A comparison of an evidence based regime with the standard protocol for monitoring postoperative observation: a randomised controlled trial.

BACKGROUND Monitoring patients' vital signs is an important component of postoperative observations. OBJECTIVE To compare the safety and efficacy of the current standard practice for monitoring postoperative observations in one hospital with an experimental protocol. METHOD Patients who were classified as American Society of Anaesthesiologists (ASA) Class 1 or 2 and who met the inclusion criteria were randomised to one of two groups. Following their return to the ward from the recovery unit, these patients were monitored according to either the standard practice (n=96) or the experimental protocol (n=93). Data collected included patient demographics, medical and surgical history, the postoperative observations and the number and type of untoward events. RESULTS The findings indicated that there was no statistically significant difference in the incidence of abnormal vital signs between the groups in the first four hours as well as within the 24 hours following return to the ward from the recovery unit. Additionally, none of the patients required either transfer to the intensive care unit /high dependency unit or management by the intensive care team. Patients in both groups were successfully discharged within 24 hours following surgery. CONCLUSION This study provides evidence to inform clinicians of a safe and cost effective regime in the management of the patient in the postoperative period following discharge from the recovery to the ward. Clinicians, however, must utilise clinical judgement to determine which patients require close monitoring during the postoperative period.