Study: Postoperative thirst often overlooked by OR, ward nurses

Editor's Note

Postoperative thirst, affecting up to 89.6% of surgical patients, is a significant yet often overlooked source of discomfort, according to a recent study of ward and OR nurses in Japan. Published December 30 in Cureus, the study of how nurses recognized and address postoperative thirst revealed gaps in awareness, communication, and evidence-based care practices.

The cross-sectional study used a self-administered questionnaire to gather data from 341 nurses (298 ward nurses, 43 OR nurses) from two university-affiliated hospitals on recognition of thirst, care practices, and reasons for their actions or inactions. Key findings include:

• Low observation of thirst. While postoperative pain, nausea, and delirium were frequently monitored, thirst was the least observed symptom. Only 55.8% of OR nurses and 38.9% of ward nurses reported sometimes observing thirst.
• Reliance on patient complaints. Nurses primarily recognized thirst when patients explicitly complained, rather than through physical observations like dry lips or skin. Fewer than half of OR nurses recognized thirst based on physical signs.
• Limited use of assessment tools. None of the nurses used standardized scales, such as numerical rating or visual analog scales, to evaluate thirst severity.
• Inconsistent information sharing. Communication about thirst between ward and OR nurses was inconsistent. While 89.2% of ward nurses reported not receiving thirst-related information from OR nurses, 56.1% of OR nurses believed they shared such details.

During preoperative care, ward nurses often used water mouthwashes to address thirst (97.4%), while OR nurses relied on moist gauze (80%), researchers found. However, many refrained from providing care due to instructions to restrict fluids, lack of knowledge, or time constraints. During postoperative care, more ward nurses (67.1%) than OR nurses (18.6%) addressed postoperative thirst, primarily using water mouthwashes. Reasons for withholding care included concerns about aspiration and unclear protocols.

Overall, nurses demonstrated a reactive approach to thirst management, focusing on patient complaints rather than proactive monitoring, researchers conclude. A lack of evidence-based guidelines and standardized assessment tools contributed to the inconsistent and experiential care practices observed. Communication gaps between wards and operating rooms further hindered coordinated care. The study underscores the need for evidence-based guidelines, standardized assessment tools, and improved interdepartmental communication to enhance postoperative comfort and safety for patients.