Post-Operative PACU Assessment Checklist
Comprehensive post-operative PACU assessment including vital signs monitoring, pain management, and discharge readiness criteria.
- Industry: Healthcare
- Frequency: PACU admission/Ongoing
- Estimated Time: Throughout PACU stay
- Role: PACU Nurse
- Total Items: 32
- Compliance: ASPAN Standards, Joint Commission Standards, Hospital PACU Policy
PACU Admission Assessment
Initial assessment
- Verbal report received from OR?
- Airway patent?
- Initial vital signs documented?
- Level of consciousness assessed?
Pain Management
Pain assessment and treatment
- Pain level assessed?
- Pain treated per order?
- Pain reassessed after treatment?
Nausea/Vomiting
PONV management
- Nausea assessed?
- Antiemetic given if needed?
Ongoing Monitoring
Continuous assessment
- Vital signs monitored per protocol?
- Surgical site assessed?
- Drains/output documented?
- IV fluids per order?
Discharge Criteria
Readiness for discharge
- Aldrete/discharge score documented?
- Vital signs stable?
- Pain controlled?
- No excessive bleeding?
- Voided (if required)?
Pre-Assessment Information
Initial assessment documentation and patient/facility identification
- Assessor Name / Credentials
- Assessment Date
- Department / Unit
- Assessment Type (Routine/Annual/Complaint)
- Previous assessment findings reviewed?
Infection Prevention & Control
Verify infection control practices per CDC and Joint Commission standards
- Hand hygiene compliance observed?
- Appropriate PPE available and properly used?
- Isolation precautions properly implemented?
- Sharps containers available and not overfilled?
- High-touch surfaces properly disinfected?
Patient Safety & Identification
Verify patient safety protocols and identification procedures
- Two patient identifiers used before procedures?
- Fall risk assessment completed?
- Call light within patient reach?
- Bed in lowest position with brakes locked?
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Why Use This Post-Operative PACU Assessment Checklist?
This post-operative pacu assessment checklist helps healthcare teams maintain compliance and operational excellence. Designed for pacu nurse professionals, this checklist covers 32 critical inspection points across 8 sections. Recommended frequency: pacu admission/ongoing.
Ensures compliance with ASPAN Standards, Joint Commission Standards, Hospital PACU Policy. Regulatory-aligned for audit readiness and inspection documentation.
Frequently Asked Questions
What does the Post-Operative PACU Assessment Checklist cover?
This checklist covers 32 inspection items across 8 sections: PACU Admission Assessment, Pain Management, Nausea/Vomiting, Ongoing Monitoring, Discharge Criteria, Pre-Assessment Information, Infection Prevention & Control, Patient Safety & Identification. It is designed for healthcare operations and compliance.
How often should this checklist be completed?
This checklist should be completed pacu admission/ongoing. Each completion takes approximately Throughout PACU stay.
Who should use this Post-Operative PACU Assessment Checklist?
This checklist is designed for PACU Nurse professionals in the healthcare industry. It can be used for self-assessments, team audits, and regulatory compliance documentation.
Can I download this checklist as a PDF?
Yes, this checklist is available as a free PDF download. You can also use it digitally in the POPProbe mobile app for real-time data capture, photo documentation, and automatic reporting.