Abstract
Summary Introduction Nurses are the linchpin of any Enhanced Recovery After Surgery (ERAS) program, as they are in direct contact with patients and various caregivers. The aim of the present survey was to assess ERAS key factors and challenges from a nurse’s perspective. Methods A qualitative study among ERAS dedicated nurses and ERAS Interactive Audit System (EIAS) administrators using an online questionnaire (Survey Monkey®, Palo Alto, CA, United States) comprising 29 questions. The survey focused on challenges and drawbacks encountered during ERAS training, implementation and daily clinical practice. Closed multiple-choice and open-end questions and semantic differential scales (0–10) were used. Those invited to participate received three reminders within 4 and 8 weeks after invitation. Results Of 306 nurses invited, 123 completed the survey (response rate 40%). Overall, the success of the institutional ERAS program was rated as 6.9 ± 2/10. Improving both patient outcomes (90%) and satisfaction (69%) were rated as main motivators for ERAS implementation, while time restraints (50%) and logistics (43%) were identified as the main barriers. The study revealed a wide heterogeneity in coordination and management strategies (ERAS meetings, work models, teaching strategies). Sustained staff education before (9.1/10) and after (9.1/10) implementation, a dedicated ERAS coordinator (8.9/10) and regular meetings (8.3/10 scale) were rated as key factors for a successful program. Difficulty of implementation, maintenance and data acquisition were all rated > 5/10. Conclusion Despite heterogeneity in coordination and management, the ERAS program is evaluated as successful from a nurse’s perspective. Continuous staff education and coordination beyond the implementation period appear to be of the utmost importance for a sustained program.
Highlights
The Enhanced Recovery After Surgery (ERAS) concept has disseminated worldwide, with established positive effects on patients and healthcare due to reduced complications, length of stay and costs [1]
Continuous staff education beyond the implementation period and a dedicated coordinator appeared to be of key importance for an ERAS program of sustained high quality
An international qualitative multicenter study was conducted through two separate channels: All nurses and ERAS Interactive Audit System (EIAS) administrators registered at the annual ERAS international meeting in 2017 and registered in the Encare society
Summary
The Enhanced Recovery After Surgery (ERAS) concept has disseminated worldwide, with established positive effects on patients and healthcare due to reduced complications, length of stay and costs [1]. The success of this modus operandi is based on multimodal and multidisciplinary care. While studies have primarily focused on clinical outcomes and hospital economics, the specific needs and point of view of nursing staff remains poorly explored [4, 5]. The aim of the present survey was to study key elements and challenges for ERAS care from a nurse’s perspective
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