About Day Surgery
Day Surgery is easily defined as a surgical procedure that is performed when the patient is able to be safely discharged on the same day.
- Day Surgery was first documented in Glasgow in 1909 when Dr Nicoll (a paediatric surgeon) performed day surgery in the outpatient setting with very successful outcomes. However, it was not well received by his medical collegues and as a result it did not appear again until 1970 in Fresco, Arizona, when the first freestanding day surgery unit was opened.
- Day Surgery has thrived ever since and Australia’s first freestanding day surgery unit (The Surgicentre) opened in Dandenong, Victoria in 1985.
- There were 326 freestanding private day hospitals operating in Australia in 2013-14.
- Day Surgery is a popular choice for many people who need surgery as they are able to recover at home.
- It is performed in many different places, however almost all are performed in either:
- Freestanding Units: An independent, fully contained unit, or
- Integrated Units: A ward or unit within a hospital setting, both private and public
- In America in 1985, 35% of all surgery performed was day surgery compared with 2000 when it was between 72 – 85%! Australia is currently performing 59% of all surgery as day surgery.
Most common types of surgery performed as a day case:
- Dental extractions
- Ear Grommets
- Cataract surgery
What makes Day Surgery possible?
- Less invasive surgical procedures, i.e. Laparoscopic approaches
- New and improved anaesthetic agents
- Increased use of local anaesthetics & nonsteroidal antiinflammatory drugs (NSAIDs)
- Better understanding & use of pre and post operative analgesia
- Better management of post operative nausea and vomiting (PONV)
- Purpose built day surgery units
- Appropriate patient selection
- Pre-admission, recovery and discharge policies
The most important issues for day surgery
- Patients are given adequate information pre operatively to make informed decisions
- Patients are assessed to make sure they are safe for day surgery (eg. uncontrolled diabetes or recent cardiac episodes may mean the patient will need overnight monitoring for an existing condition rather than the type of surgery they are having)
- Patients have a carer who stays with them for the first 24 hours and a number to contact in case of emergencies
What is it like to work in a day surgery unit? Great!!
- There are many different roles and depending upon the size of the unit, it is possible to work in all areas:
- Scrub / Scout
- PACU (post anaesthetic care unit)
- Day surgery discharge area (stage 2&3)
- Post discharge care
- Many hospitals give graduate nurses the opportunity to work in the day surgery unit, if it is not normally available – ask!!
- Day surgery is not just simple surgery; all patients are different and respond to surgery differently and remember – there is no such thing as a minor operation to a patient!!
If you would like to know more about day surgery: