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Schmid ME, Stock S, Girdauskas E. Implementation of an innovative ERAS protocol in cardiac surgery: A qualitative evaluation from patients' perspective. PLoS One 2024; 19:e0303399. [PMID: 38728336 PMCID: PMC11086837 DOI: 10.1371/journal.pone.0303399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/15/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVE Enhanced recovery after surgery (ERAS) protocols aim to optimize the recovery process for patients after surgical interventions and focus on patient-centered care. In cardiac surgery, the ERAS concept is still in its early stages. Our university hospital has implemented an innovative ERAS protocol for minimally invasive heart valve surgery since 2021. Therefore, our study aimed to comprehensively assess the patient experience within this newly established ERAS protocol and focused on exploring and understanding the nuances of optimal healthcare delivery under the ERAS framework from the unique perspective of the patients undergoing cardiac surgery. METHODS Qualitative research was conducted using semi-structured interviews. Data was analyzed using Kuckartz´s qualitative content analysis. RESULTS The following main themes emerged from the 12 completed patient interviews: 1) information and communication flow, 2) perioperative patient care, and 3) rehabilitation. Patients found the pre-operative patient education and preconditioning very helpful. Patients were satisfied with the flow of information throughout the whole perioperative care process. Most patients expressed a need for more information about the course of surgery. The intensity of care provided by different professions was perceived as optimal. The support and inclusion of relatives in perioperative care were considered crucial. Patients appreciated the direct transfer to the rehabilitation and mainly were able to cope with daily life tasks afterward. CONCLUSION In summary, all patients experienced the ERAS protocol positively, and their healthcare process was well established. Active inclusion and education of patients in their treatment can improve patient empowerment. Two further aspects that deserve major consideration in the healthcare process are the inclusion of relatives and interprofessional cooperation.
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Affiliation(s)
| | - Sina Stock
- Cardiothoracic Surgery, University Hospital Augsburg, Augsburg, Germany
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Ester Molina Beltran E, Neuzillet C, Chorin F. La préhabilitation, un nouveau parcours préopératoire pour améliorer la condition des patients. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2024; 69:18-21. [PMID: 38614513 DOI: 10.1016/j.soin.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/15/2024]
Abstract
The maintenance and optimization of functional capacities before, during, and after treatment are major challenges for frailty persons as cancer's patients. It is now known that physical activity in prehabilitation plays a crucial role in limiting, among other things, post-operative complications. The benefits have already been demonstrated in various studies, including a decrease in hospitalization duration, an increase in cardiorespiratory endurance, improvement in quality of life, and better fatigue management. It is observed that patients who undergo prehabilitation are those who recover their preoperative capacities the fastest. However, it is estimated that only one-third of patients with access to prehabilitation improve their physical capacities.
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Affiliation(s)
| | - Cindy Neuzillet
- Institut Curie, 35 avenue Dailly, 92210 Saint-Cloud, France; Université Versailles Saint-Quentin-en-Yvelines, 47 boulevard Vauban, 78047 Guyancourt, France
| | - Frédéric Chorin
- France Université Côte d'Azur, Laboratoire motricité humaine expertise sport santé (Lamhess), Campus STAPS-Sciences du Sport, 261 boulevard du Mercantour BP3259, 06205 Nice cedex 03, France
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Soydaş D, Makal Orğan E, Yıldız Fındık Ü, Gökce Işıklı A. The relationship between the perception of surgical fear and nursing satisfaction. J Perioper Pract 2023; 33:380-385. [PMID: 36515433 DOI: 10.1177/17504589221137983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Since patient satisfaction is considered a criterion in the evaluation of nursing care, it is important and necessary to know the factors associated with satisfaction. The aim of this study is to determine the relationship between surgical fear and satisfaction with nursing care in surgical patients. This descriptive correlational study was conducted with 110 patients who underwent planned major surgical intervention in a university hospital in Turkey. A patient introduction form, the Surgical Fear Questionnaire and Newcastle Satisfaction with Nursing Care Scale were used to collect data, as well as a face to face interview with patients during the pre and postoperative periods. The results showed that the surgical fear levels of the patients were low, their satisfaction with nursing care was high, and a weak correlation existed between the fear and satisfaction levels. We recommend nursing care interventions aimed at keeping the surgical fear levels of patients low and their satisfaction high.
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Affiliation(s)
- Duygu Soydaş
- Nursing Department, Faculty of Health Sciences, Trakya University, Edirne, Turkey
| | - Esra Makal Orğan
- Nursing Department, Faculty of Health Sciences, Trakya University, Edirne, Turkey
| | - Ümmü Yıldız Fındık
- Nursing Department, Faculty of Health Sciences, Trakya University, Edirne, Turkey
| | - Ayşe Gökce Işıklı
- Health Research and Practice Centre, Thoracic Surgery Department, Trakya University, Edirne, Turkey
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Belouaer A, Cossu G, Papadakis GE, Gaudet JG, Perez MH, Chanez V, Boegli Y, Mury C, Peters D, Addor V, Levivier M, Daniel RT, Demartines N, Messerer M. Implementation of the Enhanced Recovery After Surgery (ERAS®) program in neurosurgery. Acta Neurochir (Wien) 2023; 165:3137-3145. [PMID: 37688648 PMCID: PMC10624709 DOI: 10.1007/s00701-023-05789-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/22/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND Over the past decade, Enhanced Recovery After Surgery (ERAS®) guidelines have been proven to simplify postoperative care and improve recovery in several surgical disciplines. The authors set out to create and launch an ERAS® program for cranial neurosurgery that meets official ERAS® Society standards. The authors summarize the successive steps taken to achieve this goal in two specific neurosurgical conditions and describe the challenges they faced. METHODS Pituitary neuroendocrine tumors (Pit-NET) resected by a transsphenoidal approach and craniosynostosis (Cs) repair were selected as appropriate targets for the implementation of ERAS® program in the Department of Neurosurgery. A multidisciplinary team with experience in managing these pathologies was created. A specialized ERAS® nurse coordinator was hired. An ERAS® certification process was performed involving 4 seminars separated by 3 active phases under the supervision of an ERAS® coach. RESULTS The ERAS® Pit-NET team included 8 active members. The ERAS® Cs team included 12 active members. Through the ERAS® certification process, areas for improvement were identified, local protocols were written, and the ERAS® program was implemented. Patient-centered strategies were developed to increase compliance with the ERAS® protocols. A prospective database was designed for ongoing program evaluation. Certification was achieved in 18 months. Direct costs and time requirements are reported. CONCLUSION Successful ERAS® certification requires a committed multidisciplinary team, an ERAS® coach, and a dedicated nurse coordinator.
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Affiliation(s)
- Amani Belouaer
- Department of Clinical Neuroscience, Service of Neurosurgery, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Giulia Cossu
- Department of Clinical Neuroscience, Service of Neurosurgery, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Georgios E Papadakis
- Service of Endocrinology, Diabetology, and Metabolism, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - John G Gaudet
- Department of Anesthesiology, Neurospinal Unit, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Maria-Helena Perez
- Pediatric Intensive and Intermediate Care Units, Department of Pediatrics, Women-Mother-Child Department, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Vivianne Chanez
- Pediatric Intensive and Intermediate Care Units, Department of Pediatrics, Women-Mother-Child Department, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Yann Boegli
- Department of Anesthesiology, Pediatric Unit, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Caroline Mury
- Department of Anesthesiology, Pediatric Unit, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - David Peters
- Department of Clinical Neuroscience, Service of Neurosurgery, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Valérie Addor
- Department of Visceral Surgery, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Marc Levivier
- Department of Clinical Neuroscience, Service of Neurosurgery, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Roy Thomas Daniel
- Department of Clinical Neuroscience, Service of Neurosurgery, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Nicolas Demartines
- Department of Visceral Surgery, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Mahmoud Messerer
- Department of Clinical Neuroscience, Service of Neurosurgery, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
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Feng C, Lv C, Zhang X, Guo Y, Li X. Effect of 1 + N Extended Nursing Service on Functional Recovery of Colostomy Patients. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:2645528. [PMID: 36072734 PMCID: PMC9444352 DOI: 10.1155/2022/2645528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/12/2022] [Accepted: 07/21/2022] [Indexed: 11/17/2022]
Abstract
To many hospitals' management as well as to patients, the nursing service is one of the most important aspects. Many diseases like sugar, blood pressure, urine passage, and gas are a little bit dangerous to handle by patients themselves. The earlier stage models are unable to give good services to patients; therefore, an advanced JHE: Effect of 1 + N extended nursing service is necessary to crossover the above limitations. Colostomy and colorectal cancers are very dangerous syndromes thus, disease monitoring is so difficult. In this research work, an extended JHE: Effect of 1 + N extended nursing service modeling is discussed with experimental modeling. Apart from conventional nursing care provided by the observation group, it was given online training as well as service providing. Self-efficacy and self-care competence were assessed in both groups 6 months after the discharge. Quality of life and mental health were also assessed. Besides, their dimensional and total self-care ability scores, and the observation group's self-efficacy ratings were substantially higher than those of the control group (P 0.05) after the intervention. It was observed that the intervention group's 6-month adjustment to the stoma was statistically more favorable than the control group's (P 0.001), and only the intervention group showed a significantly major change (P 0.001) between their two evaluations. This proposed methodology can improve the accuracy rate by 93.23%, and succussive treatment rate of 92.14% had been attained.
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Affiliation(s)
- Chunlan Feng
- Department of Nursing, Wuwei Cancer Hospital, Wuwei 733000, Gansu, China
| | - Caixia Lv
- Department of Nursing, Heavy Ion Center of Wuwei Cancer Hospital, Wuwei 733000, Gansu, China
| | - Xia Zhang
- Department of Nursing, Heavy Ion Center of Wuwei Cancer Hospital, Wuwei 733000, Gansu, China
| | - Yumei Guo
- Department of Nursing, Wuwei Cancer Hospital, Wuwei 733000, Gansu, China
| | - Xiaojun Li
- Department of Nursing, Heavy Ion Center of Wuwei Cancer Hospital, Wuwei 733000, Gansu, China
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Abstract
OBJECTIVE This article provides a map of key knowledge gaps regarding the evidence supporting prehabilitation and its integration with enhanced recovery after surgery (ERAS) programs. Filling this lack of knowledge with future research will further establish the effectiveness of prehabilitation. DATA SOURCES These are electronic databases including PubMed and CINAHL. CONCLUSION Future efforts must embrace the elderly frail or cognitively impaired patient with specific needs to further promote restoration of postoperative function throughout the surgical pathway. Prehabilitation should be coupled and integrated within the existent concept of the ERAS framework, to facilitate the continuous evolution of screening, assessment, and optimization of high-risk surgical patients who are at risk of not being restored to physical and psychological function after surgery, including independence. IMPLICATIONS FOR NURSING PRACTICE In the future, the ERAS nurse will be an essential figure of the prehabilitation program, proactively coordinating the assessment, optimization, and adjustment of perioperative comorbidity and guiding the rehabilitation process to improve patients' outcomes. These skills and characteristics will be required to provide optimal nursing care in the context of an integrated prehabilitation ERAS pathway.
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From Fast-track to Enhanced Recovery after Surgery (ERAS) in Radical Cystectomy Pathways –a Nursing Perspective. Asia Pac J Oncol Nurs 2022; 9:100048. [PMID: 35647225 PMCID: PMC9136268 DOI: 10.1016/j.apjon.2022.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/24/2022] [Indexed: 01/02/2023] Open
Abstract
Objective The purpose of this narrative review is to summarize existing knowledge and evidence about the establishment of enhanced recovery after surgery (ERAS) pathways with emphasize on radical cystectomy (RC), and the emerging and prominent role of nursing within the ERAS pathway. The current status of implementation and adherence to ERAS protocol in RC is discussed and the impact on primary outcomes according to ERAS is summarized. Methods The review was conducted based on a focused search in PubMed and CINAHL. Results The goal of a modern RC enhanced recovery protocols (ERPs) anno 2022 is to have a positive impact on patient care from diagnosis throughout recovery with focus on the quality, rather than speed, of recovery. This may be more in alignment with the patient's needs and preferences. Conclusions Nursing has been in the forefront since the establishment of ERAS, and the nurse-coordinator must be skilled in evidence-based medicine and have excellent communicative competencies to support the patient journey. Implementation of ERAS have reduced hospitalization by improved minimal surgery, optimized anesthetic regimes without increasing readmission rates. It is not known which items can reduce post-operative complications. In the future, nurses should seek a more prominent and leading role during the implementation process and take responsibility for continued education of the staff. Likewise, future nursing interventions will focus on early identification of modifiable risk factors, and a deeper exploration of the patients personally needs and preferences to upcoming surgery could optimize adherence throughout the pathway, which may add to positive outcomes.
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Balfour A, Amery J, Burch J, Smid – Nanninga H. Enhanced recovery after surgery (ERAS®): barriers and solutions for nurses. Asia Pac J Oncol Nurs 2022; 9:100040. [PMID: 35647226 PMCID: PMC9130527 DOI: 10.1016/j.apjon.2022.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 02/06/2022] [Indexed: 11/25/2022] Open
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