surgery is performed. "Optimizing the nutritional
status of patients is an opportunity to provide prac-
tical, low-cost and rational recommendations that
can impact our healthcare system in a meaningful
way," he says.
Food for thought
Malnourished patients arrive for surgery feeling
hungry and dehydrated, and perhaps not in the right
mindset that contributes to positive outcomes.
"Fasting after midnight affects their anxiety levels,
their perception of how procedures will go and how
well they'll feel afterward," says Lynda Schoppe,
MSN, RN, CNOR, CAPA, CNEcl. "Letting them drink
clear fluids on the morning of their surgeries
improves their overall well-being."
She should know. Ms. Schoppe, quality and
process improvement supervisor of surgical servic-
es at St. David's South Austin (Texas) Medical
Center, downed a carbohydrate-rich pre-surgical
drink — a key component of the facility's ERAS
program — a couple hours before undergoing major
surgery last month. She awoke in recovery without
experiencing nausea or pain, drank a cup of coffee
and went home feeling surprisingly well.
Patients scheduled for surgery at St. David's South
Austin undergo a nutrition screening two weeks out
and receive high-protein supplements to drink lead-
ing up to their procedures. Patients are also given a
complex carbohydrate pre-surgical drink to imbibe
up to two hours before the scheduled start times of
their cases. "Research has shown clear liquids move
through the stomach in about 90 minutes, so we're
moving away from traditional NPO requirements
before surgery," says Ms. Schoppe.
She acknowledges individuals react to anesthesia
and surgery differently, but has noticed that many
patients who have carbohydrate-loaded drinks
before surgery are able to eat and ambulate soon
after arriving in recovery and feel good enough to
go home the day of surgery, even after complex
procedures. "Researching the benefits of ERAS pro-
tocols for many years, watching patients go through
them and then experiencing the positive impact
they had during my surgery has sold me on the ben-
efits," says Ms. Schoppe.
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