our real-world experience has supported those findings," she adds.
Patient-pleasing protocols
The hospital launched the ERAS pathway to position itself on the cut-
ting edge of care with a concept that promised to reduce the amount
of opioids needed to manage post-op pain. Today, members of the sur-
gical team praise the pathway for getting patients to emerge from sur-
gery in less pain and more engaged in their own care. There were
some growing pains along the way, however. For example, patients
traditionally go NPO the night before surgery, but patients in the
ERAS pathway are permitted to drink clear liquids up to 2 hours
before their scheduled procedures.
"It's engrained in nurses that patients have nothing to eat or drink
after midnight, so there was some initial anxiety among the staff when
caring for ERAS patients," says Ms. Preston. "Implementing the pro-
gram demanded a culture change."
But as the staff's comfort level grew, they began to see a positive
impact on patient care and realized they could manage post-op pain with-
out relying on opioids as the first-line treatment option, says Ms. Cooper.
Putting patients on the ERAS pathway begins in surgeons' offices,
where they receive information about preparing their bodies for the
physiological stress of surgery. Providers from numerous departments
and specialties then coordinate their efforts to manage blood sugar lev-
els in diabetic patients, help smokers kick the habit and encourage
imbibers to limit their alcohol intake. Optimizing patients for surgery
beforehand prepares them for faster discharges.
Part of that education involves setting realistic expectations about
the pain they'll feel after surgery. Staff tell patients that surgery will
hurt, but they coolly reassure them that the surgical team has a
proven plan in place to minimize their discomfort.
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