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    Enhanced Recovery After Surgery ERAS. ANMF

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    Taufiqurrahman Rizki
    The document outlines the goals and components of an Enhanced Recovery After Surgery (ERAS) program. The goals are to reduce stress response after surgery, accelerate recovery, and return patients to pre-admission function or better. Key components include preoperative counseling and optimization, limited fasting, early oral feeding and mobilization postoperatively. Multimodal analgesia and prevention of nausea and vomiting are emphasized to facilitate early mobilization and discharge. Successful implementation requires a multidisciplinary team approach and patient education.

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    Enhanced Recovery After Surgery ERAS. ANMF

    Uploaded by

    Taufiqurrahman Rizki
    136 views17 pages
    The document outlines the goals and components of an Enhanced Recovery After Surgery (ERAS) program. The goals are to reduce stress response after surgery, accelerate recovery, and return patients to pre-admission function or better. Key components include preoperative counseling and optimization, limited fasting, early oral feeding and mobilization postoperatively. Multimodal analgesia and prevention of nausea and vomiting are emphasized to facilitate early mobilization and discharge. Successful implementation requires a multidisciplinary team approach and patient education.

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    Eras

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    The document outlines the goals and components of an Enhanced Recovery After Surgery (ERAS) program. The goals are to reduce stress response after surgery, accelerate recovery, and return patients to pre-admission function or better. Key components include preoperative counseling and optimization, limited fasting, early oral feeding and mobilization postoperatively. Multimodal analgesia and prevention of nausea and vomiting are emphasized to facilitate early mobilization and discharge. Successful implementation requires a multidisciplinary team approach and patient education.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    136 views17 pages

    Enhanced Recovery After Surgery ERAS. ANMF

    Uploaded by

    Taufiqurrahman Rizki
    The document outlines the goals and components of an Enhanced Recovery After Surgery (ERAS) program. The goals are to reduce stress response after surgery, accelerate recovery, and return patients to pre-admission function or better. Key components include preoperative counseling and optimization, limited fasting, early oral feeding and mobilization postoperatively. Multimodal analgesia and prevention of nausea and vomiting are emphasized to facilitate early mobilization and discharge. Successful implementation requires a multidisciplinary team approach and patient education.

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    Enhanced Recovery after Surgery

    (ERAS)
    Colette Burford
    Advanced Nurse Consultant
    ERAS Project
    2017
    ERAS Goals

     Reduction of stress response after surgery

     Acceleration of Recovery

     Return to pre admission function or better…

     A happy patient at discharge who has felt well


    informed and involved in their care
    ERAS Components

    Preoperative Postoperative
    Outpatients  Preventative & active pain
     Surgeon & patient discussion control
    Preadmission  Hydration (Avoid fluid overload)
     Optimisation  Aggressive management of N&V
     Counselling  Early oral feeding
     Discharge planning  EARLY MOBILISATION
     Oral Supplements
     Early removal of IDC’s & drains
     Limited fasting
     Early discharge planning
     Admission day of surgery
    Preoperative discussion/counselling

     Clear explanations of what will happen periop

     Explanation of the role of the patient with regards to


    preop activity, food intake, oral nutritional drinks,
    limited fasting.

     Expectations of patient postop; early eating, fluid


    intake, MOBILISATION, pain management, discharge
    planning.
    Preoperative carbohydrate loading

     Reduces preoperative thirst, hunger and anxiety.

     Significantly reduces postoperative insulin resistance.


    Postoperative Pain Control

     opioids in postoperative analgesic regimens results in


    adverse effects, such as sedation, postoperative
    nausea and vomiting, urinary retention, ileus, and
    respiratory depression, which can delay discharge.

     Multimodal analgesia, i.e., the use of more than one


    analgesic modality to achieve effective pain control
    while reducing opioid-related side effects, has
    become the cornerstone of enhanced recovery.
    Postoperative Hydration/ feeding

     Encourage early oral intake


     Facilitates early return of bowel function
     Allows stopping of IVT’s
     Aids mobilisation
     Avoid IV fluid overload….
    Prevention of Postoperative Nausea
    and Vomiting (PONV)

     PONV is unpleasant, delays gut function, affects


    mobility and has metabolic consequences.

     Strict post-operative nausea and vomiting


    prophylaxis.
    Early Mobilisation

    Prolonged bed rest

     Increased risk of thromboembolism

     Decrease in muscle strength, pulmonary function and tissue oxygenation

    ERAS

     Patients get out of bed on day of surgery and increase activity daily with planned structured walks.

     IDC’s and drains out early

     Patients should be getting dressed in day clothes as so0n as


    possible.
    Discharge Planning

     The earlier discharge planning is undertaken the better

     It’s all been said before……

     Good planning requires anticipation of potential problems by


    good information gathering, early resolution of potential
    barriers to discharge, and timely referral to the multidisciplinary
    team

     Planning involves close collaboration between the patient, the


    family, and the multidisciplinary team; this leads to improved
    patient and carer satisfaction
    Team Members for Successful ERAS

    Nurses
    Dietitians
    Physiotherapists
    Pain Team
    Theatre staff
    Anaesthetists
    Surgeons
    Hospital management
    Audit team
    Anyone not mentioned who is involved in the care of the patient…..

    WIDESPREAD STAFF AND PATIENT EDUCATION PRIOR TO ROLL OUT IS PIVOTAL TO A


    SUCCESSFUL OUTCOME OF ERAS PATHWAYS
    Some patients will fall
    off the pathway
    The challenge for the team is to
    reassess the needs for each patient
    and optimise the recovery within the
    changed pathway.
    Acknowledgement

     Su White
     Co Director Surgical Directorate/Director of Nursing RAH
     CALHN

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