Abstract

Gynecologic surgeons at the hospital believe that patients undergoing minimally invasive gynecologic surgery (MIGS) experience an increased length of stay (LOS). Generic enhanced recovery after surgery (ERAS) order sets exist but are not consistently used, nor are the sets specific to MIGS patients. Preoperative education/counseling regarding ERAS is limited in pre-admission testing (PAT) and provider clinics. It is unclear what intraoperative and postoperative components of ERAS are being implemented consistently. The PICOT question to be answered is: In patients undergoing minimally invasive gynecology surgery (P), how will the implementation of Intraoperative ERAS elements (I), compared to the current absence of ERAS elements (C), affect the length of stay and same-day discharge rates (O) within four months of implementation (T)?

A literature search was performed, and the evidence was appraised to select interventions for implementation. After implementing the selected ERAS interventions, pre-and post-implementation outcomes were analyzed and compared. The outcomes achieved in the three months following implementation matched the outcomes found in the literature. The LOS decreased, and the same-day discharge (SDD) rate increased in the MIGS population; however, it is unclear if this was related to the ERAS implementation or a change in one surgeon's practice. The results of this project were disseminated internally through department meetings and quality committees. The sustainability of this project is questionable since the outcomes appear to be related to surgeon practice and not the selected interventions.

Date of publication

Spring 5-18-2024

Document Type

DNP Scholarly Project

Language

english

Persistent identifier

http://hdl.handle.net/10950/4699

Committee members

Dr. Lauri John, Dr. Gina Nickels-Nelson, Dr. Cheryl Parker

Degree

Doctor of Nursing Practice

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