Clinicians' views on implementing enhanced recovery after surgery: a descriptive qualitative study.

IF 1.5 4区医学 Q3 SURGERY

ANZ Journal of Surgery Pub Date : 2024-12-06 DOI:10.1111/ans.19342

Georgia Tobiano, Rhea Liang, Wendy Chaboyer, Josephine Lovegrove, Keith Addy, Brigid M Gillespie

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引用次数: 0

Abstract

Background: Enhanced recovery after surgery (ERAS) protocols have existed for the past three decades; these protocols may improve patient outcomes and healthcare costs. Yet, ERAS is difficult to implement, and there has been limited focus on processes used to promote ERAS use. Thus, the aim of this study was to identify and describe the barriers and enablers to implementing ERAS.

Methods: In this qualitative descriptive sub-study, semi-structured interviews, guided by the Theoretical Domains Framework, were conducted with surgeons, anaesthetists, and nurses. Interviews were analyzed using inductive and deductive content analysis.

Results: Three categories were found, which mapped to 12 domains in the Theoretical Domains Framework. Category 1 'realizing the value of ERAS, despite varying levels of exposure and motivation' showed clinicians' different views and knowledge towards ERAS, with a general belief that ERAS was evidence-based. Category 2, 'building momentum for ERAS implementation' outlined strategies to encourage clinicians to practice ERAS. The final category 'providing resources for ERAS' illustrated the tools and up-front costs needed for ERAS implementation.

Conclusion: Motivational strategies are required to inspire individual clinicians to adopt ERAS. Additionally, resources are needed for ERAS to guide practice and support implementation (i.e., staffing and time), underscoring the need for hospital leadership support.

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临床医生对加强术后恢复的看法：一项描述性质的研究。

背景：手术后增强恢复（ERAS）协议已经存在了近三十年；这些方案可以改善患者的治疗效果，降低医疗成本。然而，ERAS很难实施，并且对用于促进ERAS使用的过程的关注有限。因此，本研究的目的是确定和描述实施ERAS的障碍和推动因素。方法：在这个定性描述性的子研究中，在理论领域框架的指导下，对外科医生、麻醉师和护士进行了半结构化访谈。访谈分析采用归纳和演绎内容分析。结果：发现了三个类别，映射到理论领域框架中的12个领域。第1类“实现ERAS的价值，尽管不同程度的暴露和动机”显示了临床医生对ERAS的不同观点和知识，普遍认为ERAS是基于证据的。第2类“为ERAS的实施建立动力”概述了鼓励临床医生实施ERAS的策略。最后一个类别“为ERAS提供资源”说明了实施ERAS所需的工具和前期成本。结论：需要动机策略来激励个体临床医生采用ERAS。此外，ERAS还需要资源来指导实践和支持实施（即人员配备和时间），这强调了医院领导支持的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ANZ Journal of Surgery 医学-外科

CiteScore

2.50

自引率

11.80%

发文量

720

审稿时长

2 months

期刊介绍： ANZ Journal of Surgery is published by Wiley on behalf of the Royal Australasian College of Surgeons to provide a medium for the publication of peer-reviewed original contributions related to clinical practice and/or research in all fields of surgery and related disciplines. It also provides a programme of continuing education for surgeons. All articles are peer-reviewed by at least two researchers expert in the field of the submitted paper.