In recent years, day surgery has grown rapidly and has become a major surgical pattern in In Britain, the United States, and Canada.[12–15] Ophthalmic surgeries require short operative time and are usually performed on patients in good conditions, contributing to the application of ophthalmic day surgeries.[2] There are 7 steps in the surgery process: outpatient consultation, pre-operative examination, surgery appointment, admission, surgery, discharge, and follow-up.[16, 17] We established a set of procedures to ensure safety and quality. The admission criteria include: 1, patients are in stable condition with good physical function to undergo local anesthetic surgery; 2, blood pressure or blood glucose in patients with hypertension or diabetes is within the normal range; 3, patients taking oral aspirin discontinue the drug for at least five days; 4, treatment strategy has been determined; 5, surgery time doesn’t exceed 2 hours, preferably within 1 hour; 6, low risk of postoperative bleeding; 7, consciousness is clear and accompanied by relatives; 8, fixed contact information to facilitate post-discharge follow-up.
Day-care ward is a patient-centered medical service that facilitates inpatient medical care, which has been widely applied in the medical field.[18–20] Effective management of day-care wards improved nursing quality, which could reduce adverse events and nursing errors, such as information errors, iatrogenic injury, equipment failure, and medication errors.[9] Our hospital established an ophthalmic day-care ward with 40 hospital beds in 2021. From January 2021 to December 2021, we treated 4830 patients with a total of 3840 surgeries. The probability of adverse events, the age distribution of patients, and types of disease were analyzed to evaluate the treatment of day wards. The operation of day-care wards was evaluated by operation cancellation rate, patient satisfaction rate, and incidence of adverse events. Herein, we aim to provide a reference for the management of day-care wards.
In 2021, a total of 4830 patients were admitted. The majority of patients is the elderly over 60 (74.47%). A total of 3840 surgeries were performed in 2021, including 3433 cataracts (89.4%), 177 silicone oil fillings (4.61%), 191 pterygium (4.97%), 36 myopia (0.94%), and 3 glaucoma (0.08%). The reasons for canceling surgery included upper respiratory tract infection, abnormal blood glucose/pressure, high intraocular pressure, and abnormal preoperative examination results. The number of day surgeries rose rapidly, which accounted for about 40% of ophthalmic surgeries performed in 2021. Our findings highlight the critical role of day-care wards in future medical care. The main limitations of our study included the small sample size and lack of a control group. We only analyzed the data of the ophthalmic day ward in our hospital, thus lacking a comparison with the operation and management models of foreign day wards. Additionally, the ratio of male-female ratio should be considered.
Conclusively, the keys to a well-functioning ophthalmic day ward are management by nursing staff with adequate clinical experience, pre-operative preparation and assessment, and standard medical procedures. Day-care ward is an efficient medical service that shortens hospital stay, relieves mental pressure, and increases the bed occupancy rate. Effective management of the day-care wards will benefit both the medical staff and inpatients. Ophthalmic surgery is performed during the daytime in large numbers, which can easily result in a large number of surgical patients in a short period of time. At the same time, the lack of human resources for ophthalmic nursing and the safety risk caused by high-load work have brought new challenges to the hospital management. More clinical research is warranted to help with the management of day wards.