The continuing increase in day surgery procedures has led to a number of issues, as nurses are challenged to provide the best possible care within a short time frame as well as to minimize the length of hospital stay. Utilizing the evidence from the literature, I am focusing especially on factors that lead to a delay in discharge and the introduction of guidelines to overcome the issue.
I presently work the day surgery unit of a new hospital and it is the only acute government hospital on an island of half a million inhabitants. The unit consists of 46 beds and a wide variety of procedures are performed, from gynaecological, orthopaedic, ophthalmology, laparoscopy, herniotomies, and pain management, excision of lesions or masses and endoscopy procedures.
In the last few years, the hospital administrators, put on pressure from the health authorities, have been tasked with bringing waiting lists, for elective surgery, down. However, as with many other hospitals, there is an acute problem of available inpatient beds, with a considerable number of scheduled operations cancelled.
In order to alleviate the increasing back-log and growing waiting lists, management elected to utilise the facilities available within my unit. Inevitably, this has put pressure on our unit and as a result, 30% of beds allocated to day surgery cases are being used for inpatient procedures, which in turn are creating a backlog on our list. There is an obvious need in finding a long-term solution and if I were to ask myself, as a nurse, what kind of strategy can be used in solving this problem, I would consider the following.
There is no doubt that the common problem with these delays and cancellations is the acute shortage of beds (Fessey, 2005). Focusing on the day surgery unit and my daily observations, I would highlight better bed management as a key area for alleviating this on going problem.
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