Nursing Role in the Management of Major Ambulatory Surgery Units: A Scoping Review

Background: Major Ambulatory Surgery is an increasingly common care model, but evidence on nurses' specific organizational roles remains limited. Objectives: To identify and map evidence on nursing roles in the organization, management, and optimization of MAS units. Methods: A scoping review was conducted according to Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Embase, MEDLINE ALL (Ovid), CINAHL Complete, and Web of Science Core Collection were searched on 30-31 July 2025. Following an exploratory phase, the eligibility period was set from January 2000 to July 2025. Observational, qualitative, interventional, and review studies published in English or Spanish were included. Results: Of 922 records identified, 18 sources were included: 16 primary studies and two literature reviews, the latter analyzed separately as contextual evidence. The primary studies most frequently documented nursing roles in preoperative assessment, patient education, discharge preparation, postoperative follow-up, continuity of care, and care-process coordination. Six primary studies measured a service-level indicator (day-of-surgery cancellations, waiting times, or theatre utilization), all with uncontrolled before-after or descriptive designs; only one study addressed management, staffing, leadership, or organizational planning. Direct evidence on managerial, strategic, and organizational-planning roles was scarce. Conclusions: The central finding is the scarcity of evidence on nurses' managerial, strategic, and organizational-planning roles, in contrast with the well-documented roles in preoperative assessment, patient education, postoperative follow-up, and care coordination. Because methodological quality was not appraised, the findings do not establish the effectiveness or comparative superiority of specific nursing models. Future research should define and evaluate nursing competencies and organizational models in MAS using robust comparative, qualitative, and mixed-methods designs.