NURS 5050 Week 8 explores the practical implementation of Enhanced Recovery After Surgery for improved patient outcomes.
Introduction
Enhanced Recovery After Surgery (ERAS) is an evidence-based program aimed at improving perioperative care and patient outcomes. It utilizes a multimodal and interdisciplinary approach to enhance recovery, decrease complications, and shorten hospital length of stay (LOS). The program includes interventions such as preoperative nutrition, goal-directed fluid therapy, multimodal analgesics, and early feeding post-operatively. Nurses play a crucial role in the design and implementation of the program, advocating for patients and ensuring adherence to protocols.
Costs and Projected Outcomes
The implementation of ERAS in our facility has resulted in significant cost avoidance. In the six other facilities within our system that have implemented the program, a total of $5.2 million in cost avoidance has been achieved from fiscal year 2015 to 2018. The program has also demonstrated LOS reduction in various surgical procedures, including colorectal surgery (2-3 days), general surgery (2-3 days), liver procedures (1-2 days), and surgical oncology (1-2 days).
NURS 5050 Week 8 Implementation of Enhanced Recovery After Surgery Target Population
The target population for the ERAS program is patients scheduled to undergo surgical procedures within the facility. The program aims to improve outcomes and enhance recovery for this specific group of patients.
Role of Nurses in Program Design
Nurses play a crucial role in providing input for the design of the ERAS program. As frontline caregivers, nurses possess valuable insights into patient care delivery. They contribute to the design process by ensuring accurate implementation plans and proposing improvements. For example, nurses in our facility suggested adding non-opioid medications, such as intravenous Tylenol and Toradol, to the postoperative pain medication orders. This design change was implemented to promote multimodal analgesia and reduce opioid use.
Role of Nurses as Advocates
As advocates for the target population, nurses have a responsibility to ensure that patients receive the recommended postoperative multimodal approach to pain control. Nurses advocate for patients by communicating with physicians to change medication orders and align them with the program’s recommendations. Nurses also have input into design decisions through policy change committees, where their voices are heard to shape program implementation.
NURS 5050 Week 8 Implementation of Enhanced Recovery After Surgery Role of Nurses in Program Implementation
Nurses play a key role in the implementation of healthcare programs. They need to be knowledgeable about new protocols and act as guides to ensure that program goals are met. During the implementation phase, nurses carry out the program protocols and monitor adherence. For instance, in the case of the ERAS program, nurses ensure that physicians use the new order sheet correctly and follow the established protocols.
Key Healthcare Team Members for Program Implementation
Nurses and physicians are both essential members of the healthcare team for successful program implementation. Physicians are responsible for ordering appropriate medications and treatments according to the program protocols. Nurses, on the other hand, play a critical role in carrying out the orders and ensuring adherence to the program. Collaboration between nurses and physicians is vital to achieving successful program implementation.
References
American Nurses Association (ANA). (n.d.). Advocacy. Retrieved from
https://www.nursingworld.org/practice-policy/advocacy/
Centers for Disease Control and Prevention (CDC). (n.d.). Step by step: Evaluating violence and injury prevention policies: Brief 4: Evaluating policy implementation. Retrieved from
www.cdc.gov/injury/pdfs/policy/Brief%204-a.pdf
Esper, S.A. & Holder-Murray, J. (2019) ERAS & CPC: UPMC Perioperative Services [PowerPoint Presentation]. Feldheiser, A., Aziz, O., Baldini, G., Cox, B. P. B. W., Fearon, K. C. H., Feldman, L. S., … Carli, F. (2016). Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 2: consensus statement for anaesthesia practice. Acta Anaesthesiologica Scandinavica, 60(3), 289–334.
https://doi-org.ezp.waldenulibrary.org/10.1111/aas.12651
