Perioperative and Surgical Nursing
Perioperative and surgical nursing is the field of nursing practice that spans the entire surgical journey of a patient: the period before an operation (preoperative), the operation itself (intraoperative), and the recovery that follows (postoperative). It frames the nurse's role as continuous across these phases, coordinating assessment, safety, comfort, and education so that patients move through surgery and back to function with the least avoidable harm.
Definition
Perioperative nursing is nursing care delivered across the preoperative, intraoperative, and postoperative phases surrounding a surgical procedure, with the goal of safe, coordinated patient management throughout the surgical episode.
Scope
This area orients readers to the structure of perioperative care as a discipline. It introduces the three perioperative phases, the safety systems that span them (such as the surgical safety checklist), and the enhanced-recovery philosophy that has reshaped modern surgical care. The detailed essentials of each phase, of wound care, and of complication recognition are developed in the child topics; this entry is a reference overview rather than clinical guidance.
Sub-topics
Key concepts
- Perioperative phases (preoperative, intraoperative, postoperative)
- Surgical safety checklist
- Enhanced Recovery After Surgery (ERAS)
- Continuity of care across the surgical episode
- Patient advocacy and safety in the operating environment
- Surgical-site infection prevention
- Multidisciplinary surgical team
Mechanisms
Surgery imposes a predictable physiological stress response and a set of recurring risks (bleeding, infection, thromboembolism, pain, delayed recovery) that change in character across the three perioperative phases. Perioperative nursing organises care around these phases so that risks are anticipated before they manifest: preoperative assessment identifies vulnerable patients, intraoperative practice maintains a sterile and physiologically stable environment, and postoperative care detects and responds to complications early. Cross-phase safety systems such as the WHO surgical safety checklist add structured communication that reduces preventable morbidity and mortality, while enhanced-recovery pathways bundle evidence-based measures to attenuate the surgical stress response.
Clinical relevance
Surgery is among the highest-volume health interventions worldwide, and the way care is organised around it influences outcomes. Understanding the perioperative structure helps in appraising why safety checklists, recovery pathways, and infection-prevention measures are emphasised in surgical settings. This entry describes the organisation of the field for reference and education; it is not a protocol for managing any individual patient.
Epidemiology
An estimated 313 million surgical procedures were performed worldwide in 2012, underscoring the scale of perioperative care, although access remains highly uneven across regions. The introduction of structured surgical safety checklists has been associated with reductions in postoperative complications and death across diverse settings.
History
Surgical nursing emerged alongside the growth of operative surgery in the late nineteenth and twentieth centuries, formalising the operating-room and recovery-room roles. From the 1990s onward, Henrik Kehlet's work on fast-track (later enhanced-recovery) surgery reframed postoperative care around reducing the surgical stress response, and in 2008-2009 the WHO surgical safety checklist established a global standard for structured perioperative safety communication.
Key figures
- Atul Gawande
- Henrik Kehlet
- Olle Ljungqvist
- Alex Haynes
Related topics
Seminal works
- haynes-2009
- kehlet-2008
- ljungqvist-2017
Frequently asked questions
- What are the three perioperative phases?
- The preoperative phase (from the decision to operate until the patient enters the operating room), the intraoperative phase (during the operation), and the postoperative phase (from the end of surgery through recovery and discharge).
- What is Enhanced Recovery After Surgery (ERAS)?
- ERAS is an evidence-based, multidisciplinary care pathway that bundles measures across the perioperative phases to reduce the physiological stress of surgery and support faster, safer recovery; it evolved from earlier fast-track surgery concepts.