Elevating Surgical Recovery: A Comprehensive, Integrated, and Scholarly Approach to Fostering Nursing Excellence Through the Entire Perioperative Process
Abstract
Background: The process of surgical recovery is significantly influenced by the quality of perioperative care delivered across the preoperative, intraoperative, and postoperative continuum. Surgical skill is paramount, yet the integrative and consistent contribution of nursing care is a primary determinant of patient success, influencing the rate of complications, rate of recovery, and overall satisfaction.
Aim: This study aims to develop an integrative model that depicts the intricate roles of nurses in advancing operative outcomes. It aims to go beyond task-level explanation to provide a view of care that looks back at assessment, education, technological integration, and interprofessional collaboration.
Methods: A Systematic review of recent literature was conducted from databases including PubMed, CINAHL, and the Cochrane Library. Synthesis included meta-analyses, randomized controlled trials, and qualitative studies published between 2014 and 2024 on evidence-based nursing practice in perioperative settings.
Results: The review confirms that nursing interventions form the foundation of surgical success. Key features noted are organized preoperative optimization, meticulous intraoperative stewardship, early mobilization and comfort management postoperatively, and robust discharge coordination. The addition of digital health technologies and a patient-centered ethos further increases such positive outcomes.
Conclusion: This model provides a pragmatic roadmap for healthcare settings to enable nursing staff, organize high-impact interventions and ultimately increase the quality of perioperative care. In the future, an effort must be made to get around implementation barriers, such as resource limitations and resistance to change, to optimize the potential for nurses in the operating room.
Full text article
References
Arakelian, E., Swenne, C. L., Lindberg, S., Rudolfsson, G., & von Vogelsang, A. C. (2017). The meaning of person‐centred care in the perioperative nursing context from the patient's perspective–an integrative review. Journal of clinical nursing, 26(17-18), 2527-2544. https://doi.org/10.1111/jocn.13639
Ban, K. A., Minei, J. P., Laronga, C., Harbrecht, B. G., Jensen, E. H., Fry, D. E., ... & Duane, T. M. (2017). American College of Surgeons and Surgical Infection Society: surgical site infection guidelines, 2016 update. Journal of the American College of Surgeons, 224(1), 59-74. DOI: 10.1016/j.jamcollsurg.2016.10.029
Benner, P. (1984). From novice to expert excellence and power in clinical nursing practice. AJN The American Journal of Nursing, 84(12), 1479. https://journals.lww.com/ajnonline/toc/1984/12000
Cai, J., Huang, X., & He, L. (2023). An evidence‐based general anaesthesia and prone position nursing checklist: Development and testing. Nursing Open, 10(3), 1340-1349. https://doi.org/10.1002/nop2.1382
Chellam Singh, B., & Arulappan, J. (2023). Operating room nurses’ understanding of their roles and responsibilities for patient care and safety measures in intraoperative practice. SAGE open nursing, 9, 23779608231186247. https://doi.org/10.1177/23779608231186247
Ge, J., Zhang, Y., Fan, E., Yang, X., Chu, L., Zhou, X., ... & Liu, W. (2023). Community nurses are important providers of continuity of care for patients with chronic diseases: a qualitative study. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 60, 00469580231160888. https://doi.org/10.1177/00469580231160888
Greenlee, H., DuPont‐Reyes, M. J., Balneaves, L. G., Carlson, L. E., Cohen, M. R., Deng, G., ... & Tripathy, D. (2017). Clinical practice guidelines on the evidence‐based use of integrative therapies during and after breast cancer treatment. CA: a cancer journal for clinicians, 67(3), 194-232. https://doi.org/10.3322/caac.21397
Knight, S. R., Ng, N., Tsanas, A., Mclean, K., Pagliari, C., & Harrison, E. M. (2021). Mobile devices and wearable technology for measuring patient outcomes after surgery: a systematic review. NPJ digital medicine, 4(1), 157. https://doi.org/10.1038/s41746-021-00525-1
Ljungqvist, O., Scott, M., & Fearon, K. C. (2017). Enhanced recovery after surgery: a review. JAMA surgery, 152(3), 292-298. doi:10.1001/jamasurg.2016.4952
Liu, L. B., Li, J., Lai, J. X., & Shi, S. (2023). Harnessing interventions during the immediate perioperative period to improve the long-term survival of patients following radical gastrectomy. World Journal of Gastrointestinal Surgery, 15(4), 520. https://doi.org/10.4240/wjgs.v15.i4.520
Markovic, D., Jevtovic-Stoimenov, T., Stojanovic, M., Vukovic, A., Dinic, V., Markovic-Zivkovic, B., & Jankovic, R. J. (2018). Addition of clinical risk scores improves prediction performance of American Society of Anesthesiologists (ASA) physical status classification for postoperative mortality in older patients: a pilot study. European Geriatric Medicine, 9(1), 51-59. https://doi.org/10.1007/s41999-017-0002-6
Marsman, M., Kappen, T. H., Vernooij, L. M., Van Der Hout, E. C., Van Waes, J. A., & Van Klei, W. A. (2023). Association of a liberal fasting policy of clear fluids before surgery with fasting duration and patient well-being and safety. JAMA surgery, 158(3), 254-263. doi:10.1001/jamasurg.2022.5867
McGinigle, K. L., Eldrup-Jorgensen, J., McCall, R., Freeman, N. L., Pascarella, L., Farber, M. A., ... & Crowner, J. R. (2019). A systematic review of enhanced recovery after surgery for vascular operations. Journal of vascular surgery, 70(2), 629-640. https://doi.org/10.1016/j.jvs.2019.01.050
Mithany, R. H., Daniel, N., Shahid, M. H., Aslam, S., Abdelmaseeh, M., Gerges, F., ... & Abdallah, S. (2023). Revolutionizing surgical care: the power of enhanced recovery after surgery (ERAS). Cureus, 15(11). DOI: 10.7759/cureus.48795
Moayed, M. S., Khalili, R., Ebadi, A., & Parandeh, A. (2022). Factors determining the quality of health services provided to COVID-19 patients from the perspective of healthcare providers: Based on the Donabedian model. Frontiers in public health, 10, 967431. https://doi.org/10.3389/fpubh.2022.967431
Mohammmed Iddrisu, S., Hutchinson, A. F., Sungkar, Y., & Considine, J. (2018). Nurses' role in recognising and responding to clinical deterioration in surgical patients. Journal of Clinical Nursing, 27(9-10), 1920-1930. https://doi.org/10.1111/jocn.14331
Mustoe, M. M., Clark, J. M., Huynh, T. T., Tong, E. K., Wolf, T. P., Brown, L. M., & Cooke, D. T. (2020). Engagement and effectiveness of a smoking cessation quitline intervention in a thoracic surgery clinic. JAMA surgery, 155(9), 816-822. doi:10.1001/jamasurg.2020.1915
Patel, P. M., Green, M., Tram, J., Wang, E., Murphy, M. Z., Abd-Elsayed, A., & Chakravarthy, K. (2024). Beyond the pain management clinic: the role of AI-integrated remote patient monitoring in chronic disease management–a narrative review. Journal of Pain Research, 4223-4237. https://doi.org/10.2147/JPR.S494238
Pérez-Jover, V., Sala-González, M., Guilabert, M., & Mira, J. J. (2019). Mobile apps for increasing treatment adherence: systematic review. Journal of medical Internet research, 21(6), e12505. https://doi.org/10.2196/12505
Rothrock, J. C. (2022). Alexander's care of the patient in surgery-E-Book. Elsevier Health Sciences.
Santa Mina, D., Clarke, H., Ritvo, P., Leung, Y. W., Matthew, A. G., Katz, J., ... & Alibhai, S. M. H. (2014). Effect of total-body prehabilitation on postoperative outcomes: a systematic review and meta-analysis. Physiotherapy, 100(3), 196-207. https://doi.org/10.1016/j.physio.2013.08.008
Sherrer, M., Simmons, J. W., & Dobyns, J. B. (2022). Preoperative risk stratification: identifying modifiable risks for optimization. Current Anesthesiology Reports, 12(1), 10-25. https://doi.org/10.1007/s40140-022-00519-z
Stephenson, C., Mohabbat, A., Raslau, D., Gilman, E., Wight, E., & Kashiwagi, D. (2020, November). Management of common postoperative complications. In Mayo Clinic Proceedings (Vol. 95, No. 11, pp. 2540-2554). Elsevier. https://doi.org/10.1016/j.mayocp.2020.03.008
Stock, G., & McDermott, C. (2023). The effects of physicians on operational and financial performance in United States hospitals: staffing, human capital and knowledge spillovers. International Journal of Operations & Production Management, 43(7), 1068-1097. https://doi.org/10.1108/IJOPM-07-2022-0457
Sunkara, P. R., Islam, T., Bose, A., Rosenthal, G. E., Chevli, P., Jogu, H., ... & Speiser, J. L. (2020). Impact of structured interdisciplinary bedside rounding on patient outcomes at a large academic health centre. BMJ quality & safety, 29(7), 569-575. https://doi.org/10.1136/bmjqs-2019-009936
Umana, J. (2023). Implementation of a Patient Mobility Program to Reduce Length of Stay & Venous Thromboembolism (VTE) (Doctoral dissertation, Rutgers University The State University of New Jersey, RBHS School of Nursing).
Vincent, J. L., Pelosi, P., Pearse, R., Payen, D., Perel, A., Hoeft, A., ... & Rhodes, A. (2015). Perioperative cardiovascular monitoring of high-risk patients: a consensus of 12. Critical Care, 19(1), 224. https://doi.org/10.1186/s13054-015-0932-7
Wahba, S. (2016). Nurses' knowledge, attitude and practice regarding infection control in operating rooms in Port Said hospitals. Port Said scientific journal of nursing, 3(1), 23-38. https://doi.org/10.21608/pssjn.2019.32283
Walia, H., Banoub, R., Cambier, G. S., Rice, J., Tumin, D., Tobias, J. D., & Raman, V. T. (2019). Perioperative provider and staff competency in providing culturally competent LGBTQ healthcare in pediatric setting. Advances in Medical Education and Practice, 1097-1102. https://doi.org/10.2147/AMEP.S220578
Walker, D. D., Walton, T. O., Jaffe, A. E., Graupensperger, S., Rhew, I. C., & Kaysen, D. (2023). Improving voluntary engagement for posttraumatic stress disorder treatment among active-duty service members using motivational enhancement therapy. Psychological trauma: theory, research, practice, and policy. https://doi.org/10.1037/tra0001562
Wongkietkachorn, A., Wongkietkachorn, N., & Rhunsiri, P. (2018). Preoperative needs-based education to reduce anxiety, increase satisfaction, and decrease time spent in day surgery: a randomized controlled trial. World journal of surgery, 42(3), 666-674. https://doi.org/10.1007/s00268-017-4207-0
Yun, J., Lee, Y. J., Kang, K., & Park, J. (2023). Effectiveness of SBAR-based simulation programs for nursing students: a systematic review. BMC Medical Education, 23(1), 507. https://doi.org/10.1186/s12909-023-04495-8
Zeleke, S., Kassaw, A., & Eshetie, Y. (2021). Non-pharmacological pain management practice and barriers among nurses working in Debre Tabor Comprehensive Specialized Hospital, Ethiopia. Plos one, 16(6), e0253086. https://doi.org/10.1371/journal.pone.0253086
Authors
Copyright (c) 2024 Essa Abdulelah Bin Ruddah Alotaibi, Mohamed Bani Zaid, Abdullah Ali Asiri, Ahmed Abbas Rajab ALNakhli, Qasem Abdullah Ali alhajuj, Zaid Bani Alshammari, Fadel Abbas Alnakhli, Mohammed Abdulrahman Alkhoraif, Mona Mohammed ALFawaz, Abdulmajeed Sameer Almutairi, Hasan Mohammed Alnakhli, ALAwjan Tariq Abdulrahman S

This work is licensed under a Creative Commons Attribution 4.0 International License.