An integrative review of a preoperative nursing care structure.
OBJECTIVE
The aims of this integrative literature review are to define the role of a preoperative nurse and to describe the main components and hypothetical outcomes of a preoperative nursing care structure before a surgical patient arrives to an elective procedure.


BACKGROUND
The development of medical care has impacted surgical processes, and patients are now spending less time in hospital settings. Patients often enter the hospital on the day of a procedure and are discharged as soon as it is medically safe, creating challenges for nursing care. Preoperative clinics have been opened, and the importance of preoperative nursing care has been widely understood. Previous literature has provided descriptions about the roles, tasks and outcomes of preoperative nurses; however, the terminology is heterogeneous, and the optimal model remains unknown.


METHODS
A systematic procedure for searching, selecting, and evaluating the literature was followed. The data were collected from PubMed and CINAHL between 1 January 2004 and 20 September 2014. In total, 41 articles were included in the study and were analysed by qualitative inductive content analysis.


RESULTS
The data provided seven main tasks of a preoperative nurse, tools to support preoperative nursing and outcomes of structured preoperative nursing care.


CONCLUSIONS
A preoperative nurse is a specialised coordinator of patient care, and the main purposes of this role are to meet the patient's and the family's needs individually and to prepare them for the scheduled procedure and postoperative recovery. By following the structure of the seven main tasks and using different supportive tools, preoperative nursing can positively impact patient and provider satisfaction, patient safety, quality of care and cost savings.


CONCLUSIONS
A preoperative nursing care structure should be implemented in clinical practice and then evaluated to measure whether the hypothetical outcomes reported in this literature review can be achieved.
Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
Elina
E
Turunen
Kuopio University Hospital, Kuopio, Finland.
Merja
M
Miettinen
Kuopio University Hospital, Kuopio, Finland.
Leena
L
Setälä
Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.|Kuopio University Hospital, Kuopio, Finland.
Katri
K
Vehviläinen-Julkunen
D002983:Clinical Competence; D006801:Humans; D005791:Patient Care / Q000379:methods*; D057184:Practice Patterns, Nurses' / Q000592:standards*; D011300:Preoperative Care / Q000451:nursing* / Q000592:standards*
integrative review; preoperative assessment; preoperative care; preoperative nursing; registered nurse; surgical care