Post Anesthesia Care Unit
Post Anesthesia Care Unit or PACU is a vital part of APMC special areas and is located along the Operating Room complex designed to provide care for patients recovering from anesthesia, whether it be general, regional or local anesthesia. In coordination with APMC’s ISO 9001:2008 accreditation, PACU contributes in delivering total and comprehensive post-anesthetic care to post-operative clients with competence and standard-based focusing on preventing complications, alleviating pain, promoting self-care and reestablishing the patient’s physiologic equilibrium.
PACU is also committed to achieve patient satisfaction by providing optimum peri-operative and post-operative management. These were the following accomplishments achieved by our area for the entire year of 2013: Organizational Structure: The unit is under the nursing service with the direct supervision of the anesthesiologist chair - Dr. Achmad Disangcopan DPBA and the chief nurse - Marilyn D. Lucman, RN,MN, MPA. The area is composed of 12 registered nurses, highly trained BLS and ACLS provider, with thorough knowledge on post operative management and equipments. Equipments: After years of improvement and expansion: PACU have 10 stretchers which includes 2 SICU beds, 3 Dinamap GE Monitor, 1 Bionet Cardiac Monitor, 1 Versa Med Mechanical Ventilator, 2 infusion pumps, 4 suction machine, 5 UPS, 2 portable BP apparatus, 3 droplights, 6 Oxygen gauge and tanks, 10 IV stands, intubation supplies and a fully-equipped emergency cart. Sterility: Since PACU is a semi-sterile area, installation of proper ventilation is utilized having 4 exhaust fans surrounding the section promoting reverse isolation avoiding airborne contamination.
Use of Personal Protective Equipments is strictly practiced by the watchers and nurses, such as caps, gown and masks, to prevent nosocomial infection along the premises. One watcher per patient policy is also implemented in the visitation of patient. General cleaning and UV routine occurs every 3 months together with the operating room staffs, to ensure the 100 % safety and recovery of our patients. Medical missions: One of APMC’s missions is to provide quality and holistic care to the people in Marawi City. By the extensive service of our medical specialist and collaboration with the private sector health groups through medical missions and various surgical programs throughout the year including our hospital week celebration following Ramadan. These include free cataract removal, prenatal and obygne screening, and other out-patient procedures. Continuing Education: Dr. Disangcopan stressed this year that learning is a life-long endeavor and knowledge is a progressive process to one’s career. With his advance efforts and pursue to widen our knowledge, a series of lecture was organized in the nursing department with the following topics: (1) Discharge Criteria using Aldrete Scoring, (2) Pain: pathophysiology and management, (3) Post Operative Nausea and vomiting (PONV), (4) Post Operative Complications, (5) HIV/AIDS, (6) Post Operative Medications and (7) Hypertension. Waste Management: In compliance with the ISO journey of the medical center, waste segregation is a concern that is addressed by our area. RED: sharp objects, placed in a gallon container or receptacle labeled with red color, YELLOW: infectious and pathological waste, GREEN: for non-infectious wet waste, BLACK: non-infectious dry waste. Patient’s body wastes (vomits, secretions, urine, feces) are contained in a container like basin, bedpan and etc.
The PACU nurse then separates the waste different from other receptacles. Soiled linens, especially those from OR should not place in PACU, and is moved out from the area at once. All wastes is collected by the PACU institutional worker for proper disposal provided by the hospital. Post-operative Census: Because of the institution ’s continuing growth and development on infrastructures, there is also an increase of patient admission in the emergency room influencing the number of surgical cases attended per month. An estimated number of 90-160 patients are admitted at the unit every month with a total sum of 1200-1400 patients catered a year. Post-operative Recovery: One of the quality objectives of the unit is to ensure patient safety upon admission and promoting 100% full recovery with no complications. That is why we strictly follow several guidelines prior to admission and before discharge from PACU. Constant review of the patient’s chart and operative checklist is done pre-operatively after the ward/ ER nurse-on-duty endorses the patient. All equipments needed after the procedure is prepared once the patient is wheeled to the operating room. Aldrete Scoring is the common discharge criteria used by our department as basis for the patient’s post-operative status and if the patient is ready and well enough for trans-out. There has been minimal incident reported of post-operative sepsis in the area, that’s why swabbing of wheels and stretchers are quarterly done by the laboratory department for us to be alarmed and corrected for any possible bacterial growth in the area