The new challenges for nursing in ambulatory surgery

Abstract

Ambulatory Surgery (AC) is defined as a “scheduled surgical intervention, performed under general, loco-regional or local anesthesia which, although usually performed in an inpatient setting, can be carried out in the patient's facilities, safely and in accordance with current legis artis, with admission and discharge in less than twenty-four hours” (Ministerial Order no. 132/2009 of January 30, article 3, point 1, p. 660). This surgical modality has multiple advantages, internationally recognized, both at an economic level due to the reduction in hospital costs and lower associated morbidity and at an organizational level, allowing for a reduction in waiting times for surgeries (Pinto et al., 2020).

The innovative vision of the AC, currently highlighted as an organizational model, has a multitude of advantages for all those involved, particularly users, as it allows them to convalesce in a familiar environment, as well as promoting faster socio-professional integration (Sarmento et al., 2013).

At the beginning of the 21st century, the low operational efficiency and poor management of human and technical resources in public health organizations in Portugal were unmistakable. Health professionals were demotivated by their working conditions and careers, and users were dissatisfied with the services provided and the long waiting times for appointments, tests and surgeries (Major & Magalhães, 2014). These factors, coupled with the need to contain public spending, led to the corporatization of public hospitals in order to improve their management and performance. The adoption of business models in the management of public hospitals in Portugal allowed for the introduction of new management practices. Thus, management elements were introduced that were able to monitor and control the activity of hospitals that are Public Business Entities (EPE), focusing on a culture of management by objectives and accountability for results, improving quality and operational efficiency, promoting merit and personal development and improving communication (Campos, 2019).