Assitência ao paciente no pós-operatório imediato: preenchimento do índice de aldrete e kroulik por enfermeiros

Abstract

Introduction: The Post-Anesthesia Care Unit (PAU) is a section of the surgical center designated for patients who have undergone anesthetic medication, where they will be continuously monitored until their vital signs and level of consciousness stabilize. Therefore, nurses working in this area must ensure patient safety and provide continuous, qualified nursing care through assistance and bureaucratic activities, such as completing the Aldrete-Kroulik Index. Objectives: To analyze the difficulties nurses face in applying the Aldrete-Kroulik Score in the Post-Anesthesia Care Unit (PAU). Methods: This is a descriptive, qualitative field study, based on the experiences and perspectives of the participants. The research was conducted in the Post-Anesthesia Care Unit (PACU) of a surgical center at a teaching hospital, which is a leading reference institution in Teresina, Piauí. The unit has an adequate physical structure with a capacity for 10 simultaneous beds. Inclusion criteria for the study were nurses working in the PACU during the day shift. Exclusion criteria were nurses who have worked in the surgical center for less than six months, are on vacation or on leave, or work exclusively the night shift in the PACU. The project was approved by the Research Ethics Committee (CEP) of the Faculdade de Tecnologia de Teresina (CET) under opinion number 7.509.743 and the Ethical Approval Presentation Certificate (CAAE) number 86885325.5.0000.0406. It was subsequently submitted to the CEP of the collaborating institution, receiving approval under opinion number 7.611.338 and CAAE number 86885325.5.3001.5613. Data collection was carried out in June and July 2025 using a semi-structured interview script with nurses working in the PACU. The objective was to identify the nurses' personal experiences related to the difficulties encountered while filling out the Aldrete-Kroulik Score. Results: The study found that the documentation, such as the checklist, is completed inadequately, being filled out only upon a patient's admission and discharge from the Post-Anesthesia Care Unit (PACU). The main causes for this issue are: a high patient-to-staff ratio, an overload of nursing duties, and the lack of adequate physical infrastructure within the institution's PACU. Despite these difficulties, the nurses affirmed their commitment to ensuring proper nursing care and maintaining patient safety. Conclusion: This study highlights that nurses play a central and indispensable role in the Post-Anesthesia Care Unit (PACU), being directly involved in the monitoring, care, and safety of patients during the postoperative period. However, despite difficulties such as a high demand for complex patients, an insufficient number of professionals, and an inadequate physical structure, the nurses demonstrated a strong sense of responsibility and commitment to patient care. They also showed appreciation for instruments like the Aldrete and Kroulik Score, recognizing it as a fundamental tool for assessing anesthetic recovery.