Enhanced Recovery After Bowel Surgery: Implementing Pre-operative Counseling Booklet at Our Lady of Lourdes Hospital
"Introducing an interdisciplinary patient information booklet for elective colorectal surgeries at Our Lady of Lourdes Hospital to improve compliance with Enhanced Recovery After Surgery (ERAS) guidelines. The booklet covers surgery details, pre- and post-operative expectations, self-optimization advice, and patient preparations. Positive feedback indicates improved patient preparedness, surgical experience, and post-operative outcomes. The initiative aims to reduce morbidities, decrease length of stay, and sustain surgical team efficiency through ongoing educational and printing strategies."
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Preparing for your Bowel Surgery Booklet Our Lady of Lourdes Hospital, Drogheda Surgical Department Ms Eleanor Faul, Consultant General Surgeon, Claire Treanor, Senior Occupational Therapist, Jillian Smith, Senior Physiotherapist, Maria McCabe, Dietitian, Roz Cheshire, Stoma CNS, Wendy O Dea, Colorectal CNS
Background Enhanced Recovery After Surgery (ERAS) aims to reduce pre-operative stress, improve recovery and reduce complications in elective colorectal surgical patients. Comprehensive pre-operative counselling, the first principle of ERAS, reduces stress and anxiety and improves patients satisfaction and preparedness for surgery journey with associated improved LOS and morbidity postoperatively. In 2019 in Our Lady of Lourdes Hospital(OLOLH) Drogheda 71 patients (average age 62years) underwent elective colorectal surgery in OLOLH compromising 606 bed days. No formal perioperative counselling was available to patients Aim: To improve OLOLH s compliance with evidence based ERAS Pre-operative counselling from no formal pre-operative education to introducing a patient booklet provided to all elective colorectal surgeries pre-operatively by October 2022. Interdisciplinary Patient information booklet includes information on; Surgery and stoma ERAS expectations postop Packing for surgery Self-optimisation pre-op Diet Exercise Smoking/Alcohol Cessation Post-operative expectations
Development of Interdisciplinary Booklet Trial with Prehabilitation population Indication for intervention to achieve compliance with Pre- operative Counselling element of ERAS Plan Do Phase 2: Official booklet printing, NALA approved and dissemination to all patients attending OLOLH for elective bowel surgery Phase 1 Phase 1: Trial with Prehabilitation Patients Act Study Receive feedback from Prehabilitation population Adapt Booklet based on feedback Get officially printed for all patients Qualitative Feedback 100% strongly agreed that the booklet helped them understand expectations post- operatively 100% of patients agree the booklet prepared them for surgery 100% strongly agree it helped them know what to bring to hospital 100% of patients have brought in correct footwear 0% reported the booklet as overwhelming
This booklet helped me feel much more prepared for surgery, I felt I could do something to help me while awaiting my surgery date Improved Patient Preparedness Value of our Booklet to Patients Surgical Journeys: I found it hugely beneficial knowing that you would meet my husband the day after surgery and that you knew all about him Improved Surgical Experience I was expecting to see you, I have already started my breathing exercises and I am ready to get out of the bed Post-operative Expectations Assistance organised for discharge pre-operatively Reduced Morbidities Reduced aLOS Sustainment Static Surgical MDT Regular PDSA Cycles Recurrent education sessions to NCHDs Formal printing of booklets after approval from all stakeholders Spreadability NCHD education Surgical Governance education Surgical Ground rounds RCSI education First all- Ireland Integrated Care Conference
