The role of the Advanced Practice Nurse in a prehabilitation program designed for all patients undergoing scheduled surgical procedures

Classically, Enhanced Recovery Programs were applied only to patients undergoing high-complexity surgeries with long hospital stays. This article describes the role of the Advanced Practice Nurse (APN) in the implementation process of an Enhanced Recovery Program in Surgery with the purpose of addressing all patients scheduled for surgical intervention and expected hospital admission. The three preoperative areas were identified based on the complexity of the surgery, risk of postoperative complications, and length of hospital stay, and prehabilitation interventions were standardized for each of them. A retrospective analysis was conducted by reviewing data collected through the Electronic Health Record during the period from 2022 to 2023. A total of 8426 participants were included in the program, distributed across three areas: Short Stay Unit (41.95%), Inpatient Unit (41.53%), and Prehabilitation (16.52%). All participants were assessed by the APN, and 6002 positive screenings were detected (2031; 3179; 792 respectively), with proposed referral to the appropriate professional in all cases, with acceptance rates ranging from 12.91% to 98.92%. Thanks to the leadership of the APN throughout the Program, the development and implementation of necessary protocols and interventions to adequately address all surgical patients of the hospital were ensured, detecting their needs and demands early and in a standardized manner before surgery.