Date Available

12-2-2019

Year of Publication

2019

Degree Name

Doctor of Nursing Practice

Advisor

Dr. Melanie Hardin-Pierce

Committee Member

Dr. Sheila Melander

Co-Director of Graduate Studies

Dr. Kristin Pickerell

Abstract

Abstract

BACKGROUND: Compliance with the enhanced recovery after surgery (ERAS) protocols for colorectal surgery patients in the post-operative inpatient setting is low, creating a gap in successful outcomes of the program.

OBJECTIVE: The purpose of this project is to evaluate the impact of an education plan on inpatient nursing staff. A second purpose of the study is to examine the relationship between ERAS and specific post-operative nursing interventions linked to length of stay (LOS).

METHODS: A prospective cohort study analyzing the effect of a knowledge to action (KTA) education plan on nursing compliance with ERAS protocols was conducted on bedside nursing staff caring for the colorectal ERAS post-operative population using a new test instrument for pre- and post-testing. Patient chart reviews were conducted on 164 pre education intervention and 19 post education intervention. Outcome measures of patient data include time to liquids, solids and mobility, pain modality used first post-operatively, length of stay and readmissions.

RESULTS: Nursing knowledge demonstrated post-test improvement in scores by 4.33 points with a p value of 0.058. There was clinical significance in process measures of time to liquids, solids and mobility which decreased by 2.8-13.9 hours from closure time. There was a slight increase is opioid-first mediated pain management which was not statistically significant. Length of stay showed clinical significance in reduction by one day, but ungeneralizable.

CONCLUSION: There were limitations in this study most notably small sample size affecting the ability to obtain statistically significant data. The KTA education intervention for nursing staff in areas of ERAS inpatient populations does suggest evidence of increasing compliance to order sets and ERAS initiatives.

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