Advanced practice nursing in surgery: A scoping review of roles, responsibilities, and educational programs

Abstract

Introduction: The increasing complexity of the healthcare sector requires an evolution in nursing education to effectively manage care in complex and interdisciplinary contexts.

Aim: This review aims to analyze the role of advanced practice nurse (APN) in the surgical context within hospital settings, detailing their functions and responsibilities. It also provides an overview of the main degrees and postgraduate training programs for specialization in perioperative management in major Western countries.

Methods: This scoping review followed the Arksey-O'Malley framework and Joanna Briggs Institute methodology. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used to ensure rigorous and transparent reporting.

Results: Among the 3663 records analyzed, 20 were included in this review. The role of the APN spans across the preoperative, intraoperative, and postoperative phases, encompassing follow-up care as leaders, mentors, and contributors to research. APNs play a pivotal role by offering direct and indirect patient care at each stage of the surgical journey. Acting as liaisons between the healthcare team and patients, APNs enhance healthcare delivery through personalized, coordinated care, while also fostering ongoing education and research in the field.

Conclusions: APNs enhance surgical care by providing in-depth clinical assessments, education, and support throughout the treatment process. However, the lack of standardized regulatory frameworks in some countries limits the autonomy of APNs within the healthcare system, compromising their ability to address unmet health needs and engage in international collaboration.

Implications for nursing and health policy: The findings underscore the need for standardized educational pathways, roles, responsibilities, and autonomy for APNs, facilitating better international collaboration and contributing to scientific research.

Keywords: Advanced Practice Nurse; Clinical Nurse Specialist; General Surgery; Nurse Practitioner; Nurse Specialists; Surgery.