National survey of enhanced recovery after thoracic surgery practice in the United Kingdom and Ireland

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National survey of enhanced recovery after thoracic surgery practice in the United Kingdom and Ireland. / Budacan, Alina-Maria; Mehdi, Rana; Kerr, Amy Pamela; Kadiri, Salma Bibi; Batchelor, Timothy J P; Naidu, Babu.

In: Journal of Cardiothoracic Surgery, Vol. 15, No. 1, 95, 14.05.2020.

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Budacan, Alina-Maria ; Mehdi, Rana ; Kerr, Amy Pamela ; Kadiri, Salma Bibi ; Batchelor, Timothy J P ; Naidu, Babu. / National survey of enhanced recovery after thoracic surgery practice in the United Kingdom and Ireland. In: Journal of Cardiothoracic Surgery. 2020 ; Vol. 15, No. 1.

Bibtex

@article{464a4e1c23454c3db1cf45608827eb89,
title = "National survey of enhanced recovery after thoracic surgery practice in the United Kingdom and Ireland",
abstract = "BACKGROUND: Evidence that Enhanced Recovery After Thoracic Surgery (ERAS) improves clinical outcomes is growing. Following the recent publications of the international ERAS guidelines in Thoracic surgery, the aim of this audit was to capture variation and perceived difficulties to ERAS implementation, thus helping its development at a national level.METHODS: We designed an anonymous online survey and distributed it via email to all 36 centres that perform lung lobectomy surgery in the UK and Ireland. It included 38 closed, open and multiple-choice questions on the core elements of ERAS and took an average of 10 min to complete.RESULTS: Eighty-two healthcare professionals from 34 out of 36 centres completed the survey; majority were completed by consultant thoracic surgeons (57%). Smoking cessation support varied and only 37% of individuals implemented the recommended period for fluid fasting; 59% screen patients for malnutrition and 60% do not give preoperative carbohydrate loading. The compliance with nerve sparing techniques when a thoracotomy is performed was poor (22%). 66% of respondents apply suction on intercostal drains and although 91% refer all lobectomies for physiotherapeutic assessment, the physiotherapy adjuncts varied across centres. Perceived barriers to implementation were staffing levels, lack of teamwork/consistency, limited resources over weekend and the reduced access to smoking cessation services.CONCLUSION: Centres across the UK are working to develop the ERAS pathway. This survey aids this process by providing insight into {"}real life{"} ERAS, increasing exposure of staff to the ESTS- ERAS recommendations and identifying barriers to implementation.",
keywords = "ERAS, Enhanced recovery, Thoracic surgery, Lobectomy",
author = "Alina-Maria Budacan and Rana Mehdi and Kerr, {Amy Pamela} and Kadiri, {Salma Bibi} and Batchelor, {Timothy J P} and Babu Naidu",
year = "2020",
month = may,
day = "14",
doi = "10.1186/s13019-020-01121-2",
language = "English",
volume = "15",
journal = "Journal of Cardiothoracic Surgery",
issn = "1749-8090",
publisher = "Springer",
number = "1",

}

RIS

TY - JOUR

T1 - National survey of enhanced recovery after thoracic surgery practice in the United Kingdom and Ireland

AU - Budacan, Alina-Maria

AU - Mehdi, Rana

AU - Kerr, Amy Pamela

AU - Kadiri, Salma Bibi

AU - Batchelor, Timothy J P

AU - Naidu, Babu

PY - 2020/5/14

Y1 - 2020/5/14

N2 - BACKGROUND: Evidence that Enhanced Recovery After Thoracic Surgery (ERAS) improves clinical outcomes is growing. Following the recent publications of the international ERAS guidelines in Thoracic surgery, the aim of this audit was to capture variation and perceived difficulties to ERAS implementation, thus helping its development at a national level.METHODS: We designed an anonymous online survey and distributed it via email to all 36 centres that perform lung lobectomy surgery in the UK and Ireland. It included 38 closed, open and multiple-choice questions on the core elements of ERAS and took an average of 10 min to complete.RESULTS: Eighty-two healthcare professionals from 34 out of 36 centres completed the survey; majority were completed by consultant thoracic surgeons (57%). Smoking cessation support varied and only 37% of individuals implemented the recommended period for fluid fasting; 59% screen patients for malnutrition and 60% do not give preoperative carbohydrate loading. The compliance with nerve sparing techniques when a thoracotomy is performed was poor (22%). 66% of respondents apply suction on intercostal drains and although 91% refer all lobectomies for physiotherapeutic assessment, the physiotherapy adjuncts varied across centres. Perceived barriers to implementation were staffing levels, lack of teamwork/consistency, limited resources over weekend and the reduced access to smoking cessation services.CONCLUSION: Centres across the UK are working to develop the ERAS pathway. This survey aids this process by providing insight into "real life" ERAS, increasing exposure of staff to the ESTS- ERAS recommendations and identifying barriers to implementation.

AB - BACKGROUND: Evidence that Enhanced Recovery After Thoracic Surgery (ERAS) improves clinical outcomes is growing. Following the recent publications of the international ERAS guidelines in Thoracic surgery, the aim of this audit was to capture variation and perceived difficulties to ERAS implementation, thus helping its development at a national level.METHODS: We designed an anonymous online survey and distributed it via email to all 36 centres that perform lung lobectomy surgery in the UK and Ireland. It included 38 closed, open and multiple-choice questions on the core elements of ERAS and took an average of 10 min to complete.RESULTS: Eighty-two healthcare professionals from 34 out of 36 centres completed the survey; majority were completed by consultant thoracic surgeons (57%). Smoking cessation support varied and only 37% of individuals implemented the recommended period for fluid fasting; 59% screen patients for malnutrition and 60% do not give preoperative carbohydrate loading. The compliance with nerve sparing techniques when a thoracotomy is performed was poor (22%). 66% of respondents apply suction on intercostal drains and although 91% refer all lobectomies for physiotherapeutic assessment, the physiotherapy adjuncts varied across centres. Perceived barriers to implementation were staffing levels, lack of teamwork/consistency, limited resources over weekend and the reduced access to smoking cessation services.CONCLUSION: Centres across the UK are working to develop the ERAS pathway. This survey aids this process by providing insight into "real life" ERAS, increasing exposure of staff to the ESTS- ERAS recommendations and identifying barriers to implementation.

KW - ERAS

KW - Enhanced recovery

KW - Thoracic surgery

KW - Lobectomy

U2 - 10.1186/s13019-020-01121-2

DO - 10.1186/s13019-020-01121-2

M3 - Article

C2 - 32410658

VL - 15

JO - Journal of Cardiothoracic Surgery

JF - Journal of Cardiothoracic Surgery

SN - 1749-8090

IS - 1

M1 - 95

ER -