experienced any intraoperative complications. The circulating nurse should inform the PACU nurse of any medications he or she gave intraoperatively including the dose(s), time(s), and therapeutic responses. The circulating nurse also should report the patient’s current comfort level to the PACU nurse.
HAND-OFF COMMUNICATION BETWEEN PHASE I PACU TO THE PHASE II RECOVERY AREA. At the completion of phase I recovery, patients may be admitted to a hospital room or proceed to phase II recovery for discharge. These transitions of care are similar, but are differentiated by emphasis placed either on continuing hospitalization or discharge. Table 3 outlines the SBAR elements of the PACU to inpatient unit hand-off communication, which should mirror that of the intraoperative to PACU transition. Specific emphasis is placed on medication reconciliation. Medications administered in the PACU must be added to the medication reconciliation form and the patient response noted, as well as the time that the last dose was administered. Vital signs and pain level also are emphasized during this transition of care. As the patient’s level of consciousness returns, assessment parameters are reestablished as a baseline for hand-off communication to the next caregiver. Patients who are fully recovered and are preparing to leave the health care facility require education for discharge as well as the completed medication reconciliation form.
CASE STUDY
Mrs L is a 66-year-old woman who presented to her physician’s office with a three-month history of vaginal bleeding. After a lengthy discussion and physical examination, the physician recommended and the patient consented to undergoing an abdominal hysterectomy. Mrs L met with the physician’s surgical coordinator to have her surgery scheduled. The office was busy with telephones ringing, several patients