Publication Date

Spring 2023

Degree Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Wei-Chen Tung

Second Advisor

Lisa Walker-Vischer

Third Advisor

Lizanne Regudon

Keywords

Enhanced recovery after surgery, fast track, gynecology, length of stay, readmission rate, gynecology, improved patient outcomes

Abstract

The Enhanced Recovery After Surgery (ERAS) pathway promotes an early recovery after surgery using an evidence-based multidisciplinary approach. The ERAS protocol is aimed at standardizing care to improve patient outcomes. There is consistent evidence that ERAS pathways reduce hospital length of stay (LOS) and readmission rates, decrease healthcare costs, and improve patient satisfaction and outcomes. By attenuating the surgical stress response and supporting the return of physiological function, the ERAS pathway achieves its effectiveness. This scholarly project aimed to evaluate how ERAS improves patient outcomes in gynecology patients at a county hospital. A standardized method for improving patient recovery was not in place at the institution prior to the implementation of the ERAS pathway. ERAS-boarded gynecology surgery patients were reviewed retrospectively as part of this quality improvement project. Through this quality improvement project, hospital LOS was reduced without increasing readmissions or complications. There were no significant relationships between readmission rate and categorical extraneous variables. However, two significant relationships were found among LOS and the categorical extraneous variables. Hispanics had a shorter LOS and women who had an open procedure had longer LOS. As a result of the evaluation of this pathway, modifications may be made to the implementation of ERAS to ensure the high level of success of the program and enhance its expansion to other surgical specialties.

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