AB152. SOH24AB_232. Implementation of an enhanced recovery after surgery (ERAS) programme in a model 3 hospital

Background: Enhanced recovery after surgery (ERAS) protocols have demonstrated positive impacts on complication rate and patient length of stay. We report on the initial experience of implementing an evidence-based ERAS protocol for elective colonic resections at a model 3 hospital.

Methods: This retrospective audit of compliance to a newly implemented ERAS protocol was conducted in Midland Regional Hospital, Tullamore, from January to September 2023, including all patients who had colonic resections for either benign or malignant pathology. The ERAS protocol was produced according to National Health Service (NHS) guidelines 3. Patients undergoing emergency colonic resections or non-colonic general surgery procedures were not eligible for inclusion. Descriptive statistics are reported with reference to the published literature.

Results: We report on the experience of ERAS implementation for 10 consecutive patients undergoing colonic resections (right hemi-colectomy n=5, left hemi-colectomy n=3, and subtotal colectomy n=2). All patients received pre-operative carbohydrate loading and minimized pre-operative fasting. Per oral fluids were commenced on the same post-operative date. Compliance with early mobilization was high; 8/10 patients received physiotherapy on day 1 post-operation. Adherence to diet progression guidelines was adequate. The median length of stay was 5 days. Only 4 patients had urinary catheters removed on day 1 post-operation, suggesting an area for targeted quality improvement.

Conclusions: We describe our experience of implementing ERAS guidelines in a model 3 hospital. Adherence to protocol was high, though early removal of catheterization represents an area for future improvement. This led to improved length of stay in patients undergoing colonic resection.

Keywords: Enhanced recovery after surgery (ERAS); colorectal; quality improvement; early mobilization; length of stay