Nursing care for ambulatory day surgery: the concept and organization of nursing care

Background: the Day Surgery Unit at the University Hospital in Uppsala provides ambulatory care for people requirering Ear Nose and Throat surgery, hand and minor plastic surgery, as well as for children and adults needing dental treatment. Aim: the Day Surgery Unit has as it’s goal to provide an effective form of surgery with a high level of quality care, both pre and post operative on an ambulatory basis. To attain this goal, nursing care has as it s aim to provide high quality care through knowledge and good nursing, thereby creating trust, security and well being between patients and staff. All this together puts the patient in the center and gives individual nursing care. In this project we also wanted to evaluate patients satisfaction with the nursing care. Methods: the nursing care is organized according to four principles: patient information, primary nursing, nursing documentation and quality assurance. The patients receive information on repeated occasions, both written and oral. Written infonnation is first given to the patient by the co-ordinating nurse when the time for surgery is set up. A nurse and an assistant nurse from the care team work together with each individual patient.These nurses are primarily responsible for the patient from the first visit one week before surgery until the day after surgery. The nurses document in the patients joumal according to a Swedish system called VIPS. At the first contact a health status is taken and nursing care goals are set up with the patient. After the follow up telephone call with the patient on the day after surgery, are all the interview results with regards to post surgery and nursing care documented. The quality of nursing care is continually evaluated according to the model for quality assurance, DySSSy. Evaluation of the nursing care has been made in a patient survey in which 100 adults between the ages of 30–69 years were given questionnaires. Of these, 68 were returned and one was not responded to. Result: we found that the day surgery clinic provides a more effective form of care with a high quality of service. There is a shorter length of stay for the patients and the overall quality of care is maintained through an active program of information and a system of continuity of care. Conclusions: we have written pre and post operative information for each diagnosis. A survey is being conducted to evaluate the patients response to the post operative infonnation provided. Documentation undergoes continual evaluation and development. The DySSSy projects have included, patient integrity and safety in giving hand-over reports to the operating personel; evaluation of post operative information and pain management and nutrition for patients undergoing tonsillectomy and uvulopharyngopalatiplasty.