Ensuring Early Mobilization Within an Enhanced Recovery Program for Colorectal Surgery

Fiore, Julio F.; Castelino, Tanya; Pecorelli, Nicolò; Niculiseanu, Petru; Balvardi, Saba; Hershorn, Olivia; Liberman, Sender; Charlebois, Patrick; Stein, Barry; Carli, Franco; Mayo, Nancy E.; Feldman, Liane S.

doi:10.1097/sla.0000000000002114

Cited by 88 publications

(123 citation statements)

References 46 publications

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“…The rising demand for continuous quality improvement in patient care and the need to reduce healthcare costs has led to hospitals introducing accelerated care pathways to decrease patients' length of stay after major surgery (Fiore et al, 2017). With shorter hospital stays there is reduced time and resources available to prepare patients transitioning to home to manage their recovery (Maloney & Weiss, 2008;Weiss, Yakusheva, & Bobay, 2010).…”

Section: Introductionmentioning

confidence: 99%

General surgical patients’ experience of hospital discharge education: A qualitative study

Kang

Gillespie

Tobiano

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To explore adult general surgical patients’ perceptions of, and satisfaction with, discharge education provided by healthcare providers. Background Discharge education is essential for general surgical patients as it equips them with the required knowledge and skills to engage in their care after discharge. Insufficient knowledge to self‐manage or assess their symptoms can result in postdischarge complications, unplanned hospital readmission and overall dissatisfaction with the hospital experience. Design A constructivist‐interpretivist paradigm using qualitative interviews. Methods Telephone interviews were conducted with 13 patients between August 2018 and November 2018 and analysed using inductive content analysis. COREQ guidelines were adopted for the conduct and reporting of the study. Results Four themes were uncovered: (a) The quality of discharge information influences patients’ postdischarge experience; (b) The negative impact of contextual influences on delivery of discharge education; (c) Patients actively participating in their surgical journey; (d) Patients’ preferences with the delivery of discharge education. Conclusion Inadequate discharge education leads to patients’ inability to self‐manage their recovery process. Information sharing with patients fosters shared understanding towards goals and expectations. Relevance to clinical practice Understanding patients’ view may inform the design of patient‐centred discharge education interventions for patients to self‐manage their recovery postdischarge.

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Section: Introductionmentioning

confidence: 99%

General surgical patients’ experience of hospital discharge education: A qualitative study

Kang

Gillespie

Tobiano

et al. 2019

Journal of Clinical Nursing

View full text Add to dashboard Cite

show abstract

“…Wiklund et al observed that goals for steps did not signi cantly improve bowel function recovery or shorten LOS in patients undergoing gastric-bypass surgery (18). Staff-assisted facilitation of early mobilization also did not improve outcomes compared with traditional ERAS care for colorectal surgery (19).…”

Section: Discussionmentioning

confidence: 98%

Smartband use during enhanced recovery after surgery facilitates inpatient recuperation following minimally invasive colorectal surgery

Yin

Huang

Tsai

et al. 2020

Preprint

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Background Enhanced recovery after surgery (ERAS) is valuable in perioperative care for its ability to improve short-term surgical outcomes and facilitate patient recuperation after major surgery. Early postoperative mobilization is a vital component of the integrated care pathway and is a factor strongly associated with successful outcomes. However, early mobilization still has various definitions and lacks specific strategies. Methods Patients who underwent minimally invasive surgery for colorectal cancer followed our perioperative ERAS program, including mobilization from the first postoperative day. After perioperative care skills were improved in our well-established program, compliance, inpatient surgical outcomes, and complications associated with adding smartband use were evaluated and compared with the outcomes for standard protocol. Quality of recovery was evaluated using patient-rated QoR-40 questionnaires the day before surgery, on postoperative day 1 and 3, and on the day of discharge. Results Smartband use after minimally invasive colorectal surgery failed to increase compliance with early mobilization or reduce the occurrence of postoperative complications significantly compared with standard ERAS protocol. However, when smartbands were utilized, quality of recovery was optimized and patients returned to their preoperative status earlier, at postoperative day 3. The duration of theoretical hospital stays and hospital stays of uncomplicated patients wearing smartbands was also reduced by 1.1 and 0.9 days, respectively ( P = 0.0091 and 0.049). Conclusions Smartbands enable enhanced communication between patients and surgical teams and strengthen self-management in patients undergoing minimally invasive colorectal resection surgery. Accelerated recovery to preoperative functional status can be facilitated by integrating smartbands into the process of early mobilization during ERAS.

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“…Wiklund et al observed that goals for steps did not significantly improve bowel function recovery or shorten LOS in patients undergoing gastric-bypass surgery (16). Staff-assisted facilitation of early mobilization also did not improve outcomes compared with traditional ERAS care for colorectal surgery (17).…”

Section: Discussionmentioning

confidence: 99%

Smartband use during enhanced recovery after surgery facilitates inpatient recuperation following minimally invasive colorectal surgery

Yin

Huang

Tsai

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundEnhanced recovery after surgery (ERAS) is valuable in perioperative care for its ability to improve short-term surgical outcomes and facilitate patient recuperation after major surgery. Early postoperative mobilization is a vital component of the integrated care pathway and is a factor strongly associated with successful outcomes. However, early mobilization still has various definitions and lacks specific strategies.MethodsPatients who underwent minimally invasive surgery for colorectal cancer followed our perioperative ERAS program, including mobilization from the first postoperative day. After perioperative care skills were improved in our well-established program, compliance, inpatient surgical outcomes, and complications associated with adding smartband use were evaluated and compared with the outcomes for standard protocol. Quality of recovery was evaluated using patient-rated QoR-40 questionnaires the day before surgery, on postoperative day 1 and 3, and on the day of discharge.ResultsSmartband use after minimally invasive colorectal surgery failed to increase compliance with early mobilization or reduce the occurrence of postoperative complications significantly compared with standard ERAS protocol. However, when smartbands were utilized, quality of recovery was optimized and patients returned to their preoperative status earlier, at postoperative day 3. The duration of theoretical hospital stays and hospital stays of uncomplicated patients wearing smartbands was also reduced by 1.1 and 0.9 days, respectively (P = 0.0091 and 0.049).ConclusionsSmartbands enable enhanced communication between patients and surgical teams and strengthen self-management in patients undergoing minimally invasive colorectal resection surgery. Accelerated recovery to preoperative functional status can be facilitated by integrating smartbands into the process of early mobilization during ERAS.

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Ensuring Early Mobilization Within an Enhanced Recovery Program for Colorectal Surgery

Abstract: ClinicalTrials.gov Identifier: NCT02131844.

Cited by 88 publications

References 46 publications

General surgical patients’ experience of hospital discharge education: A qualitative study

General surgical patients’ experience of hospital discharge education: A qualitative study

Smartband use during enhanced recovery after surgery facilitates inpatient recuperation following minimally invasive colorectal surgery

Smartband use during enhanced recovery after surgery facilitates inpatient recuperation following minimally invasive colorectal surgery

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