Consulta de enfermagem pré-operatória no programa Enhanced Recovery After Surgery®

: implementação e avaliação

Abstract

Introduction: This study starting point was the Enhanced Recovery After Surgeryâ (ERASâ) and consisted in planning, implementation of a preoperative nursing consultation and its evaluation. ERASâ is a perioperative care program that promotes patient preoperative optimization and reduce surgery stress for better health outcomes. This nursing consultation pretend to know better the patient and provide information for patient to get a more active role in its recovery. Objectives: Three main objectives were defined: (1) structure the consultation, (2) implement the consultation, and (3) evaluate the consultation. For this evaluation, specific objectives were listed to the main focuses of consultation evaluation: the information transmitted, the patient's experience with the surgical process; the patient's responsibility and participation in the surgical process; the patient´s satisfaction, the implications for the return of autonomy in mobilization and the implications for the length of stay. Method: This is a descriptive, longitudinal and quantitative study. The study design is divided into three parts: structuring, operationalization and consultation evaluation. To carry out this evaluation, two data collection instruments were used: a survey and a clinical results audit platform. Two non-probabilistic samples of patients were considered, one before the ERAS® program implementation and the other with the program implementation and comparing the results obtained according to the evaluation focuses. Data processing was performed through the Statistical Package for the Social Sciences® (SPSS®) and the results presented according to specific objectives. Results: Regarding the importance of the information transmitted, it was inferred that 59.1% of patients considered the information transmitted in the consultation was very important and for 34.4% was important. 74.2% of patients reported being very satisfied with the consultation and 19.4% satisfied. 100.0% of patients said they would like to have a preoperative nursing consultation if they had surgery again. The average length of stay was slightly reduced from 7.09 days to 6.73 days (p=0.044). Approximately 80.6% of patients started to perform the mobilization on the day of surgery in the ERASâ sample, as opposed to 3.2% of patients in the pre-ERASâ sample. Regarding the return to mobilization autonomy in the postoperative period, the mean time decreased from 3.48 to 2.00 days (p<0.001). Conclusion: The information conveyed in the consultation was important for the patients and for their participation in postoperative care. Satisfaction levels with this nursing intervention was high and the patient recognized its importance. The average length of stay was not much affected by the consultation, however, the return to autonomy in mobilization in days was strongly influenced by the information transmitted in the consultation. It is a patient centered intervention and therefore clearly added value to the care provided.

Date of Award	12 Jan 2021
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Cândida Ferrito (Supervisor)