The Effect of Implementing the ERAS (Enhanced Recovery After Surgery) Protocol on Length of Stay in Post-Surgery Patients
DOI:
https://doi.org/10.53089/medula.v13i3.653Keywords:
ERAS, Post-Operative, Length of StayAbstract
Surgery is a follow-up action of invasive emergency treatment by making an incision in a certain part of the body so that it can reach the target organ, after which it ends with closing or suturing the wound. The patient will experience the postoperative impact which is limited movement due to the pain felt after the surgical wound. Furthermore, because the patient cannot mobilize properly, it will affect wound healing. This has an impact on the patient's length of stay which is getting longer and will ultimately make the patient's quality of life worse. Patients with prolonged length of stay are at risk of developing other complications because the patient experiences a decrease in functional status during hospitalization. In addition, the impact of an extended length of stay can increase the financing burden for the hospital. Therefore, efforts are needed to accelerate effective post-surgical healing by implementing the ERAS (Enhanced Recovery After Surgery) protocol. ERAS is a multidisciplinary-based perioperative management protocol with the aim that postoperative patients experience immediate recovery by maintaining postoperative organ function, reducing stress response during surgery, and reducing morbidity in surgery. In several studies, the length of stay of postoperative patients applying the ERAS protocol was shorter than that of patients who did not use the ERAS protocol. This is because in the ERAS protocol, preparations are made for patients starting from pre-admission, pre-operative, intra-operative, and post-operative, each of which has components that can have an impact on accelerating post-operative patient recovery so that the patient's length of stay becomes shorter.
References
Aarts MA, Okrainec A, Glicksman A, Pearsall E, Charles Victor J, McLeod RS. Adoption of enhanced recovery after surgery (ERAS) strategies for colorectal surgery at academic teaching hospitals and impact on total length of hospital stay. Surg Endosc. 2012;26(2):442–450.
Elly N, Asmawati. Faktor-Faktor yang Mempengaruhi Lama Hari Rawat Pasien Laparotomi di Rumah Sakit DR. M Yunus Bengkulu. J Ilmu Kesehat. 2016;8(2):14–18.
World Health Organization. WHO Guidelines for Safe Surgery 2009. Geneva: World Health Organization; 2009.
Melnyk M, Casey RG, Black P, Koupparis AJ. Enhanced recovery after surgery (eras) protocols: Time to change practice? J Can Urol Assoc. 2011;5(5):342–348.
Klek S, Salowka J, Choruz R, Cegielny T, Welanyk J, Wilczek M, et al. Enhanced recovery after surgery (Eras) protocol is a safe and effective approach in patients with gastrointestinal fistulas undergoing reconstruction: Results from a prospective study. Nutrients. 2021;13(6):1–8.
Smith TW, Wang X, Singer MA, Godellas C V., Vaince FT. Enhanced recovery after surgery: A clinical review of implementation across multiple surgical subspecialties. Am J Surg [Internet]. 2020;219(3):530–534. Available from: https://doi.org/10.1016/j.amjsurg.2019.11.009
Muhammad Yusuf, Yasir T, Pratama R. Penerapan Protokol Enhance Recovery After Surgery ( ERAS ) Pada Pasien Operasi Elektif Digestif Sebagai Upaya Menurunkan Length Of Stay Pasien Pasca Pembedahan di RSUD dr. Zainoel Abidin Banda Aceh Tahun 2019. J Med Sci. 2021;2(1):16–20.
Gustafsson UO, Scott MJ, Hubner M, Nygren J, Demartines N, Francis N, et al. Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations: 2018. World J Surg [Internet]. 2019;43(3):659–695. Available from: https://doi.org/10.1007/s00268-018-4844-y
Pedziwiatr M, Kisialeuski M, Wierdak M, Stanek M, Natkaniec M, Matłok M, et al. Early implementation of Enhanced Recovery After Surgery (ERAS®) protocol - Compliance improves outcomes: A prospective cohort study. Int J Surg. 2015;21:75–81.
Kahokehr AA, Sammour T, Sahakian V, Zargar-Shoshtari K, Hill AG. Influences on length of stay in an enhanced recovery programme after colonic surgery. Color Dis. 2011;13(5):594–599.
Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery a review. JAMA Surg. 2017;152(3):292–298.
Murdiman N, Harun AA, L NRD, Solo TP. Hubungan Pemberian Informed Consent Dengan Kecemasan Pada Pasien Pre Operasi Appendisitis Di Ruang Bedah BLUD Rumah Sakit Konawe. J Keperawatan. 2019;02(03):1–8.
Sutinah. Pengaruh Tehnik Distraksi Auditori Terhadap Tingkat Kecemasan Klien Preoperasi Appendisitis. J Kesehat Indones. 2019;X(1):11–16.
Dewi RL, Hakam M, Murtaqib. Gambaran Activity of Daily Living pada Pasien Post Operasi. e-Journal Pustaka Kesehat. 2022;10(3):157–161.
Li L, Chen J, Liu Z, Li Q, Shi Y. Enhanced recovery program versus traditional care after hepatectomy: A meta-analysis. Med (United States). 2017;96(38):1–7.
Kurniawaty J, Anindita MP. Manajemen Preoperatif Pada Protokol Enhanced. J Komplikasi Anestesi. 2018;5(2):61–72.
Bisch S, Nelson G, Altman A. Impact of nutrition on enhanced recovery after surgery (ERAS) in gynecologic oncology. Nutrients. 2019;11(5):1–9.
Olson KA, Fleming RYD, Fox AW, Grimes AE, Mohiuddin SS, Robertson HT, et al. The Enhanced Recovery After Surgery (ERAS) Elements that Most Greatly Impact Length of Stay and Readmission. Am Surg. 2021;87(3):473–479.
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