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Aims: This work aims to investigate the association between obesity and risk of delayed discharge and unplanned readmission in day surgery patients. Background: Day surgeries are well received and developing rapidly. Associations between obesity and delayed discharge and unplanned readmission, which are clinically relevant outcomes in day surgeries, are complex. Design: A systematic review and meta‐analysis was conducted. Data Sources: The PubMed, Web of Science, EMBASE, Cochrane Library, CNKI, VIP, and Wan Fang databases were comprehensively searched from inception until January 2021. Review Methods: Two independent reviewers assessed the studies and extracted data. Pooled estimates were obtained using a random‐effects model. Results: Eleven articles published between 2007 and 2020 were finally included. Obesity appeared not to increase the risk of delayed discharge. However, morbid obesity seemed to be associated with a higher risk of delayed discharge. The meta‐analysis revealed no relationship between higher body mass index (BMI) and unplanned readmission for day surgery patients. Conclusions: Obesity appeared not to increase the risk of delayed discharge except in patients with morbid obesity. Additionally, a higher BMI was not associated with increased risk of unplanned readmission after day surgery. Future studies are required to address this issue further in different types of surgery and areas. Summary statement: What is already known about this topic? The complexity and flexibility of day surgeries have gradually broadened, but selecting the most suitable patients for day surgery is important for safety.Controversies exist on the association between obesity and risk of delayed discharge and unplanned readmission in day surgery patients. What this paper adds? This systematic review and meta‐analysis suggests that obesity did not significantly increase the risk of delayed discharge except in patients with morbid obesity.A higher BMI was not associated with increased risk of unplanned readmission after day surgery. The implications of this paper: Obesity should not be regarded as a contraindication to day surgery although patients with morbid obesity should be scheduled with caution and evaluated on a case‐by‐case basis. Future studies are required to address this issue further in more types of surgery and in different areas. [ABSTRACT FROM AUTHOR]

Background: Digital storytelling is an arts-informed approach that engages short, first-person videos, typically three to five minutes in length, to communicate a personal narrative. Prior to the pandemic, digital storytelling initiatives in health services research were often conducted during face-to-face workshops scheduled over multiple days. However, throughout the COVID-19 lockdowns where social distancing requirements needed to be maintained, many digital storytelling projects were adapted to online platforms. Methods: As part of a research project aiming to explore the day surgery treatment and recovery experiences of women with breast cancer in Peel region, we decided to pivot our digital storytelling process to an online format. During the process, we observed that the online digital storytelling format had multiple opportunities and challenges to implementation. Results: This paper outlines our promising practices and lessons learned when designing and implementing an online digital storytelling project including pre-production, production and post-production considerations. Conclusions: We provide lessons learned for future teams intending to conduct an online digital storytelling project. Plain English Summary: Digital storytelling uses pictures, video clips and audio to create a short, first-person video, to share a person's story. Before the pandemic, digital storytelling workshops were often held in-person over multiple days to help members of the community create their own digital stories. However, throughout COVID-19, many digital storytelling workshops were held online instead. This paper outlines our lessons learned when hosting an online digital storytelling workshop series to capture women's experiences with breast cancer in our local community. We hope our lessons learned are helpful for other teams who are considering using online digital storytelling workshops for their own research projects. [ABSTRACT FROM AUTHOR]

Background: Nursing interventions in the post‐operative time period including psychological and emotional support, adverse event education, and instructions for follow‐up care contribute patient satisfaction, safety, and quality of life. However, the time spent in the post‐anesthesia care unit (PACU) and hospital continues to shorten around the world to reduce health care spending and improve patient outcomes. Nurses conducting research during the important post‐operative recovery period need to utilize unique techniques and emerging technologies to contact, recruit and collect data outside of the hospital setting including the Research Electronic Data Capture (REDCap) platform. Aims: This paper describes the feasibility and acceptability, facilitators and barriers of the software application, REDCap, to complete a repeated‐measures, descriptive correlational study in patients undergoing outpatient breast cancer surgeries. Methods & Materials: The recruitment, data collection and storage were completed utilizing the secure REDCap Platform. The Institutional Research Board (IRB)‐approved study was a repeated‐measures, descriptive, correlational study with data collection at three time points. The data points aligned with important transitions and routine visits to improve data collection feasibility and increase relevance to clinical practice. Results: The sample consisted of women diagnosed with breast cancer undergoing breast conserving surgery between August 15 and October 15, 2020. There were 123 potential participants, of which 76 started the surveys and 75 participated (61%) responded and participated in the study on Post‐operative Day 1. Fifty‐nine participants (78%) completed the surveys on post‐operative Day 14. Discussion: As the frequency of outpatient treatment increases, nurses conducting post‐operative research will need to collect the data outside of the hospital setting. Conclusion: Email provides a method of studying new phenomena by recruiting participants, providing information about the study, and collecting results in a non‐traditional setting. REDCap provides a method to facilitate nursing research through a securely encrypted integrated process. [ABSTRACT FROM AUTHOR]

The article explores the issue of intraoperative hypotension (IOH) and the lack of a standardized definition for it. Different studies and research papers use varying definitions and thresholds for IOH, which affects reported outcomes and management strategies. The authors stress the need for a consistent approach to reporting and managing IOH. They discuss the importance of both absolute and relative thresholds, as well as the duration of hypotension. The article suggests that a personalized approach and considering a 20% fall from baseline may be the most effective way to define IOH. [Extracted from the article]

BACKGROUND Adequate postoperative pain treatment is important for quality of life, patient satisfaction, rehabilitation, function, and total opioid consumption, and might lower both the risk of chronic postoperative pain and the costs for society. Prolonged opioid consumption is a well-known risk factor for addiction. Previous studies in upper extremity surgery have shown that total opioid consumption is a third of the amount prescribed, which can be explained by package size. The aim of this study was to examine whether implementation of prepacked takehome analgesia bags reduced the quantity of prescribed and dispensed opioids. MATERIAL AND METHODS We introduced prepacked take-home analgesia bags for postoperative pain treatment in outpatient surgery. The bags came in two sizes, each containing paracetamol, etoricoxib, and oxycodone. The first 147 patients who received the prepacked analgesia bags were included in the study, and received a questionnaire one month after surgery covering self-assessed pain (visual analog scale of 0–10) and satisfaction (0–5), as well as opioid consumption. Prescription data after introducing the analgesia bags were compared with data before the bags were introduced. RESULTS Of the 147 patients included in the study, 58 responded. Compared to standard prescription (small bag group: 14 oxycodone immediate release capsules (5 mg), large bag group: additional 28 oxycodone extended release tablets (5 mg), based on the smallest available package), the patients in the small analgesia bag group received 50% less oxycodone and 67% less for the large bag group. Patients with small bags consumed a median of 0.0 mg oxycodone and those with large bags consumed a median of 25.0 mg oxycodone. The median satisfaction was 5.0 (range: 2–5) and the median pain score was acceptable at the first postoperative day. Prescription data showed a significant reduction of 60.0% in the total amount of prescribed opioids after the introduction of prepacked analgesia bags. CONCLUSIONS The introduction of prepacked analgesia bags dramatically reduced the quantity of opioids prescribed after outpatient hand surgery. Patient satisfaction was high and the postoperative pain level was acceptable. [ABSTRACT FROM AUTHOR]

Background: A recent meta-analysis concluded that outpatient appendectomy appears feasible and safe, but there is a lack of high-quality evidence and a randomized trial is needed. The aim of this trial is to demonstrate that outpatient appendectomy is non-inferior to conventional inpatient appendectomy in terms of overall morbi-mortality on the 30th postoperative day (D30). Methods: SAMBA is a prospective, randomized, controlled, multicenter non-inferiority trial. We will include 1400 patients admitted to 15 French hospitals between January 2023 and June 2025. Inclusion criteria are patients aged between 15 and 74 years presenting acute uncomplicated appendicitis suitable to be operated by laparoscopy. Patients will be randomized to receive outpatient care (day-surgery) or conventional inpatient care with overnight hospitalization in the surgery department. The primary outcome is postoperative morbi-mortality at D30. Secondary outcomes include time from diagnosis to appendectomy, length of total hospital stay, re-hospitalization, interventional radiology, re-interventions until D30, conversion from outpatient to inpatient, and quality of life and patient satisfaction using validated questionnaires. Discussion: The SAMBA trial tests the hypothesis that outpatient surgery (i.e., without an overnight hospital stay) of uncomplicated acute appendicitis is a feasible and reliable procedure in establishments with a technical platform able to support this management strategy. Trial registration: ClinicalTrials.gov NCT05691348. Registered on 20 January 2023. [ABSTRACT FROM AUTHOR]

Introduction: Leucine-rich alpha-2-glycoprotein 1(LRG-1) is a human protein that has shown potential usefulness as a biomarker for diagnosing pediatric acute appendicitis (PAA). This study aims to validate the diagnostic performance of serum LRG-1 in PAA. Material and Methods: This work is a subgroup analysis from BIDIAP (BIomarkers for DIagnosing Appendicitis in Pediatrics), a prospective single-center observational cohort, to validate serum LRG-1 as a diagnostic tool in PAA. This analysis included 200 patients, divided into three groups: (1) healthy patients undergoing major outpatient surgery (n = 56), (2) patients with non-surgical abdominal pain (n = 52), and (3) patients with a confirmed diagnosis of PAA (n = 92). Patients in group 3 were divided into complicated and uncomplicated PAA. In all patients, a serum sample was obtained during recruitment, and LRG-1 concentration was determined by Enzyme-Linked ImmunoSorbent Assay (ELISA). Comparative statistical analyses were performed using the Mann–Whitney U, Kruskal–Wallis, and Fisher's exact tests. The area under the receiver operating characteristic curves (AUC) was calculated for all pertinent analyses. Results: Serum LRG-1 values, expressed as median (interquartile range) were 23,145 (18,246–27,453) ng/mL in group 1, 27,655 (21,151–38,795) ng/mL in group 2 and 40,409 (32,631–53,655) ng/mL in group 3 (p < 0.0001). Concerning the type of appendicitis, the serum LRG-1 values obtained were 38,686 (31,804–48,816) ng/mL in the uncomplicated PAA group and 51,857 (34,013–64,202) ng/mL in the complicated PAA group (p = 0.02). The area under the curve (AUC) obtained (group 2 vs. 3) was 0.75 (95% CI 0.67–0.84). For the discrimination between complicated and uncomplicated PAA, the AUC obtained was 0.66 (95% CI 0.52–0.79). Conclusions: This work establishes normative health ranges for serum LRG-1 values in the pediatric population and shows that serum LRG-1 could be a potentially helpful tool for diagnosing PAA in the future. Future prospective multicenter studies, with the parallel evaluation of urinary and salivary LRG-1, are necessary to assess the implementability of this molecule in actual clinical practice. [ABSTRACT FROM AUTHOR]

Currently, telemedicine and telehealth have grown, prompting healthcare institutions to seek innovative ways to incorporate them into their services. Challenges such as resource allocation, system integration, and data compatibility persist in healthcare. Utilizing an open data approach in a versatile mobile platform holds great promise for addressing these challenges. This research focuses on adopting such an approach for a mobile platform catering to personalized care services. It aims to bridge identified gaps in healthcare, including fragmented communication channels and limited real-time data access, through an open data approach. This study builds upon previous research in omnichannel healthcare using prototyping to design a mobile companion for personalized care. By combining an omnichannel mobile companion with open data principles, this research successfully tackles key healthcare gaps, enhancing patient-centered care and improving data accessibility and integration. The strategy proves effective despite encountering challenges, although additional issues in personalized care services warrant further exploration and consideration. [ABSTRACT FROM AUTHOR]

Background & Objective: Ambulatory surgeries are increasingly prevalent, yet they often result in postoperative pain and anxiety, impacting patient recovery and satisfaction. Effective management of these complications is crucial, and nursing care interventions have been proposed as a potential solution. This meta-analysis aims to evaluate the effectiveness of nursing care interventions in reducing pain and anxiety and improving functional status among patients undergoing ambulatory surgery. Methods: A comprehensive literature search done on December 2023 of PubMed Central, MEDLINE, Scopus, Google Scholar, Cochrane library, CINAHL, and trial registries was done for studies from inception till November 2023, that met predefined eligibility criteria. Standardized mean differences (SMD) for continuous outcomes and odds ratios (OR) for binary outcomes were calculated using a random-effects inverse-variance model. Sensitivity analysis was performed to assess the robustness of the findings, and heterogeneity was evaluated using I² statistics. Results: Nine studies were included. Pooled analysis revealed a significant reduction in pain (SMD = -1.224, 95% CI: -2.445 to -0.003, p=0.049) and anxiety (SMD = -1.53, 95% CI: -2.77 to -0.28, p=0.016) among patients receiving nursing care interventions, with substantial heterogeneity (I² = 98.2% for pain and 96.6% for anxiety). However, no significant improvement was observed in the functional status (SMD = -0.28, 95% CI: -0.35 to 0.91, p=0.385). Sensitivity analysis confirmed the stability of these results. Conclusion: Nursing care interventions are effective in significantly reducing pain and anxiety in patients undergoing ambulatory surgery. However, their impact on improving functional status remains inconclusive. Our findings underscore the importance of integrating nursing care into postoperative management protocols in ambulatory surgeries and highlight areas for future research, particularly concerning functional recovery. [ABSTRACT FROM AUTHOR]

(1) Background: The surgical procedure to create an arteriovenous fistula (AVF) can be performed in either an ambulatory or in-patient hospital setting, depending on the case's complexity, the anesthesia type used, and the patient's comorbidities. The main scope of this study is to assess the cost-effectiveness and clinical implications of surgically creating an AVF in both ambulatory and in-hospital settings. (2) Methods: We conducted a retrospective observational study, in which we initially enrolled all patients with end-stage kidney disease (ESKD) admitted to the Vascular Surgery Department, Emergency County Hospital of Targu Mures, Romania, to surgically create an AVF for dialysis, between January 2020 and December 2022. The primary endpoint of this study is to assess the cost-effectiveness of surgically creating an AVF in an ambulatory vs. in-hospital setting by comparing the costs required for the two types of admissions. Further, the 116 patients enrolled in this study were divided into two groups based on their preference for hospitalization: out-patients and in-patients. (3) Results: Regarding in-patient comorbidities, there was a higher prevalence of peripheral artery disease (PAD) (p = 0.006), malignancy (p = 0.020), and previous myocardial infarction (p = 0.012). In addition, active smoking (p = 0.006) and obesity (p = 0.018) were more frequent among these patients. Regarding the laboratory data, the in-patients had lower levels of white blood cells (WBC) (p = 0.004), neutrophils count (p = 0.025), lymphocytes (p = 0.034), and monocytes (p = 0.032), but there were no differences between the two groups regarding the systemic inflammatory biomarkers or the AVF type. Additionally, we did not register any difference regarding the outcomes: local complications (p = 0.588), maturation failure (p = 0.267), and primary patency (p = 0.834). In our subsequent analysis, we discovered no significant difference between the hospitalization type chosen by patients regarding AVF primary patency failure (p = 0.195). We found no significant association between the hospitalization type and the recorded outcomes (all ps > 0.05) in both multivariate linear regression and Cox proportional hazard analysis. (4) Conclusions: In conclusion, there are no significant differences in the clinical implications, short-term and long-term complications of AVF for out-patient and in-patient admissions. Additionally, we found no variation in the costs associated with laboratory tests and surgical supplies for an AVF creation. Therefore, it is safe to perform ambulatory AVFs, which can reduce the risk of hospital-acquired infections and provide greater comfort to the patient. [ABSTRACT FROM AUTHOR]

Introduction: Day surgery is often preferred by patients, but it can pose challenges in self-management after discharge. In addition, patients undergoing orthopedic surgery report poorer rates of postoperative recovery than patients undergoing general surgery. Understanding patients' perceptions of feeling safe while undergoing surgery facilitates individualized care and is important since it may affect their recovery. Objective: The aim of this study was to describe patients' perceptions of feeling safe in the perioperative period when undergoing orthopedic day surgery under regional anesthesia. Methods: The design was qualitative and descriptive. Data were collected through a cross-sectional questionnaire containing open-ended questions. Qualitative content analysis with an inductive approach was used for data analysis. Participants' characteristics were presented descriptively. The study population consisted of a consecutive sample of 97 patients who had undergone orthopedic day surgery under regional anesthesia between March and October 2022. Results: The categorization process resulted in the development of two categories describing participants' experience of perioperative feelings of safety when undergoing orthopedic day surgery: having someone near and having a sense of control. The results indicate that the relationship between patients and staff and the perceived feeling of control and participation are factors influencing patients' perception of feeling safe in the perioperative period. Conclusions: In perioperative care, nurses play a vital role in fostering patients' sense of safety by establishing relationships. This ensures that patients can be actively engaged in their own care. Patients also need access to professional and competent staff who strives to add a personal touch and considers their perspective. Since patients undergoing orthopedic day surgery might face a more demanding postoperative recovery than they had initially anticipated, further research is suggested to explore the association between a perceived feeling of safety and postoperative recovery. [ABSTRACT FROM AUTHOR]

Aim: The purpose of the study was to describe the preparation of children for day surgery from the parent's viewpoint. Design: Empirical Research Mixed Method. Methods: The research applied a mixed‐methods study design. The study was conducted at the Paediatric Day Surgical Department of one REDACTED between 2018 and 2020 at the same time as an associated randomised controlled conduct trial. Parents of 41 children (ages 2–6 years) completed measures assessing their preparation for day surgery and satisfaction with the procedure. Semi‐structured interviews were conducted with 15 parents to better understand their experiences. Results: According to the results, most of the parents (95%) told their children about the upcoming day surgery procedure. The child was prepared for the surgery with cognitive and sensory information, and the preparation usually started at home well before the surgery. The parents' experiences with the most critical aspects of preparing their child included three main categories: (1) usability of the preparation method; (2) content and timing of the preparation method and (3) consideration of the family perspective. [ABSTRACT FROM AUTHOR]

Postoperative nausea and vomiting (PONV) is a common complication of ambulatory surgery, leading to numerous deleterious effects such as decreased patient satisfaction, prolonged recovery unit stays, and rarely, more serious complications such as aspiration pneumonia or wound dehiscence. In this paper, we present a narrative review of the literature regarding common risk factors for PONV including patient factors, surgical factors, and anesthetic factors. We then will review anesthetic techniques and antiemetic drugs demonstrated to mitigate the risk of PONV. Finally, we discuss the potential economic benefits of PONV prophylaxis in the perioperative ambulatory setting.

Aim: To explore and synthesise findings from qualitative studies on adult patients' experiences of day surgery and the processes of recovery. Background: There has been a shift in the practice of elective surgery, from inpatient to ambulatory treatment. Accordingly, more patients are undergoing day surgery and expected to care for themselves at home. To our knowledge, an updated metasynthesis on patients' experiences of day surgery across diverse contexts and continents is lacking. Design: Meta‐ethnography. Methods: MEDLINE, EMBASE and CINAHL were systematically searched for qualitative research in English published between 2006 and 2023. Noblit and Hare's meta‐ethnographic approach guided the synthesis of findings from 12 qualitative studies, and the eMERGe Reporting Guidance was used in the writing of this article. Results: Four themes were revealed: (1) requests for tailored information, (2) challenges of recognising and understanding postoperative symptoms, (3) being dependent on continuous professional and personal support and (4) calling for individual adaptation. Conclusion: Our meta‐ethnography indicates there is a need to improve information provision to better prepare patients for the processes of day surgery and recovery and promote their self‐care abilities. Our findings highlight the importance of ensuring adequate levels of individualised care and support throughout the treatment process. Relevance to Clinical Practice: To improve quality of care in day surgery practice, implementation of interventions to enhance information provision and promote self‐care during recovery at home may be considered. Pre‐admission appointments that incorporate provision of tailored information and assessment of the patients' individual needs of care and support, home conditions and access to assistance from family/friends can be recommended. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate and compare the clinical efficacy of patients with cervical disc herniation (CDH) treated by low-temperature plasma radiofrequency ablation (LTP-RFA) as day surgery with traditional inpatients. Methods: According to the selection criteria, single-segment mild to moderate CDH patients who received LTP-RFA from January 2020 to December 2021 were divided into day surgery procedure (DSP) group and a traditional inpatient procedure (TIP) group. The visual analogue score (VAS) and modified Japanese Orthopedic Association score (mJOA) of neurological function of patients in the two groups were recorded at the time of preoperative, and one day, three months, six months after surgery and the last follow-up respectively. The gender, age, responsible segment, surgical complications, hospitalization time, hospitalization expenses, and patient satisfaction were recorded and analyzed for both groups. The modified Macnab standard was used to evaluate the postoperative efficacy at one month and six months after operation. Results: A total of 127 patients (75 in DSP;52 in TIP) with complete data were enrolled and completed six month follow-up. There were no statistically significant pre-treatment VAS scores and mJOA scores in the two groups (P>0.05). The postoperative VAS and mJOA scores in both groups were improved after surgery (P<0.05). However, there was no significant difference in VAS scores and mJOA scores between the two groups in the same postoperative period (all P > 0.05). The efficacy of MacNab was similar one month and six months after operation (P > 0.05). The hospitalization time and hospitalization cost were significantly lower in DSP group (all P<0.05). As the treatment effects were comparable, patients in both groups were similarly satisfied at discharge. Conclusion: LTP-RFA is an effective method for the treatment of mild to moderate CDH. We suggest that the application of LTP-RFA in DSP for mild to moderate CDH is worthy of wide application. [ABSTRACT FROM AUTHOR]

The article focuses on ambulatory colectomy and its potential benefits and challenges. Topics include the impact of Enhanced Recovery after Surgery (ERAS) protocols on early patient discharge, the effectiveness and safety data of ambulatory versus traditional colectomies, and the considerations for patient selection and satisfaction.

Background: Approximately 8.1 million outpatient surgical procedures were performed in Germany in 2021. Little is known about the quality of postoperative pain treatment in the outpatient sector. Methods: The AQS1 project comprises a combined survey of patients and staff in the framework of quality control for ambulatory surgery. The primary endpoint of this study was the prevalence of relevant incisional pain (≥ 4/10 on the numerical rating scale) up to postoperative day 3. Secondary endpoints included prognostic variables for pain and pain-associated outcomes, based on the AQS1 patient questionnaire. Moreover, mixed regression models were used to analyze potential prognostic variables and associations of pain with other outcomes (study registration number DRKS00028052). Results: Data from 330 008 patients were evaluated (from 1 July 2001 to 31 December 2021). The overall prevalence of relevant incisional pain up to postoperative day 3 was 22.5%, with major differences between different types of procedure (3.2%--51.2%). Pain was most common after hemorrhoid surgery (51.2%) and the laparoscopic lysis of large and small bowel adhesions (45.4%). The main associations of relevant pain were with younger age (odds ratio [OR] 1.87, 95% confidence interval [1.82; 1.91]), early postoperative pain (1.34, [1.30; 1.39]), inadequate provision of analgesics (2.90, [2.71; 3.09]), and surgical wound infections (2.60, [2.43; 2.78]). Patients with pain reported lower overall satisfaction with the procedure and a longer inability to work. Conclusion: These data have not been tested for representativeness. They can serve as a point of departure for the optimization of individualized perioperative pain therapy and for the planning of prospective studies. [ABSTRACT FROM AUTHOR]