Q: PACU Discharge

Is it acceptable to discharge patients from the PACU? Sometimes at small facilities beds are hard to come by. In the event there are no beds available after hours or on the weekends, is it better to discharge patients who have had surgery through the ED or PACU?

A: We do discharge from the PACU when we have to. It is the same process just in another location.

A: On weekends or after hours, our PACU discharges to home or appropriate floor all patients who originated in the ED. Our ED has become too busy to send them back through the ED.

A: We discharge through PACU when necessary, but never through the ED since they don’t know the discharge instructions and follow through that our staff performs.

A: We discharge from the PACU – same process as other nursing units.

Q: PACU Discharge Procedures

When the OR crew comes in for a case and has to recover the case and they get another case, how does one go about discharging a patient from PACU? Is there a special PACU person on call who is trained to discharge patients home? In small facilities staff have to wear multiple hats, and if the OR call nurse has to recover and discharge patients, this will slow down additional call cases that could be stacking up.

A: We are a small surgical services unit and we have an OR RN and PACU RN on call so we meet the ASPAN standard of having two RNs available when a patient is in PACU.

A: All of our PACU nurses are also cross-trained to work phase 2 recovery/discharge. With two PACU nurses coming in on call to recover patients, we would be able to care for up to four patients at once per staffing standards. We would enlist the help of the nursing supervisor to assist with taking a patient out to their car or off the unit so that there would always be two RNs in the unit. It does make the process slower, but that’s the way we do it.

A: We have separate OR and PACU staff on call.

A: We discharge from PACU. The same requirements apply when doing so.

Q: Floor Care

Do you wax the OR floors? I cannot find a reference to this in AORN guidelines and would love anyone to share that with me.

A: We wax corridors, not the OR rooms.

A: We don’t wax the OR floors.

Q: Floor Care

Is there a reason that OR floors should not be waxed? We will be opening a new department soon and planned to wax floors annually.

A: Our flooring product does not require and the vendor does not recommend waxing. With all the fluids that get spilled on the floor, waxing makes it a higher risk for falls. Check with your vendor to see what the recommendations are for your flooring.

A: We do not wax our floors because they become too slippery and we have had some close calls with staff falling. As far as AORN guidelines, I have seen nothing that either promotes or discourages waxing with respect to floors.