Nursing Commons^™

Evaluation And Education Of Enhanced Recovery After Surgery Protocols For Total Knee Arthroplasty, Lauren Hunt, Jessica Prost

Doctor of Nursing Practice Projects

Enhanced recovery after surgery (ERAS) utilizes a multimodal, multidisciplinary perioperative protocol to minimize hospital length of stay, surgical complications, readmissions, and patient hospital costs (Frassanito et al., 2020). The protocols were initially established for abdominal and colorectal surgical patients; however, ERAS protocols are now widely used in other areas, including orthopedic surgery (Kaye et al., 2019). To achieve the maximum benefits, ERAS protocols must contain preoperative, intraoperative, and postoperative components. A rural critical access hospital in Eastern Illinois, Crawford Memorial Hospital, serves numerous patients requiring total knee arthroplasties (TKA). While the providers utilize some aspects of ERAS protocols for these …

Enhanced Recovery After Surgery (Eras) Protocol For Bariatric Surgery, Krista Bunch

Doctor of Nursing Practice Projects

Bariatric surgery has been utilized in treating severe obesity and offers several benefits, such as sustainable weight loss, treatment of various metabolic comorbidities, and improved life expectancy (Sundbom et al., 2017). With these benefits and procedural improvements, there has been a marked increase in the demand for bariatric surgery and increased interest in shifting some of these procedures to an ambulatory care setting (Stenberg et al., 2022). However, postoperative complications such as pain, nausea, and inability to tolerate oral intake can cause patients to experience an increased length of stay in the hospital and suboptimal outcomes (King et al., 2018). …

Introduction Of Enhanced Recovery After Cesarean Section (Erac) Protocol, Kwame Adu-Affum

Doctor of Nursing Practice Projects

Cesarean section is one of the most performed in-patient surgeries worldwide (Wilson et al., 2018; Liu et al., 2020). Births by cesarean section have been increasing globally. Cesarean birth rate has remained above 31% in the United States, even with the consistent two percent decrease in birth rate per year (Martin et al., 2019). Illinois has also maintained a high cesarean birth rate above 30% (Hamilton et al., 2021). Cesarean patients experience inflammatory and neurohormonal changes with many adverse effects in direct response to surgical stress (Mullman et al., 2020). The post-cesarean physiological effects, including pain, reduced gastric motility, pulmonary …

Development And Implementation Of An Enhanced Recovery After Surgery Protocol For Thoracic Surgery Procedures, Nicholas Collier

Doctor of Nursing Practice Projects

A high prevalence of lung and esophageal cancers leads to significant healthcare dollars utilized for treatment and management. Surgical resection is regarded as a key component for multidisciplinary treatment and management of these cancers. By standardizing multidisciplinary patient care and utilizing evidence-based practice, Enhanced Recovery After Surgery (ERAS) protocols for thoracic surgery have offered better outcomes with fewer complications and reduced healthcare costs. The anesthesia providers at the host facility were deficient in basic knowledge related to ERAS protocols and best practice management of thoracic surgery patients. The purpose of this project was to educate anesthesia providers on ERAS principles …

Introduction Of Strong For Surgery Pre-Surgical Checklist For Elective Procedures​, Dylan Defauw

Doctor of Nursing Practice Projects

Nearly one-third of hospitalized patients experience preventable harm or adverse effects related to the care they received, often due to preventable surgical complications. Thorough preoperative assessment and management of risk factors can lessen this risk. The purpose of this quality improvement project was to increase knowledge and prepare staff for use of the preoperative tool Strong for Surgery (S4S) in a general surgery clinic in a rural hospital in southern Illinois. Support for each of the key components of the Strong for Surgery pre-surgical checklist was reviewed in the literature; these include nutrition, smoking cessation, glycemic control, medication management, safe …

Development And Implementation Of An Orthopedic Enhanced Recovery After Surgery Protocol, Beth Mccoy

Doctor of Nursing Practice Projects

Abstract

As life expectancy rates have grown and individuals desire a more active lifestyle the number of total hip arthroplasty and total knee arthroplasty surgeries performed has grown significantly. Enhanced recovery after surgery (ERAS) protocols have been shown to decrease the financial impact and improve patient outcomes in total joint surgeries. After a literature review a multidisciplinary team met and developed an ERAS protocol for total joint replacement surgeries to be implemented at a 250-bed community hospital in central Illinois. After an eleven-question pre-test was given to 34 participants consisting of perioperative nursing staff, anesthesia, and surgeons assessing their knowledge …

Implementation Of Enhanced Recovery After Surgery (Eras) Protocol After Cystectomy: A Quality Improvement Project To Evaluate Bowel Function With Implementation Of Eras Protocol, Weruche Agube

Doctor of Nursing Practice Projects

Abstract

The purpose of this Quality Improvement project was to develop and implement an enhanced recovery after surgery (ERAS) protocol for cystectomy patients at a regional hospital in central Illinois. Specific goals included reducing patient’s length of hospital stay, reducing occurrence of postoperative ileus after surgery as well as educating the nurses involved in patient care about effective implementation the protocol. An educational presentation and knowledge assessment via testing was developed and subsequently presented to the nurses both inpatient and outpatient at the host facility. A specific protocol was crafted after discussion with stakeholders and the ERAS protocol was finalized …

Introducing Enhanced Recovery After Surgery For Colorectal Procedures: Development Of An Enhanced Recovery After Surgery Protocol, Vincent Compton

Doctor of Nursing Practice Projects

Abstract

The prevalence of colorectal surgery is increasing due to the surgical demand of an aging population with various comorbidities (Ralph & Duff, 2017). Consequences include an increased burden on clinical and financial resources from perioperative costs, length of stay (LOS), complications, and readmissions (Nelson et al., 2016). Enhanced recovery programs were created to improve patient outcomes and decrease financial strain. Objectives of this practice project included researching current evidence-based literature to determine the effectiveness of ERAS implementation in open and laparoscopic colorectal procedures, developing a customized ERAS protocol, and introducing the pathway to members of anesthesia, pharmacy, and the …

Implementing An Enhanced Recovery After Surgery Protocol In A Critical Access Hospital, Joseph Grazaitis

Doctor of Nursing Practice Projects

Enhanced recovery after surgery (ERAS) protocols provide numerous benefits for patients undergoing colorectal surgery. The goal of the protocol is to decrease surgical complications, patient’s length of hospital stay, recovery time, and increase patient satisfaction. The purpose of this doctoral project was to create and implement an ERAS protocol for a 25-bed critical access hospital. The findings obtained from the literature review were presented to the multi-disciplinary team. The specific needs of the surgical team were identified, and the ERAS protocol was created. Lastly, the ERAS protocol was finalized and implemented in the institution. The outcome measures examined were the …

Enhanced Recovery After Orthopedic Surgery In Total Hips And Knees, Christine Rigg

Doctor of Nursing Practice Projects

The prevalence of total knee and hip replacement surgery is increasing related to a combination of factors including osteoarthritis, age, and obesity (Christelis et al., 2015). The increased demand for joint replacement, current cost, and length of stay (LOS) place an increasing burden on clinical and financial resources. Enhanced recovery after surgery (ERAS) protocols have facilitated improved outcomes, such as increased patient satisfaction, decreased LOS, and associated costs (Bernard & Foss, 2014; Husted, Holm, & Jacobsen, 2008). Development and subsequent anesthesia group education were the beginning steps toward orthopedic protocol implementation in this project. This practice project had two goals: …

Introduction Of Enhanced Recovery After Surgery For Colorectal Surgical Patients: A Quality Improvement Project, Amanda R. Mcvey

Doctor of Nursing Practice Projects

The purpose of this practice project was to develop and introduce an enhanced recovery after surgery (ERAS) protocol for colorectal surgical patients at a tertiary care center in southern Illinois. Project aims included reviewing available literature and study outcomes to develop an evidenced-based ERAS protocol for colorectal surgery and educating anesthesia providers about ERAS to introduce the evidenced-based ERAS protocol for colorectal surgery. An educational presentation and learning assessment tool were developed and subsequently presented to the anesthesia providers at the host facility. The first step toward implementing the protocol is education, as such, the results of the assessment questions …