Implementing enhanced recovery after surgery

32 OR Nurse2015 November www.ORNurseJournal.com General surgery carries a risk for undesirable sequela including infection, pain, thromboembolic events (such as pulmonary embolus and deep vein thrombosis), and extended hospital stay. Colorectal surgery shares many of these risks in addition to unique complications, including delayed return of bowel function, anastomotic leak, nutritional deficit, and psychological stress.1 Enhanced recovery after surgery (ERAS), also referred to as fast track, was implemented by Professor Henrik Kehlet in the 1990s.2 It is a pathway intended to optimize a patient’s perioperative course by reducing the stress of surgery, decreasing surgical complications, and accelerating postoperative recovery. The outcomes of ERAS programs have been extensively studied and are considered safe and effective.3 The role of the perioperative nurse is to initiate the pathway, including encouraging the patient to take sips of liquids and become mobile as soon as possible after surgery. Perioperative nurses are patient advocates and reinforce the principles of ERAS by educating patients regarding pain control, diet, mobilization and ostomy.