Date of Award

Spring 5-8-2020

Document Type

DNP Project

Project Team Faculty Member

Dr. Mary Zerlan

Project Team Faculty Member

Dr. Valerie Yancey

Keywords

Enhanced Recovery After Surgery (ERAS), Tylenol, Celebrex, Gabapentin, Regional Anesthesia, Opioids

Abstract

Enhanced Recovery After Surgery (ERAS) protocols are evidence-based programs utilized by hospitals to improve patient outcomes and decrease perioperative opioid administration, generally associated with abdominal surgeries. With over 850,000 orthopedic surgeries performed in 2016, the volume of operations alone indicates a need for adoption of ERAS protocols within the orthopedic patient population. A review of literature was completed to gather the most current, evidence-based non-opioid components to be included in an ERAS protocol for orthopedic patients at a 460-bed hospital in Missouri. The results showed that Acetaminophen, Celebrex, Gabapentin, and regional anesthesia techniques are the most utilized ERAS adjuncts. With these results, a screening tool was created to determine which components of the ERAS protocol could safely be administered to each patient safely accounting for each patient’s contraindications and comorbidities. Following an ERAS education session for surgical staff and a five-question post-test to assess knowledge levels, the screening tool and a three-question survey measuring staff support for the tool were made available to staff for a period of one-month. Although only four post-tests, 27 screening tools, and three surveys were collected, only 29.6% of patients received all four ERAS components, indicating the importance of screening patients before applying standardized protocols.

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