Enhance Recover After Surgery and Colorectal Bundles Nichole - PowerPoint PPT Presentation

Enhance Recover After Surgery and Colorectal Bundles Nichole Schmidt, MSN, RN, CNOR, CNL November 8, 2018

Enhanced Recovery After Colorectal Surgery » Enhanced Recovery After Surgery (ERAS) Programs utilize a standardized, interdisciplinary approach to integrate evidence-based interventions aimed at improving patient outcomes by focusing on: » Patient education » Optimal pain control » Fluid balance » Early nutrition » Early ambulation

Colorectal Bundle– Closing Process Closing process: » Double Glove—EVERYONE » Prior to fascial closure, count of as many sponges, instruments and sharps as possible » All scrubbed personnel re-glove and, if gross contamination on gown, re-gown » Utilize separate closing tray for instruments, new suction and bovie tips, replace sponges. » Field is re-blocked/squared off with new sterile towels » Closing instruments counted when closure occurs

Length of Stay (LOS) and Readmissions  Elective Bowel Cases LOS: ERAS and Colorectal Bundle were implemented  2017- 3.78 Jan 1, 2018  2018- 2.01  2017 16% of all cause 30  ERAS (Bowel Readmissions): day inpatient readmissions  2017- 5.88% (bowel were surgical cases surgery readmissions).  2018 9.6% of all cause 30  2018- Zero ERAS patients day inpatient readmissions readmitted. were surgical cases