Nursing leadership and performance metrics in artificial intelligence integrated gastrointestinal surgical care: A narrative review

Table 2 Artificial intelligence applications across perioperative phases and nursing implications in gastrointestinal and complex surgical care

Perioperative phase	AI-supported function	Surgical context	Nursing implications	Measurable nursing-sensitive indicators
Preoperative assessment	Risk stratification using demographic, laboratory, imaging, nutritional, and comorbidity data[5,25-30]	Pancreaticoduodenectomy; major hepatectomy; colorectal cancer surgery; multivisceral resection	Identification of patients requiring intensified education, nutritional support, prehabilitation, early stoma counselling, or planned higher-acuity postoperative monitoring	Completion of risk-based education; timely nutrition or physiotherapy referral; documentation of individualized monitoring plan; predefined escalation criteria
Preoperative imaging review	AI-assisted detection of sarcopenia, visceral obesity, frailty-related imaging markers, or anatomical complexity[34,35]	Hepatopancreatobiliary and oncological gastrointestinal surgery	Translation of imaging-derived risk into practical nursing care, including pressure-injury prevention, mobilization planning, respiratory preparation, and discharge support	Documentation of frailty or nutritional risk; early mobilization plan; referral to allied health professionals; pressure-injury risk reassessment
Operating room and immediate recovery	Prediction of hemodynamic instability, bleeding risk, respiratory compromise, or need for higher-acuity care[25,30,35]	Esophagectomy; major liver resection; complex abdominal surgery	Structured handover from operating room or recovery unit to ward or intensive care, with clear monitoring priorities	Completeness of AI-informed handover; time from recovery discharge to first ward reassessment; documentation of key intraoperative concerns
Early postoperative period	Detection of abnormal physiological patterns and early deterioration[5-9,25,30]	Anastomotic leak after colorectal surgery; pancreatic fistula; postoperative bleeding; sepsis; acute kidney injury	Prompt bedside reassessment, review of drain output, wound status, fluid balance, pain pattern, urine output, oxygen requirement, and escalation to surgical team	Time from alert to nursing reassessment; time from reassessment to medical escalation; proportion of alerts with documented response; missed or delayed escalation events
Postoperative ward care	Support for risk-stratified enhanced recovery pathways[10-13,47-49]	Colorectal surgery; pancreatic surgery; hepatobiliary surgery	Adjustment of monitoring frequency, mobilization targets, pain assessment, nutritional support, and discharge readiness according to risk	Adherence to individualized observation schedule; completion of ERAS-related nursing interventions; documented reasons for pathway deviation
Discharge planning	Prediction of readmission, delayed recovery, dehydration, infection, or poor self-management[5,25,27,30]	New ileostomy; complex wounds; drains at discharge; frail older patients; cancer surgery	Targeted patient education, confirmation of understanding, community nursing referral, stoma nurse involvement, and early follow-up planning	Completeness of discharge education; documentation of warning signs; referral to community or stoma services; early post-discharge contact; avoidable readmission

AI: Artificial intelligence; ERAS: Enhanced recovery after surgery.