Measures of Quality of Recovery and Discharge-readiness Tools in the Pediatric Postanesthesia Care Unit.

Abstract

The postanesthesia care unit is a critical phase of recovery, yet routine assessment often focuses on discharge readiness rather than the child's recovery experience. This study reviewed measures used in pediatric postanesthesia care unit pathways to assess discharge readiness and early recovery quality and synthesized how they capture domains that matter to children, families, and clinicians. This is a structured literature review with narrative synthesis and identified eight tools used in children: Steward score, Modified Aldrete Score, physiologic criteria-based score, White and Song fast-track score, Criteria for Fast-Tracking Children, Pediatric Post-Anesthetic Discharge Scoring System, Pediatric Readiness for Discharge Instrument, and Discerning Post Anesthesia Readiness for Transition. These tools varied by intended phase and destination, with consistent coverage of consciousness, oxygenation, and hemodynamics but variable assessment of the airway, pain, nausea and vomiting, bleeding, and function. A postanesthesia care unit-specific pediatric quality-of-recovery measure remains a key research and quality improvement gap.