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Publication Date



2021 prov rn or; 2021 prov rn mt; 2021 prov rn poster; oregon; montana; university of providence; covid-19; 2019-nCoV


Maternal, Child Health and Neonatal Nursing | Nursing | Surgery


Background: In early 2020, the appearance of the novel COVID-19 virus became a global concern, infecting hundreds of thousands of people. To reduce the spread of the virus, the United States government instituted social distancing and required hospitals to take steps to create extra beds for patient with COVID. One method to increase hospital capacity was the cancellation of scheduled, elective surgeries. In one large pediatric hospital in the Pacific Northwest, there was no formal process in place for cancelling elective procedures or for prioritizing when or how to reschedule the case. Because nurses were being called on to provide direct patient care with increased volumes during the pandemic, non-licensed surgery schedulers were tasked with calling patients to cancel cases without ability to assess patient conditions or provide guidance on when the case might be rescheduled. As a consequence, children and their families who were impacted by cancellations experienced uncertainty and fear that, if left untreated and unevaluated, the underlying condition might worsen and lead to an emergency situation. Nurses in this pediatric surgery center therefore conducted a deep dive into the literature to identify best practices to inform when and how to resume elective surgeries in this vulnerable population.

Purpose/aims: To investigate the role of pediatric nurses following unexpected surgery cancellation for at-risk children.

Methods/Approach: An integrative literature review was conducted. The Cochrane Library, the Cumulative Index of Nursing and Allied Health Literature (CINAHL), and OVID databases were searched using the key words “pediatric surgeries”, “delayed”, “COVID-19”, and “nursing assessment”. Retrieved evidence was limited to peer-reviewed publications, government websites and reputable healthcare organizations published between January 2018 and September 2020. Results: A total of 25 articles and government-sponsored websites met search criteria. Evidence supported that the following criteria merit high priority for rescheduling surgeries for patients: risk for loss of life, limb, organ function, delayed breastfeeding, and developmental delay. Furthermore, nurses are uniquely trained to prevent illness, facilitate healing, and alleviate suffering, and are recommended to assess ongoing individualized care needs that could drive prioritization of surgery rescheduling following unexpected cancellation.

Conclusion: In pediatric patients awaiting non-emergent, elective surgery during the COVID-19 pandemic, literature supports that pediatric surgery nurses must provide ongoing assessment and care of each child affected by cancellation of an elective surgery. Appropriate and timely assessment of evolving family and child needs related to the cancelled surgery can reduce the likelihood of harm during the pre- and post-operative periods.

Implications for practice: Pediatric surgery nurses are uniquely positioned to minimize the impact of cancelled elective surgeries by advocating for rescheduling procedures based on assessment of evolving pediatric patients’ need for care. Moving forward, pediatric surgery nurses should collaborate with interdisciplinary teams to write specific institutional policies to guide decisions regarding how and when to resume and prioritize pediatric surgeries if elective procedures need to be delayed.

Clinical Institute

Women & Children







Conference / Event Name

2021 Providence RN Conference


Virtual Conference

Pediatric Surgery Nurses Lead and Coordinate COVID-19 Recovery Efforts