Redefining perioperative advanced practice. The nurse specialist in anaesthesia and emergency surgery. Part I. Defining the problem and providing a solution.

The development of the specialist nursing role was born out of an honest and clinically-driven review of the system that emergency patients experienced. The approaches taken during this review consistently returned facts that this pathway was less than optimal, and a great many improvements could be made. It is important to identify at this stage that simply adding more resources, i.e.: theatre space and beds, would not have improved the patient's experience. The pathway needed greater continuity and better co-ordination. This required a great deal of cooperation between clinical and managerial staff, including some fundamental re-examination of traditionally held beliefs about the role that perioperative nursing could have in managing this patient group. Part Two of the paper (Radford et al 2003) will present the details of how the development of this post challenged the care delivery system for emergency surgical patients. Particular reference will be made to the scope of practice, clinical and organisational impacts and future directions.