TY - JOUR
T1 - Implementation of Enhanced Recovery After Surgery in a Community Hospital
T2 - An Evidence-Based Approach
AU - Persico, Michele
AU - Miller, David
AU - Way, Cassandra
AU - Williamson, Marsha
AU - O'Keefe, Kate
AU - Strnatko, Dennis
AU - Wright, Fay
N1 - Publisher Copyright:
© 2018 American Society of PeriAnesthesia Nurses
PY - 2019/2
Y1 - 2019/2
N2 - 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.
AB - 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.
KW - enhanced recovery after surgery
KW - laparoscopy
KW - postanesthesia recovery
KW - preoperative and postoperative care
KW - robotic surgery
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U2 - 10.1016/j.jopan.2018.02.005
DO - 10.1016/j.jopan.2018.02.005
M3 - Article
C2 - 29921549
AN - SCOPUS:85048538914
SN - 1089-9472
VL - 34
SP - 188
EP - 197
JO - Journal of Perianesthesia Nursing
JF - Journal of Perianesthesia Nursing
IS - 1
ER -