A nursing-driven enhanced recovery after surgery protocol improves postoperative outcomes in hip surgery: a prospective cohort study.

IF 1.3 4区 医学 Q2 SURGERY
Wei Guo, Yuan Chen
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引用次数: 0

Abstract

Background: Enhanced recovery after surgery (ERAS) programs improve outcomes after major orthopedic procedures, but the specific contribution of nursing-led implementation has not been well defined. This study evaluated the impact of a nursing-driven ERAS protocol on recovery outcomes in patients undergoing hip surgery.

Methods: A prospective cohort study was conducted in a tertiary academic center. Patients managed under a structured nursing-coordinated ERAS pathway (N.=36) were compared with historical controls receiving conventional perioperative care (N.=34). The cohort included total hip arthroplasty, hemiarthroplasty, and internal fixation procedures. The ERAS protocol emphasized nurse-led preoperative education, multimodal analgesia, early mobilization, nutritional optimization, and standardized postoperative monitoring. Primary outcomes were hospital length of stay (LOS) and postoperative complications. Secondary outcomes included pain scores, opioid consumption, early functional recovery, discharge disposition, and patient satisfaction.

Results: Baseline characteristics and distribution of surgical procedures were comparable between groups. The ERAS cohort experienced a significantly shorter LOS (median 7 vs. 9 days; P<0.01) and fewer postoperative complications, with the control group exhibiting approximately triple the complication rate. ERAS patients reported lower pain scores and nearly 50% less opioid use postoperatively. Early mobilization within 24 hours was achieved in 89% of ERAS patients versus 50% of controls (P<0.01). More ERAS patients were discharged directly home, and satisfaction scores were higher (94% vs. 76%; P=0.04).

Conclusions: A nursing-driven ERAS protocol significantly enhanced postoperative recovery across a heterogeneous hip surgery population. Nurse-led coordination and adherence monitoring were central to improved outcomes. These findings support broader adoption of nursing-centered ERAS pathways to optimize surgical recovery.

一项前瞻性队列研究:护理驱动的术后恢复方案提高了髋关节手术后的预后。
背景:手术后增强恢复(ERAS)计划可改善重大骨科手术后的预后,但护理主导实施的具体贡献尚未得到很好的定义。本研究评估了护理驱动的ERAS方案对髋关节手术患者恢复结果的影响。方法:在某大专院校开展前瞻性队列研究。采用结构化护理协调的ERAS途径管理的患者(36例)与接受常规围手术期护理的历史对照组(34例)进行比较。该队列包括全髋关节置换术、半髋关节置换术和内固定手术。ERAS方案强调护士主导的术前教育、多模式镇痛、早期活动、营养优化和标准化的术后监测。主要结局是住院时间(LOS)和术后并发症。次要结局包括疼痛评分、阿片类药物消耗、早期功能恢复、出院处置和患者满意度。结果:两组间手术的基线特征和分布具有可比性。ERAS队列的LOS显著缩短(中位7天vs. 9天)。结论:护理驱动的ERAS方案显著提高了异质髋关节手术人群的术后恢复。护士主导的协调和依从性监测是改善结果的核心。这些发现支持更广泛地采用以护理为中心的ERAS途径来优化手术恢复。
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
Minerva Surgery
Minerva Surgery SURGERY-
CiteScore
1.90
自引率
7.10%
发文量
320
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