Supervised Nurse Assisted Preoperative Assessment (SNAP) (SNAP)

Preoperative anesthesia consultations (PACs) are a key moment in the perioperative care journey. During the PAC, the doctor assesses the patient's state of health (allowing an assessment of the perioperative risk), establishes the anesthesia protocol and writes the preoperative prescriptions. PAC also helps inform and educate patients to reduce their anxiety.

Indeed, if the perioperative care pathway and the risks associated with anesthesia are poorly understood, there is an increased risk of preoperative anxiety, poor compliance with preoperative prescriptions, and therefore potential cancellation of the surgical intervention.

In many countries, preoperative PACs are performed by nurses trained and supervised by anesthetists. These PACs take longer than a consultation carried out by a doctor alone, but would on the one hand have a positive effect on patient education and, on the other hand, ultimately reduce the time and costs associated with the PAC . On the other hand, the impact of PACs performed by nurses supervised by physicians on the perioperative experience of patients and on the rate of cancellations of scheduled interventions has not yet been demonstrated.

Since 2013, so-called "optimized" consultations (PAC carried out by a state-certified nurse - IDE - supervised by an anesthesiologist) have been carried out at the Adolphe de Rothschild Foundation (Paris), for patients having a scheduled surgery intervention. cataract under locoregional or general anesthesia. First, the IDE collects the patient's history and treatments and informs him of the perioperative care pathway. In a second step, the doctor performs the pre-anesthetic medical examination, completes the medical examination and writes the appropriate pre and postoperative prescriptions. This method of consultation made it possible to optimize medical time while providing complete, even better, information to the patient.

That is why optimized PACs may improve the patient's perioperative experience and reduce preoperative cancellations regardless of the type of surgery. programmed.