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Clinical Protocol Documentation - Patient Eligibility for Day Surgery

A patients’ fitness for day surgery should be judged at the time of the final surgical visit prior to the surgery, during the preoperative assessment
visits, and will include the nurse coordinators involved in the care of the patient. To achieve the goals of patient selection for day surgery, the
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protocol includes 3 criteria :
1. SURGICAL: The surgical criterion evaluates factors specific to the surgical procedure required.

2. MEDICAL : The medical criterion evaluates factors specific to the patient’s health.
3. SOCIAL : The social criterion evaluates factors specific to the patient’s environment.

Recommendations around day surgery are continually evolving. An increasing number of surgical procedures are being accepted on a day case
basis. Day cases require better preparation and coordination, so it is important to develop a day surgery protocol based on considerations of the
local culture and clinical environment. We believe that day surgery is a safer and ultimately better alternative for some procedures and patients,
but we are more conservative than other countries in applying the relevant criteria.

Below, each criterion specifies the elements relevant to that criteria and factors relevant to the element based on evidence-based research
regarding day case surgery. Each decision factor in all criteria must be reviewed and applied before the surgeon is comfortable proceeding forward
with day surgery.

Criterion 1: Surgical

Overview:
The surgical procedure itself needs to be considered to determine whether the benefits outweigh any risks associated with day surgery. The key
question to consider is whether the management or outcome would be improved by pre- or post-operative hospitalization. 3

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“Model of Care for Elective Surgery: Improving the Patient Journey National Clinical Program”, Health Service Executive Royal College of Surgeons in Ireland, College of Anesthetists of
Ireland, 2013.
3 Day Surgery as the new paradigm of surgery: best practices and recommendations; Danish Regions 2013: http://www.daysafe.eu/wp-content/uploads/2013/11/Policy-Brief.pdf.
The Shoulder and Upper Limb Unit