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postoperative recovery audit

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https://www.readbyqxmd.com/read/29666000/how-does-the-application-of-surgical-components-in-enhanced-recovery-programs-for-colorectal-surgery-change-over-time
#1
Julie Veziant, Daniel Leonard, Bruno Pereira, Karem Slim
BACKGROUND: Enhanced recovery programs (ERP) improve post-operative outcomes in proportion to how fully they are implemented. Maintaining an optimal level of application of all the ER components is thus essential. Our aim was to assess the sustainability of ER surgical components 2 years after their first implementation. METHOD: Patients undergoing elective colorectal resections were included in a prospective database. To retrospectively analyze compliance with ERP over a period of 24 months, the following components were considered: colonic preparation, surgical approach, nasogastric tube omission and absence of abdominal drainage...
April 14, 2018: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/29661495/narcotics-reduction-quality-and-safety-in-gynecologic-oncology-surgery-in-the-first-year-of-enhanced-recovery-after-surgery-protocol-implementation
#2
Jennifer E Bergstrom, Marla E Scott, Yewande Alimi, Ting-Tai Yen, Deborah Hobson, Karime K Machado, Edward J Tanner, Amanda N Fader, Sarah M Temkin, Stephanie Wethington, Kimberly Levinson, Sam Sokolinsky, Brandyn Lau, Rebecca L Stone
OBJECTIVES: Enhanced Recovery After Surgery (ERAS) programs are mechanisms for achieving value-based improvements in surgery. This report provides a detailed analysis of the impact of an ERAS program on patient outcomes as well as quality and safety measures during implementation on a gynecologic oncology service at a major academic medical center. METHODS: A retrospective review of gynecologic oncology patients undergoing elective laparotomy during the implementation phase of an ERAS program (January 2016 through December 2016) was performed...
April 13, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29596678/follow-the-blue-feet-nurse-implemented-postoperative-mobility-program
#3
E Shannon Walters, Kathryn Curtin, Melissa M McLawhorn, Katherine Lee, Jeffrey W Shupp
To establish the effectiveness of a nurse-led postoperative MOBILITY program implemented on the Burn/Surgical/Trauma unit at our facility to increase documentation of patient mobility and to develop nurse and patient understanding of the importance of movement in postoperative recovery while increasing patient satisfaction with mobility. The MOBILITY program was implemented on a 24-bed Burn/Surgical/Trauma unit. Lewin's Change Theory guided the development of the program, while the Iowa Model of Evidence-Based Practice for Quality Care was the framework for the project...
December 27, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29582421/the-enhanced-recovery-after-surgery-eras-greenie-board-a-navy-inspired-quality-improvement-tool
#4
A J Smirk, J J Nicholson, Y L Console, N J Hunt, A Herschtal, M N H H Nguyen, B Riedel
The United States Navy uses a visual feedback system for pilots, named 'the Greenie Board', to improve flight manoeuvres on aircraft carriers. Given that increased compliance with enhanced recovery after surgery protocols reduces postoperative complications, we decided to apply a similar feedback system to our institutional enhanced recovery programme. We undertook a prospective 12-month audit of 194 patients assigned to our enhanced recovery programme and evaluated adherence to the anaesthesia-related components of our protocol, before and after implementing a Greenie Board...
March 26, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29536753/-enhanced-recovery-program-in-colorectal-surgery
#5
Balázs Bánky, Miklós Lakatos, Krisztina Varga, Edit Hansági, Éva Horváth, Géza Járay
INTRODUCTION: Enhanced recovery after surgery (ERAS) programme has been described and practiced for twenty years in the perioperative management of colorectal patients. ERAS is a complex, evidence based strategy which proved to be extremely effective when linked to laparoscopy in reducing morbidity, length of hospital stay, as well as reducing cost of colorectal service. AIMS: We gradually adapted elements of ERAS protocol along with laparoscopy in the colorectal surgical treatment at a county hospital from 2013...
March 2018: Magyar Sebészet
https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#6
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
February 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29302486/early-multicentre-experience-of-pre-pectoral-implant-based-immediate-breast-reconstruction-using-braxon-%C3%A2
#7
Sadaf Jafferbhoy, Mihir Chandarana, Maria Houlihan, Rishikesh Parmeshwar, Sankaran Narayanan, Soni Soumian, Simon Harries, Lucie Jones, Dayalan Clarke
Background: The last two decades have seen significant changes in surgical management of breast cancer. The offer of immediate breast reconstruction (IBR) following mastectomy is currently standard practice. Skin sparing and nipple sparing mastectomy with implant-based IBR have emerged as oncologically safe treatment options. Prepectoral implant placement and complete coverage of implant with acellular dermal matrix (ADM) eliminates the need to detach the muscle from underlying chest wall in contrast to the subpectoral technique...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29288246/enhanced-recovery-after-surgery-as-an-auditing-framework-for-identifying-improvements-to-perioperative-nutrition-care-of-older-surgical-patients
#8
Angela Byrnes, Merrilyn Banks, Alison Mudge, Adrienne Young, Judy Bauer
Older patients are at increased risk of malnutrition and reduced physical function. Using Enhanced Recovery After Surgery (ERAS) guidelines as an auditing framework, this study aimed to determine adherence of nutrition care to perioperative best practice in older patients. A single researcher retrieved data via chart review. Seventy-five consenting patients ≥65 years (median 72 (range 65-95) years, 61% male) admitted postoperatively to general surgical wards were recruited. Sixty per cent had a primary diagnosis of cancer and 51% underwent colorectal resection...
December 29, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29122527/implementation-of-enhanced-recovery-programs-for-bariatric-surgery-results-from-the-francophone-large-scale-database
#9
Anissa Deneuvy, Karem Slim, Maxime Sodji, Pierre Blanc, Denis Gallet, Marie-Cécile Blanchet
BACKGROUND: The feasibility, safety, and efficacy of programs for enhanced recovery after bariatric surgery (ERABS) are now well established. However, data concerning their large-scale implementation remain insufficient. OBJECTIVES: The objective of the present study was to review the multicenter implementation of ERABS SETTING: This retrospective analysis of a prospective database was conducted in 15 Groupe francophone de Rehabilitation Améliorée après ChirurgiE centers from data from March 2014 to January 2017...
January 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29067634/best-practice-in-major-elective-rectal-pelvic-surgery-enhanced-recovery-after-surgery-eras
#10
REVIEW
Josefin Segelman, Jonas Nygren
Within traditional clinical care, the postoperative recovery after pelvic/rectal surgery has been slow with high morbidity and long hospital stay. The enhanced recovery after surgery program is a multimodal approach to perioperative care designed to accelerate recovery and safely reduce hospital stay. This review will briefly summarize optimal perioperative care, before, during and after surgery in this group of patients and issues related to implementation and audit.
December 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28809390/clinical-features-and-surgical-outcomes-of-cervical-spondylotic-myelopathy-in-patients-of-different-ages-a-retrospective-study
#11
R J Zhang, C L Shen, J X Zhang, X J Zhang, F L Dong, H Tao, P W Song, P Ge, P Xu, H Q Zhang
STUDY DESIGN: Retrospective chart audit. OBJECTIVES: This study aims to compare the clinical features and surgical outcomes in patients with cervical spondylotic myelopathy (CSM) among different age groups. SETTING: The first Affiliated Hospital of Anhui Medical University, China. METHODS: A total of 460 patients with CSM who were surgically treated over the period of 1995-2009 were investigated. Considering the peak age (40-60 years old) for the onset of symptoms, we divided the patients into three groups by age: young (<40), middle-aged (40-60), and old (>60)...
January 2018: Spinal Cord
https://www.readbyqxmd.com/read/28070884/a-national-survey-of-neurological-monitoring-practice-after-obstetric-regional-anaesthesia-in-the-uk
#12
E Roderick, J Hoyle, S M Yentis
Neuraxial anaesthesia is widely used in obstetrics and neurological complications are rare. However, when they occur, subsequent investigation and management are time-critical and correlate with the extent of neurological recovery. The Third National Audit Project recommended the implementation of guidelines in obstetric epidural management, including advice on monitoring for early signs of problems and acting upon concerns. However, no national guideline exists for postoperative management in the obstetric population...
January 10, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28054356/impact-of-a-peri-operative-quality-improvement-programme-on-postoperative-pulmonary-complications
#13
J A Moore, D H Conway, N Thomas, D Cummings, D Atkinson
Postoperative pulmonary complications are common, with a reported incidence of 2-40%, and are associated with adverse outcomes that include death, longer hospital stay and reduced long-term survival. Enhanced recovery is now a standard of care for patients undergoing elective major surgery. Despite the high prevalence of pulmonary complications in this population, few elements of enhanced recovery specifically address reducing these complications. In 2013, a prevalence audit confirmed a postoperative pulmonary complication rate of 16/83 (19...
March 2017: Anaesthesia
https://www.readbyqxmd.com/read/28007033/efficacy-of-therapeutic-suggestions-under-general-anesthesia-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#14
REVIEW
Jenny Rosendahl, Susan Koranyi, Davina Jacob, Nina Zech, Ernil Hansen
BACKGROUND: General anesthesia does not block central nervous processing of auditive information. Therefore, positive suggestions even given during surgery might have the potential to encourage well-being and recovery of patients. Aim of this review was to summarize the evidence on the efficacy of therapeutic suggestions under general anesthesia in adults undergoing surgery compared to an attention control (i.e. white noise). METHODS: We included randomized controlled trials that investigated therapeutic suggestions presented during general anesthesia to adult patients undergoing surgery or medical procedures...
December 22, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27982488/effects-of-a-surgical-ward-care-protocol-following-open-colon-surgery-as-part-of-an-enhanced-recovery-after-surgery-programme
#15
BoYeoul Kim, SungHee Park, KyuJoo Park, SeungBum Ryoo
AIMS AND OBJECTIVES: To investigate the effects of a standardised care protocol as part of an enhanced recovery after surgery programme on the management of patients who underwent open colon surgery at the University Hospital, South Korea. BACKGROUND: Patients who undergo open colon surgery often have concerns about their care as they prepare for hospitalisation. By shortening hospital stay lengths, enhanced recovery after surgery programmes could reduce the number of opportunities for patient education and communication with nurses...
November 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27820740/enhanced-recovery-after-bariatric-surgery
#16
Adrian Alvarez, Basavana G Goudra, Preet Mohinder Singh
PURPOSE OF REVIEW: Enhanced recovery after surgery (ERAS) methodology has demonstrated consistent benefits in patients undergoing colorectal, urological and thoracic surgeries. Principles of these protocols and their advantages are expected to extend into other surgical specialties such as bariatric surgery. In this review, we summarize the components of ERAS protocols for bariatric surgery and present the evidence on the emerging role of ERAS principles in obese patients. RECENT FINDINGS: Many recent trials have evaluated ERAS protocols for bariatric surgery...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27764047/the-future-of-postoperative-quality-of-recovery-assessment-multidimensional-dichotomous-and-directed-to-individualize-care-to-patients-after-surgery
#17
REVIEW
Andrea Bowyer, Colin F Royse
PURPOSE OF REVIEW: Recovery after surgery is a complex interplay of the patient, the surgery, and the perioperative anaesthesia management. Assessment of recovery should address the needs of multiple stakeholders, including the institutions and healthcare providers, but primarily should be focused on the patients and their perception of quality of recovery and return to normalcy. This review will summarize the development of assessment of recovery to a multidimensional dichotomous construct that requires a real-time assessment tool validated for repeat measures and containing cognitive assessment...
December 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27730406/enhanced-recovery-implementation-in-colorectal-surgery-temporary-or-persistent-improvement
#18
David Martin, Didier Roulin, Valérie Addor, Catherine Blanc, Nicolas Demartines, Martin Hübner
PURPOSE: Enhanced recovery after surgery (ERAS) implementation has proven to reduce complication rate and length of hospital stay. Little is known about the sustainability of these results over time. The study aim was to assess the application of ERAS pathway over the first 4 years after initial implementation. METHODS: This retrospective study analyzed data collected prospectively from 482 consecutive elective colorectal patients operated in 2011 during the ERAS implementation process (n = 66), and after initial implementation in 2012 (n = 136), 2013 (n = 152), and 2014 (n = 128)...
December 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27709725/exploring-canadian-surgeons-decisions-about-postoperative-weight-bearing-for-their-hip-fracture-patients
#19
Leslie Carlin, Kathryn Sibley, Richard Jenkinson, Pia Kontos, Rhona McGlasson, Hans J Kreder, Susan Jaglal
For older adults with osteoporosis, a fall resulting in hip fracture is a life-changing event from which only one-third fully recover. Current best evidence argues strongly for elderly patients to bear weight on their repaired hip fracture immediately after their surgery to maximize their chances of full or nearly full recovery. Patient stakeholders in Canada have argued that some surgeons fail to issue "weight-bearing-as-tolerated" (WBAT) orders in all eligible cases, protecting their bony repair but contributing to increased mortality and long-term disability rates...
October 6, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27638322/large-scale-implementation-of-enhanced-recovery-programs-after-surgery-a-francophone-experience
#20
J Veziant, O Raspado, A Entremont, J Joris, B Pereira, K Slim
INTRODUCTION: Enhanced recovery after surgery program (ERP) has now surpassed the stage of clinical research in certain specialties and currently poses the problematic of large-scale implementation. The goal of this study was to report the experience during the first year of implementation in three French-speaking countries. MATERIAL AND METHODS: This is a prospective study in which 67 healthcare centers, all registered in the Grace-Audit databank, participated...
June 2017: Journal of Visceral Surgery
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