Experts estimate that only about 1 in 5 surgical facilities uses
enhanced recovery techniques, including managing how patients pre-
pare their bodies for the physical stress of going under the knife. That
needs to change. "We know how important it is to make sure patients,
nutritionally, are ready for surgery," says Ron Gauthier, CRNA, BSA,
BSN, MS, director of anesthesia and perioperative services at
Oaklawn Hospital in Marshall, Mich. "What they eat and drink before-
hand makes a big difference."
Set up for success
It's important to engage patients in enhanced pre-op nutrition as soon
as surgeries are scheduled, says Desiree Chappell, CRNA, of
Louisville, Ky., who's a member of the board of directors of the
American Society for Enhanced Recovery. The initial pre-op connec-
tion with patients is the perfect opportunity to talk about the impor-
tance of nutrition and how to start them down the enhanced recovery
pathway, which usually involves getting them on an immunonutrition
program — eating the right foods and taking vitamin D and omega-3
fatty acid supplements, for example — as soon as possible, according
to Ms. Chappell.
But pre-op nutrition is a major shift in thinking for many patients.
They generally aren't aware of the benefits and requirements, and the
active participation it demands on their part, so ensuring compliance
can be tricky. Experts stress providing them with detailed instruc-
tions.
"Patients need to understand what they're supposed to be doing. It's
not enough to say, 'Here you go, take this, and here's some written
instructions' that may not make sense to a lot of people," says Ms.
Chappell. "Anytime you're implementing something that's non-tradi-
tional, which this really is for surgery, you give not only written
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