Evaluation of Post Anaesthesia Care after General Anaesthesia at Eastern Regional Hospital

Abstract

Background: Good management of post-operative anaesthesia care has resulted in greater client care and surgeon satisfaction. The concept of “continuity of care”, that is, preanaesthesia evaluation, the performance of anaesthesia and post-operative care by the same anaesthetist are difficult to practice in many health facilities. Moreover, there are no established protocols for post operative anaesthesia care. The main objective of the study was to evaluate post anaesthesia care after general elective surgery at the Eastern Regional Hospital in Ghana. Methods: A mixed-method research design was employed to evaluate post anaesthesia care after general elective surgery at the Eastern Regional Hospital. The study population was made up of patients who have undergone general elective surgery, anaesthetists and post anaesthesia care unit (PACU) nurses of the Eastern Regional Hospital, Koforidua. Secondary data from patients’ anaesthesia protocol and PACU observational chart to evaluate post anaesthesia care of clients after general elective surgery. Convenience sampling technique was used to select 94 patients’ anaesthesia protocol and PACU observation chart and 12 anaesthetists and PACU nurses were selected for in-depth interviews. Purposive sampling was used to select the anaesthetists and PACU nurses for the in-depth interviews. In addition, health facility inventory questionnaire was used to collect data on equipment’s and drugs used at Eastern Regional Hospital, Koforidua. Quantitative data gathered were entered into the STATA version 16 software for analysis. The qualitative data were transcribed verbatim after data collection and thematic content analysis was conducted manually. This allowed the researcher to explore emerging issues deeper in subsequent interviews. Results: The study found that PACU lacked essential equipment such as ECG, capnograph, bispectral index and narcotrend monitors. All patients were received and cared for postoperatively at PACU and transported with an anesthesia team member, with 67% continuously evaluated during transport. The importance of discharge assessment was emphasized in the study, with participants sharing experiences and highlighting the importance of patient communication in assessing pain accurately. Some participants admitted to not being aware of post-anesthesia care standards, indicating a need for better adherence to guidelines. Conclusion: Some healthcare workers at the hospital are not aware of post-anesthesia care standards, indicating a need for better adherence to protocols. In addition, it is recommended that the Eastern Regional Hospital address the issue of the lack of functional post-anaesthetic machines in the PACU. Finally, at the PACU, vitals such as oxygen saturation, pulse rate, blood pressure, temperature, and level of consciousness, pain was not always continuously monitored for all patients.