Development of self-guided pre-surgical optimization resources for older adults

Abstract

Background: Surgical complications are a significant concern for older adults. Pre-surgical optimization is one method that has shown promise in preventing complications. However, these programs can be labour intensive for providers which is further compounded by provider shortages. Self-optimization offers a plausible alternative, enabling patients to independently improve their health before surgery to enhance their surgical outcomes. Purpose: To develop self-guided pre-surgical optimization resources for older adults. Methods: An integrative literature review of 22 sources was conducted, incorporating an embedded environmental scan and consultations with Island Health’s pre-admissions clinic, surgical services and quality improvement experts. Results: Two main themes emerged from the literature: 1) critical self-guided optimization elements for older adults preparing for surgery and 2) effective strategies for educating and preparing older adults for surgery, along with six subthemes. The review and consultations provided insights into developing resources for (1) quitting smoking, (2) improving nutrition, and (3) increasing physical activity before surgery, to best meet the needs of older adults in self-guided pre-surgical optimization within the health authority. Implications: There is a critical need for pre-surgical optimization resources for older adults, offering clear, evidence-based guidance to improve health before surgery and ensure better outcomes. The resource should focus on lifestyle modifications, such as nutrition, physical activity, and smoking cessation, which are particularly important for older adults.