b'NURSING HIGHLIGHTS 2022NURSES ROLES IN ENHANCED RECOVERY AFTER SURGERY: Improving Surgical OutcomesPamela ParisRN, MSN, CNML I DIRECTOR INPATIENT SURGICAL UNITSEnhanced Recovery After Surgery (ERAS) programs have goals ofPre-surgical testingNursesreinforce improving patient outcomes by optimizing patients readiness foreducation, encourage preoperative optimization and answer surgery pre-operatively and assisting in minimizing perioperativepatient questions about expectations on the day of the procedure. complications. In many cases, effective ERAS pathways not onlyAs a consistent point of contact for all surgical patients, the improve outcomes, but also decrease length of hospital stay andinvolvement of the Pre-surgical Testing Nurses is an integral part of can lower rates of readmission in the post-operative period. the success of perioperative initiatives such as ERAS.Concord Hospital has successfully implemented ERAS pathways forPerioperativeNursessupport the values and a number of surgical patient populations including orthopaedics,goals of an ERAS pathway at every interaction with the patient by general surgery, urologic oncology and urologic gynecology. helping to minimize patient delays, implementing the elements The implementation of an ERAS pathway relies on inter-disciplinaryof the pathway and optimizing patients for discharge. Nurses in collaboration across specialties and through the entire continuumthe perioperative areas have developed care maps to support of care. Nurses across the care continuum play an important role ineducation and standard work. These clinical guidelines include the success of ERAS programs and improving patient outcomes. adequate management of peri-operative pain and nausea, early ambulation, resumption of oral intake and education related to Successful enhanced recovery requires nursing to engage theself-care, discharge and follow up.patient in their care from the time the decision for surgery is made all the way through their recovery both in the Hospital and at home.Nurseson the patient care unitssupport patient engagement and the ERAS pathways by PracticeNursesinitiate preoperative optimizationcontinuing interventions that promote healing, self-care and interventions such as smoking cessation, implementing healthyminimization of postoperative complications. These include diet and exercise programs to enhance health and support weightutilizing non-opioid medications for pain, early and frequent loss, providing pre-surgical drinks that optimize calorie intakeambulation, timely advancement of diet, early initiation of referrals in the immediate preoperative phase and educating the patientto ancillary services such as dietary, rehabilitation and social work about what to expect at each phase of recovery. and providing education to prepare patients for discharge.P E O P L E | I N T E G R A T I O N | T R A N S F O R M A T I O N36'