACU, are patients re-evaluated and a verbal report provided to the PACU nurse by the member of the anesthesia care team who accompanies the patient?
6. Is pulse oximetry routinely employed in the initial phase of recovery?
7. Is there a policy to assure the availability of a physician capable of managing complications and providing cardiopulmonary resuscitation to PACU patients, and is there consistently a prompt response from the anesthesiologist to PACU patient needs/PACU nurse requests?
8. Is a physician responsible for the discharge of patients from the PACU?
9. Is a crash cart/defibrillator immediately available in PACU/Phase II recovery?
10. Are patients transported with supplemental oxygen from operating room to PACU (except a select portion of minimally sedated patients?)
11. Are post-anesthesia rounds made regularly in the PACU after patients have recovered from the effects of their anesthesia? Is there documentation made of these rounds?
12. Is there a policy requiring patients who receive sedation, general, or regional anesthesia to be discharged into the care of a responsible adult?
13. Do anesthesiologists and CRNAs conducting post-anesthesia visits evaluate:
    1. the assessment of stability or satisfactory control of respiratory function (respiratory rate, airway patency, oxygen situation)
    2. Stable cardiovascular function (pulse rate, blood pressure, hydration status)
    3. temperature
    4. mental status (patient participates in the evaluation)
    5. pain assessment
    6. nausea/vomiting
14. Would you allow any member of this anesthesia department to anesthetize you or a family member?
15. Is there a mechanism in place for patients to contact an anesthesiologist after discharge?

OPTIONAL QUESTIONS

1. Is there a standard procedure for hand off (i.e., SBAR) from a member of the care team to PACU RN?
2. Are cardiopulmonary emergency drills (mock codes) and malignant hyperthermia drills practiced?
3. Is the response to PACU pages (for routine matters) adequate? For emergencies?
4. If requested, does the anesthesia department offer educational opportunities for PACU staff?
5. Does the department of anesthesia have standard order-sets in place?
6. Do members of the anesthesiology department treat PACU staff members with respect?
7. Are PACU staff questions to anesthesiology staff members answered courteously and intelligently?
8. If the department cares for pediatric patients, is there a separate pediatric cart containing routine equipment for all sizes/ages?
9. If your department cares for children, are anesthesiologists and CRNAs PALS certified?
10. Do you have locally derived benchmarks for PONV and postoperative pain?

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