Emergency surgery: measure, change and benefit

Background: Emergency surgery comprises a large part of surgical services. However, it rarely has received the attention that surrounds waiting list management and elective surgery. Objective: This article identifies principles for models of emergency surgery care and describes the redesign of emergency surgery for the benefit of nurses, surgeons and patients. Setting: The redesign of emergency surgery services in New South Wales. Primary argument: Nurses understand the many challenges in delivering care to emergency surgery patients. Access to operating theatres, surgeon availability and frequent reworking of operation schedules are but some of the issues that impinge on the nurse's ability to deliver quality, planned and organised care to emergency surgery patients. The development of the NSW Health Emergency Surgery Guidelines provides nurses with an opportunity to actively contribute to the redesign of emergency surgery. The principles of emergency surgery redesign described in the Guidelines address all the major problems in emergency surgery care. Conclusion: The nursing benefits include improved access to consultant surgeons for patients, nurses and junior doctors, the alignment of surgeons to emergency surgery theatre time and a coordinated approach to the delivery of emergency surgery in a hospital or across a network of hospitals. Nurses will also benefit from a defined career path in emergency surgery, a coordinated approach to a previously unplanned workload and opportunities for career advancement in a previously professionally unstructured specialty. It is crucial nurses participate actively in emergency surgery redesign.