Variability in monitoring, training, and infrastructure in anaesthesia outside the operating theatre and its implications for patient safety and quality of care in health systems: a scoping review.

Introduction: Anaesthesia outside the operating theatre has experienced sustained growth associated with the expansion of minimally invasive diagnostic and therapeutic procedures in non-surgical settings. This increase has occurred in a context of marked variability in monitoring standards, staff training, and available infrastructure, posing relevant challenges for patient safety. The existing evidence is heterogeneous and fragmented and has not been systematically synthesised from a health systems perspective in the adult population. Methods: A scoping review will be conducted in accordance with the Joanna Briggs Institute methodology and reported following the PRISMA-ScR guidelines. Studies published in English with full-text availability between January 2010 and February 2026 will be included, evaluating adult patients undergoing anaesthesia or sedation outside the operating theatre. Searches will be performed in PubMed, Scopus, Web of Science, and ScienceDirect. Study selection will be conducted in two phases by independent reviewers using Rayyan. Data extraction will be carried out using a standardised Microsoft Excel matrix, and findings will be synthesised through descriptive and narrative analysis. Expected results: Substantial variability is anticipated in monitoring standards, staff training, and infrastructure for anaesthesia outside the operating theatre across different settings and health systems. The evidence is likely to demonstrate associations between structural or training-related limitations and a higher incidence of adverse events. The results will enable the mapping of knowledge gaps and priority areas to improve practice standardisation and strengthen patient safety.