Implementation of Enhanced Recovery After Surgery in a Community Hospital: An Evidence-Based Approach

Michele Persico, David Miller, Cassandra Way, Marsha Williamson, Kate O'Keefe, Dennis Strnatko, Fay Wright

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Enhanced recovery after surgery (ERAS) is an evidence-based practice protocol that has been shown to reduce cost, decrease length of stay (LOS), and improve surgical outcomes. Design: An evidence-based practice improvement project with a multidisciplinary team translated the ERAS protocol into practice at a community hospital. The evidence-based practice improvement design allows integration of evidence into projects to improve clinical outcomes for patients. Methods: Small tests of change using the Plan-Act-Study-Do methodology were used to evaluate the process of implementing one surgical service at a time to ensure effective outcomes. After the process was determined to be effective, patient outcomes (eg, LOS) were measured. Findings: On average, LOS was decreased from 3.2 to 1.7 days. Surgical readmission rate decreased from 3% to 1%. There has been positive feedback and nursing workload has decreased with consistent processes. Conclusions: The ERAS order set continues to be modified based on the evidence and feedback from anesthesia and registered nurses. Monthly reports ensure consistency.

Original languageEnglish (US)
Pages (from-to)188-197
Number of pages10
JournalJournal of Perianesthesia Nursing
Volume34
Issue number1
DOIs
StatePublished - Feb 2019

Keywords

  • enhanced recovery after surgery
  • laparoscopy
  • postanesthesia recovery
  • preoperative and postoperative care
  • robotic surgery

ASJC Scopus subject areas

  • Medical–Surgical

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