ABSTRACT
PURPOSE: Robotic surgery is an increasingly popular approach across surgical specialties in several countries. Nurses embedded in this highly technological environment, however, could excessively center their attention to the robot, deviating their focus from the patient. The Perioperative Patient Focused Model is proposed as a theoretical framework to guide nursing perioperative care toward a patient-centered approach based on 4 dimensions: Health System, Safety, Behavioral Responses and Physiological Responses. This review aimed to understand the role of perioperative nursing in robotic surgery according to the Perioperative Patient Focused Model. DESIGN: An integrative review. METHODS: The Whittemore and Knafl methodology guided this review. The following databases were searched: PubMed, Cochrane Library, ProQuest, Scielo, and LILACS. The keywords used were "Robotic Surgical Procedures" and "Nursing" and their equivalents in Spanish, Portuguese, and French, using the Boolean operator "AND," within the time frame of 2010-2021. FINDINGS: A total of 1,695 articles were retrieved, of which 26 were retained for the final analysis. The majority (n = 17) were written in English, with a level of evidence between 4 and 5. The main actions performed by nursing professionals were retrieved in the Health Systems, Safety, and Behavioral Responses dimensions, focusing on the intraoperative and postoperative period. However, most of the patient's responses were presented in the postoperative stage, even after discharge. Encompassing these findings, a theoretical framework is proposed. CONCLUSIONS: Nursing professional duties are diverse within the course of robotic surgery. It is necessary to expand the Perioperative Nursing specialty toward an extended care, encompassing even the community settings.
Subject(s)
Robotic Surgical Procedures , Humans , Perioperative Nursing/methodsSubject(s)
Humans , Nursing , Advanced Practice Nursing , Clinical Competence , Decision Making , Nursing CareABSTRACT
El cuidado centrado en la persona coloca en el núcleo de su atención la dignidad humana, el respeto y las necesidades individuales; y su aplicabilidad ha sido demostrada en múltiples espacios. El entorno perioperatorio, no obstante, frecuentemente invoca discursos positivistas que alejan su quehacer del enfoque mencionado, materializando en la sala de operaciones un espacio estéril de subjetividades. Más aún, la conjugación de la muerte como fracaso profesional, los debates concernientes al final de la vida y la pérdida de condición de "persona" tras la muerte, aleja a la persona sin vida del foco de la atención quirúrgica durante la cirugía de extracción multiorgánica. A pesar de esta dicotomía, el cuidado centrado en la persona encauza la Enfermería Perioperatoria hacia un cuidado integrado, para lo cual podría reformularse el enfoque como cuidado centrado en el ser humano y perpetuar la dignidad más allá de la muerte. (AU)
Person-centered care places the individual's human dignity, respect, and needs at the core of its focus, and its applicability has been demonstrated within multiple environments. The perioperative environment, nevertheless, frequently invokes positivist discourses that move away its focus from such approach, materializing in the operating theatre a space sterile from subjectivities. Furthermore, the conjugation of death as a professional failure, the debates concerning the end of life and the loss of the personhood after death, separates the person-centered care from the perioperative care of dead people, such as during the organ procurement surgery. Despite this dichotomy, person-centered care channels Perioperative Nursing towards an integrative care, for which it could be reframed as human-centered care and perpetuate dignity beyond death. (AU)
