The Introduction of ERAS Nutritional Care Can Improve the Quality of Postoperative Care

Abstract

ObjectivesShortening the length of hospital stay for surgical patients is the goal in many hospitals. Enhanced Recovery After Surgery (ERAS) is a broadly recognized multimodal, multidisciplinary approach. The care protocol is evidenced in various experimental publications. In 2017, the European Society for Parenteral and Enteral Nutrition (ESPEN) included ERAS care guidelines as the focus of surgical nutritional care. The promotion of ERAS has become a global trend. Our hospital began to implement a cross-team ERAS process in 2019. The purpose of this study is to share the observed outcome of postoperative ERAS nutritional care.MethodsOur ERAS medical team established the ERAS nutritional care process and started comprehensive nutritional care perioperative, which included 1) preoperative nutritional screening and intervention; 2) offering of carbohydrate drinks (clear fluid) on the day before surgery until two hours before anesthesia; 3) permission of oral feeding on the day of surgery. Data collection objects: colorectal cancer patients; collection items: age, gender, height, weight, etc., and postoperative eating status, hospitalization time, postoperative complications, and satisfaction. The patients after the administration of ERAS were the experimental group, and before the administration of ERAS were the control group. Two groups of data were collected about one year.ResultsThere were 70–80 patients in each group. No significant statistical difference between groups was observed in basic characteristics, such as age, gender, height, and weight. The average hospital stay in the experimental group decreased by about 5 days (P < 0.001), the time to eat a semi-liquid diet was reduced by an average of 2 days (P < 0.001), the weight change during hospitalization increased from −0.37 to 0.97 kg (P < 0.001), and the medical complications decreased from 20.6% to 2.4%. More than 80% of participants were satisfied with the nutritional care process.ConclusionsThe implementation of ERAS nutritional care shortened the fasting time and length of hospitalization stay and accelerate the return of patients to a normal diet. Through the collaboration between medical and nutritional teams, the postoperative nutritional condition of patients and quality of medical care were substantially improved.Funding SourcesTaichung Veterans General Hospital.