REVISION OF ENHANCED RECOVERY AFTER SURGERY PATHWAY FOLLOWING BLADDER SURGERY
| Main Author: | Cecilio Cay |
|---|---|
| Other Authors: | Darlene Finocchiaro, Ayman Tailakh |
| Format: | Report publication-deliverable Journal |
| Bahasa: | eng |
| Terbitan: |
, 2018
|
| Online Access: |
https://zenodo.org/record/4466748 |
Daftar Isi:
- Radical Cystectomy (RC) is the treatment of choice in muscle invasive urinary bladder cancer (MIBC). However; it carries a high-risk for morbidity and mortality, prolonged length of stay (LOS), and an increase in hospital readmission (RA) rates when compared with other urologic surgical procedures. In an effort to mitigate the morbidity associated with RC, the Enhanced Recovery after Surgery (ERAS) pathway was developed. This clinical pathway guides multi-disciplinary teams in their efforts to improve recovery from RC. The purpose of this Doctor of Nursing (DNP) project was to update the ERAS pathway to include current clinical practice guidelines and improve communication and documentation related to completion of the ERAS pathway. The measured outcomes included: 1) length of stay (LOS) in days, 2) RA within 30 days, 3) patient satisfaction, 4) return of bowel function in relation to decreased incidence of post-op ileus, and 5) incidence of DVT. During the implementation and post-intervention period, there was a reduction in 30-day RA rates, LOS, complications, increases in patient satisfaction and a shorter return of bowel activity post-RC. There were improvements in documentation practices and communication between interdisciplinary team (IDT) members related to the completion of the ERAS pathway. This project was able to develop and rejuvenate a culture of improvement and compliance among IDT members involved in the care of post-RC patients.