From the Guidelines
During post-operative ward rounds, healthcare providers should check vital signs, pain levels, wound condition, drain output, intravenous access sites, fluid balance, bowel and bladder function, mobility status, laboratory results, and medication effects, with a focus on promoting return of normal function and minimizing postoperative pain, as recommended by the most recent guidelines 1. The parameters to be checked during ward rounds for post-operative cases include:
- Vital signs (temperature, pulse, blood pressure, respiratory rate, oxygen saturation)
- Pain levels
- Wound condition (for infection, dehiscence, or hematoma)
- Drain output
- Intravenous access sites
- Fluid balance
- Bowel and bladder function
- Mobility status
- Laboratory results
- Medication effects, including analgesics Neurological status and respiratory function should be assessed, particularly in patients who received general anesthesia.
The typical discharge plan for patients includes:
- Ensuring stable vital signs
- Adequate pain control with oral medications, such as acetaminophen 650mg every 6 hours and ibuprofen 400-600mg every 6-8 hours for mild to moderate pain, or tramadol 50mg every 6 hours for more severe pain, as recommended by the British Journal of Anaesthesia 1
- Proper wound healing
- Return of bowel function
- Ability to ambulate safely
- Capability to perform self-care
- Clear instructions about medication regimens, wound care, activity restrictions, follow-up appointment details, and warning signs that necessitate immediate medical attention, such as fever, increasing pain, wound drainage, or bleeding, as outlined in the discharge planning guidelines 1. Early discharge planning is crucial as it reduces hospital stay duration, prevents readmissions, and improves patient outcomes by ensuring appropriate post-hospital care and support systems are in place before the patient leaves the hospital, as emphasized by the evidence-based expert consensus guidelines 1.
From the Research
Parameters to Check During Ward Rounds
The following parameters need to be checked during ward rounds for post-operative cases:
- Name of the consultant 2
- VTE prophylaxis 2
- Examination findings 2
- NBM/nutrition 2
- Patient's current clinical status 2
- NEWS/observations 2
- Management plans 2
- Discharge planning 3, 2
- Imaging results 3
- Complication rates 3
- Post-surgical length of stay (LOS) 3
Typical Discharge Plan
The typical discharge plan for patients involves:
- Ensuring that all aspects of patient evaluation are included 3
- Improving reporting rates of discharge planning 3
- Optimizing patient care and postoperative outcomes 3
- Enhancing patient safety and communication 2, 4
- Involving patients in the discharge planning process 5, 4
- Ensuring that critical issues are not overlooked during patient assessments on ward rounds 2