the program. Ms. Reede says a major impediment to getting a truly
holistic view of the process is the fact that multiple facilities might be
involved — the surgeon's office, the preadmission testing clinic, your
facility and the physical therapy provider.
At Oaklawn, the team tracks and analyzes numerous data points,
including readmission rates, nausea, and the length of time until
the patient is walking around and eating solids. A nurse also calls
the patient at 2 days, 2 weeks and 2 months after surgery to
acquire feedback and data.
Ms. Reede says enhanced recovery is making inroads at academic
medical centers because they have advanced resources and infra-
structure. Maybe your facility doesn't have the resources or need to
implement a comprehensive enhanced recovery program. That's OK,
says Ms. Reede. Just adding the pre-op nutrition component can pro-
vide big benefits.
She adds, "Keeping patients hydrated, by giving them carbohydrate
beverages or nutritional beverages before their procedures, improves
their ability to respond to the physical stress of surgery and means
they're able to begin eating again sooner and metabolize at a regular
blood sugar level with their insulin working properly."
Ms. Reede recommends at the very least adopting the American
Society of Anesthesiologists preoperative fasting guidelines, which
state patients can drink clear liquids up to 2 hours before surgery.
"That alone, for them to have fluids up until they come for surgery, is
such a huge value," she says. "They're not thirsty or grouchy. They
feel better and their neurotransmitters are working, so they can
actively participate in their care. Patients are very comfortable, even
after major surgeries, because they're not dizzy and dehydrated from
not eating or drinking."
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