Evaluating Nurse Practitioners' Peri-Operative Roles and Their Outcomes: A Prospective Observational Study in Surgical Care

Aims: To evaluate nurse practitioner (NP) roles during the peri-operative period and their association with healthcare outcomes, including length of stay (LOS), post-operative emergency department (ED) visits and 30-day readmissions. Design: A prospective observational study. Methods: This study, conducted at an Israeli tertiary care centre between 2022 and 2023, included 188 patients from Paediatric Orthopaedics, General Surgery and Breast and Stoma Services. Data on patient demographics, clinical details and outcomes, including LOS, post-operative ED visits and 30-day readmissions, were extracted from medical records. NPs documented interventions they performed across the pre-operative, in-hospital and post-hospital phases. Associations between NP interventions and patient outcomes were analysed using multivariate regression models. Results: NPs performed an average of 6.7 interventions per patient across the peri-operative phases. A moderate-to-high number of interventions performed during the pre-operative phase was significantly associated with a shorter LOS. Performing a moderate-to-high number of interventions during the post-hospital phase was correlated with fewer ED visits and lower rates of 30-day readmission. Conclusions: Interventions performed by NPs during the pre-operative and post-hospital phases were significantly linked to better patient outcomes, notably shorter hospitalizations and fewer post-discharge complications. Implications: Recognising the role of NPs in peri-operative care may guide healthcare systems in optimising post-surgical care pathways, ultimately minimising preventable emergency visits, reducing hospital LOS and lowering readmission rates. Impact: This study underscores the value of NPs as integral providers in peri-operative surgical care. Their involvement in pre-operative preparation and post-discharge coordination contributes meaningfully to patient recovery trajectories. The findings support expanding their role within surgical teams to enhance care continuity and promote better recovery outcomes. Reporting Method: The EQUATOR guidelines were used with the STROBE checklist for reporting this study. Patient or Public Contribution: No patient or public contribution.