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Excellent nursing care with prompt access to medical support will ensure that many key aspects of care are proactively managed to ensure good patient outcomes. Nurse-led, protocol driven care of frequently occurring problems for high risk surgical patients (such as pain, fluid imbalance, nutrition and mild cardiorespiratory compromise) can often be provided in a level 2 critical care unit or...
The risk of postoperative functional decline and complex discharge related issues should be considered.
Where the postoperative destination is a level 2 critical care unit, consideration should be given to initial care in a standard PACU until the patient has fully regained consciousness. This is of particular importance for critical care units that are not staffed with airway trained doctors.
All hospitals should have a clear policy describing the safe triage of surgical patients considered to need postoperative critical care, with guidance on which patients should be admitted immediately to critical care, and which can wait in a standard PACU for a short period while a critical care bed becomes available. Staff in critical care and PACUs should develop procedures...
Hospitals should have written policies on the management of patients whose surgery is sufficiently urgent that this proceeds when postoperative critical care is desirable but not available; this situation should be considered exceptional.
There should be easy and safe access to the delivery suite from the main hospital at all times.77
An emergency call system should be provided.77
There should be at least one fully equipped obstetric theatre within the delivery suite or immediately adjacent to it. Appropriately trained staff should be available to allow emergency operative deliveries to be undertaken without delay.22 The number of operating theatres available for obstetric procedures will depend on the number of deliveries and the operative risk profile of the...
Medication storage facilities should be available within maternity theatres to provide timely access to medicines when clinically required, while maintaining integrity of the medicinal product and allowing the organisation to comply with regulations on the safe and secure storage of medicines.71,78
Adequate recovery room facilities that comply with the Association of Anaesthetists’ recommendations for standards of monitoring during anaesthesia and recovery should be available within the delivery suite theatre complex.43
