Narrowing inequity gap: ERAS home delivery kit

Q2 Nursing Perioperative Care and Operating Room Management Pub Date : 2024-04-21 DOI:10.1016/j.pcorm.2024.100389

Marcus V. Ortega , Michael K. Hidrue , William T. Curry , Rachel Sisodia , Jeffrey Ecker , Jason H. Wasfy , Marcela G. del Carmen , Dan B. Ellis

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Abstract

Objective

To enhance adherence to Enhanced Recovery After Surgery (ERAS) protocols and address pre-operative preparation equity gaps, a system was developed to automatically mail chlorhexidine (CHG) and nutritional carbohydrate supplements (ERAS Kits) to surgical patients.

Background

This retrospective observational study focused on adult patients undergoing abdominal surgeries at a large academic hospital, using a pre-post design.

Methods

The study compared adherence to pre-operative ERAS pathways, involving nutritional supplements and chlorhexidine soap usage, before (September 2021-March 2022) and after (September 2022-March 2023) implementing automatic ERAS Kits mailing. A Chi square test analyzed adherence rates.

Results

Post-implementation, adherence to preoperative nutrition rose from 49.6 % to 57.7 % (P = 0.006), and surgical site preparation from 73.8 % to 78.7 % (P = 0.06). Notable improvements were seen among Black patients, Medicaid recipients, and those from lower-income neighborhoods in nutrition adherence, and among younger patients and Medicaid recipients in site preparation.

Conclusion

Mailing ERAS Kits directly to patients significantly enhanced compliance with preoperative protocols, demonstrating an effective strategy to improve care accessibility and reduce disparities for vulnerable groups.

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缩小不平等差距：ERAS 送货上门工具包

目的为了提高术后恢复强化方案（ERAS）的依从性并解决术前准备公平性方面的差距，我们开发了一套系统，可自动向手术患者邮寄洗必泰（CHG）和碳水化合物营养补充剂（ERAS 套件）。方法该研究比较了在实施ERAS套件自动邮寄之前（2021年9月至2022年3月）和之后（2022年9月至2023年3月）对术前ERAS路径的遵守情况，包括营养补充剂和洗必泰肥皂的使用情况。结果实施后，术前营养的坚持率从 49.6% 上升到 57.7%（P = 0.006），手术部位准备的坚持率从 73.8% 上升到 78.7%（P = 0.06）。黑人患者、医疗补助金领取者和低收入社区的患者在营养坚持率方面有显著提高，年轻患者和医疗补助金领取者在手术部位准备方面也有显著提高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Perioperative Care and Operating Room Management Nursing-Medical and Surgical Nursing

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

56 days

期刊介绍： The objective of this new online journal is to serve as a multidisciplinary, peer-reviewed source of information related to the administrative, economic, operational, safety, and quality aspects of the ambulatory and in-patient operating room and interventional procedural processes. The journal will provide high-quality information and research findings on operational and system-based approaches to ensure safe, coordinated, and high-value periprocedural care. With the current focus on value in health care it is essential that there is a venue for researchers to publish articles on quality improvement process initiatives, process flow modeling, information management, efficient design, cost improvement, use of novel technologies, and management.