KINGDOM OF SAUDI ARABIA

Al-SAFWA HOSPITAL
QUALITY DEPARTMENT

INSTITUTIONAL POLICY AND PROCEDURES

POLICY # : IPP – OR - 011 POLICY PAGES : 6

POLICY TITLE : GUIDELINES AND STANDARDS FOR DAY PROCEDURE SURGERY

ISSUING DATE : 1/08/2019 EDITION # : 001

REVISION DATE : 30/07/2021 VERSION # : 001

OR MEDICAL STAFF
APPLIED TO : STD # : OR.8
OR NURSES

Statement of Purpose
To extend the surgical services to the community of Al-Safwa, reduce the demands of
inpatient admissions and to provide cost effective surgery procedures that can be done
during the day and discharge at the same day.

Definition
Day Procedure Surgery is defined as “patient who is admitted for investigation or
operation on a planned non-resident basis and who nonetheless requires facilities for
recovery.”

Statement of Policy

1. Guidelines and standards for Day Surgery

1.1 Al-Safwa Hospital Day Procedure Unit is parallel with in- patient services using

existing admitting areas, operating theaters and recovery room.

1.2 Prior to surgery, the most responsible physician performs medical assessment and ensures
documentation of history and physical examination, signed informed consent and planned procedure
at least a day before the surgery at the Out-Patient Department.

1.3 The treating Physician’s Coordinator shall schedule the date and time of the surgery.

1.4 Patient must comply all assessment form which includes:

1.4.1 Acceptable patients are required to have a General Health status of Class I &II of ASA (American

2885444 ‫ مباشر‬12243 ‫ الرياض‬7476 ‫ب‬.‫مستشفــــــي الصفــــــــوة – طريـــــق الملــــــك عبد العزيـــــــــــز ص‬

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 KINGDOM OF SAUDI ARABIA
Al-SAFWA HOSPITAL
QUALITY DEPARTMENT

Society of Anesthesiologist)

1.4.2 Medical Laboratory Test- this include CBC, Platelet count, PT and PTT and Pregnancy Test. Other
specified medical laboratories and diagnostic test shall be requested by the treating physician and ECG
shall be required for patients over 40 years old and above.

1.4.3

2. Guidelines on the suitability of patients:

2.1 A willingness on the part of the patient to be treated.

2.2 Provision of transport by a person other than the patient and availability of a suitable

person at home to support the patient.

2.3 The pre-operative preparation by the Surgeon must include an explanation of the

procedure, the reason for it and the expected result.

2.4 Clear mechanisms must be established for the notification of pre-admission

arrangements by the facility. In the case of children, a pre admission visit to the hospital may be
helpful to reduce anxiety.

2.5 After admission to the unit, the patient is clinically admitted and prepared for theater,

inclusive of specific pre-operative preparations for their procedure.

2.6 Admission instructions should be advice that no responsibility is taken for the care of
valuables, although a storage area should be provided.

2.7 An assessment that post-operative pain and nausea and vomiting can be controlled.

2.8 An assessment that the post-operative course is predictable.

2.9 Patients should be advised not to leave the valuables behind when going to theater.

3. Suitability for Day Procedure Surgery

3.1 Physical status ASA Classes I and II are permitted

3.2 Age

3.3 Type of Surgery

3.4 Length of Anesthesia

3.5 Type of Anesthesia

3.6 Intubation

3.7 Surgeon

3.8 Recovery Criteria

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 KINGDOM OF SAUDI ARABIA
Al-SAFWA HOSPITAL
QUALITY DEPARTMENT

3.9 Transport

3.10 Post- operative pain relief

4. Contraindication to Day Procedure Surgery

4.1 Medical

4.1.1 Angina at rest ( all coronary and ischemic events)

4.1.2 Myocardial infarction in last six months ( Heart Disease is controversial)

4.1.3 Hypertensive (Diastolic › 105mmHg)

4.1.4 Cardiac Failure

4.1.5 Acute Respiratory infection

4.1.6 Asthma ( moderate to severe require increased observation)

4.1.7 Chronic Bronchitis

4.1.8 Emphysema

4.1.9 Gross obesity ( Body mass index ›35)

4.1.10 Insulin Dependent Diabetics

4.1.11 Sickle cell

4.1.12 Coagulations defects

4.1.13 Anticoagulation therapy

4.1.14 Deformity or anatomical problems in jaw or neck

4.1.15 Extent of pathology e.g. Large scrotal hernia

4.1.16 Operation more than one hour

4.1.17 Painful operations- need an increase in analgesia

4.2 Psychological

4.2.1 Psychologically unstable e.g. Psychosis

4.2.2 Concept of Day surgery unacceptable to patient

4.3 Social

4.3.1 Lives over one hour away from the hospital

4.3.2 No reliable person to take the patient home after surgery and look after them for

the first 24-48 hours post-operatively.

2885444 ‫ مباشر‬12243 ‫ الرياض‬7476 ‫ب‬.‫مستشفــــــي الصفــــــــوة – طريـــــق الملــــــك عبد العزيـــــــــــز ص‬

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 KINGDOM OF SAUDI ARABIA
Al-SAFWA HOSPITAL
QUALITY DEPARTMENT

4.3.3 At home, no access to a lift, telephone or indoor toilet and bathroom.

4.3.4 Age less than 2 or over 60 years old.

5. List of surgical cases that can be done as Day Procedure at Al-Safwa Hospital

5.1 Ophthalmology

5.1.1 Lid surgeries

5.1.1.1 Chalazion

5.1.1.2 Abscess drainage

5.1.1.3 Entropion and ectropion

5.1.1.4 Minor lid repair

5.1.1.5 Ptosis

5.1.1.6 DCR

5.1.1.7 Excision of lid masses

5.1.2 Squint surgeries

5.1.3 Some Cataract surgeries in adults

5.1.4 Vitreous tap

5.1.5 Pterygium and conjunctival masses

5.2 Plastic Surgery

5.2.1 Liposuction procedures

5.2.1.1 Liposuction Chin/ Neck

5.2.1.2 Liposuction Arms

5.2.1.3 Liposuction Accessory Breast

5.2.1.4 Liposuction Abdomen

5.2.1.5 Liposuction thighs

5.2.1.6 Liposuction Legs

5.2.1.7 Liposuction Back

5.2.1.7.1 Liposuction Upper Back

5.2.1.7.2 Liposuction Mid back

5.2.1.7.3 Liposuction Lower Back

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 KINGDOM OF SAUDI ARABIA
Al-SAFWA HOSPITAL
QUALITY DEPARTMENT

5.2.2 Vaser Procedures

5.2.2.1 Vaser Chin/ Neck

5.2.2.2 Vaser Arms

5.2.2.3 Vaser Accessory Breast

5.2.2.4 Vaser Abdomen

5.2.2.5 Vaser Thighs

5.2.2.6 Vaser Legs

5.2.2.7 Vaser Back

5.2.2.7.1 Vaser Upper back

5.2.2.7.2 Vaser Mid Back

5.2.2.7.3 Vaser Lower Back

5.2.3 Skin Lift Procedures

5.2.3.1 Face Lift

5.2.3.2 Neck Lift

5.2.3.4 Blephroplasty

5.2.3.5 Brachioplasty

5.2.3.6 Mastopexy

5.2.3.7 Abdominoplasty

5.2.3.8 Thigh Lift

5.2.3.9 Vaginoplasty

5.2.4 Lipofilling Procedures

5.2.4.1 Face Lipofilling

5.2.4.1.1 Temporal area Lipofilling

5.2.4.1.2 Jawline Area Lipofilling

5.2.4.1.3 Cheek Area Lipofilling

5.2.4.1.4 Naso-labial area Lipofilling

5.2.4.1.5 Under-eye area lipofilling

5.2.4.2 Breast Area Lipofilling

2885444 ‫ مباشر‬12243 ‫ الرياض‬7476 ‫ب‬.‫مستشفــــــي الصفــــــــوة – طريـــــق الملــــــك عبد العزيـــــــــــز ص‬

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 KINGDOM OF SAUDI ARABIA
Al-SAFWA HOSPITAL
QUALITY DEPARTMENT

5.2.4.3 Lateral thighs Lipofilling

5.2.4.4 Buttocks Lipofilling

5.2.4.5 Depressed Areas Lipofilling

5.2.4.5 Other Lipofilling (Hands, Feet, Legs and Bikini)

5.2.5 Augmentation Procedures( Implants)

5.2.5.1 Chin Implants

5.2.5.2 Breast Implants

5.2.5.2 Buttocks implants

5.2.6 Threads and Fillers

5.2.7 Hernia Repair

5.2.7 Reduction Procedures

5.2.7.1 Facial Reduction (cheek, forehead, etc)

5.2.7.2 Breast Reduction

5.2.8 Weight Reduction procedures

5.2.8.1 Balloon composing

6. In the event that any patient is considered not fit for discharge following an operation, then

the attending Surgeon should be notified and responsible for determining the appropriate

plan of management to shift the patient in the surgical ward or in the critical care areas as

needed.

Process & Procedures

1. Check all preoperative preparation and requirements before receiving patient for
operation.
2. Sterile preparations: scrubbing, gowning, gloving draping.
3. Time-out
4. Anesthesia as decided by surgeon and anesthetist is given.

2885444 ‫ مباشر‬12243 ‫ الرياض‬7476 ‫ب‬.‫مستشفــــــي الصفــــــــوة – طريـــــق الملــــــك عبد العزيـــــــــــز ص‬

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 KINGDOM OF SAUDI ARABIA
Al-SAFWA HOSPITAL
QUALITY DEPARTMENT

5. Monitoring recovery
6.Discharge and endorsement to unit.

Responsibilities
 OR medical staff, OR nurses

Equipment & Materials

 Day Surgery Forms

References
 CBAHI Standards
 Ministry of Health
 Department of Nursing Administrative Policy. Unit level orientation manuals, current
standards of nursing practice, educational preparation and licensure.

2885444 ‫ مباشر‬12243 ‫ الرياض‬7476 ‫ب‬.‫مستشفــــــي الصفــــــــوة – طريـــــق الملــــــك عبد العزيـــــــــــز ص‬

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 KINGDOM OF SAUDI ARABIA
Al-SAFWA HOSPITAL
QUALITY DEPARTMENT

Approval Sheet for

INISTITUTIONAL POLICY AND PROCEDURES

POLICY # : IPP – OR – 011 POLICY PAGES : 6

POLICY TITLE : GUIDELINES AND STANDARDS FOR DAY PROCEDURE SURGERY

ISSUING DATE : 01/08/2019 EDITION # : 001

REVISION DATE : 30/07/2021 VERSION # : 001

OR MEDICAL STAFF
APPLIED TO : STD # : OR.8
OR NURSES

Prepared By Reviewed By Reviewed By

Signature Signature
Signature

Date: / /
Date: / / Date: / /

Approved By Approved By

Signature Signature

Date: / / Date: / /

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