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J Healthc Qual ; 39(3): 129-135, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28481841

RESUMO

Enhanced recovery programs (ERPs) can improve outcomes following bowel surgery, but implementing an ERP across a large healthcare system remains challenging. In this study, a simplified ERP that focused on two process steps, early and frequent ambulation and early alimentation, was evaluated to determine its impact on outcomes. Data were collected on 5,000 adult patients undergoing elective small and large bowel operations over a 3-year period. Complication, readmission, and mortality rates were evaluated before and after ERP implementation. A composite score was calculated based on the successful completion of the two process steps. Following implementation, there was a 35.1% increase in the composite score, which was associated with significant (p < .05) reductions in overall complications, gastrointestinal complications, pulmonary complications, and readmissions. A system-wide ERP focusing on early and frequent ambulation and early alimentation is associated with decreased complications and readmissions in adult patients admitted for elective small or large bowel operations.


Assuntos
Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/cirurgia , Tempo de Internação/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos , Enfermagem em Pós-Anestésico/normas , Complicações Pós-Operatórias/prevenção & controle , Guias de Prática Clínica como Assunto , Adulto , Fenômenos Fisiológicos do Sistema Digestório , Deambulação Precoce/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Fenômenos Fisiológicos do Sistema Urinário
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