Implementation of Enhanced Recovery After Surgery (ERAS) Protocol after cystectomy: A Quality Improvement Project to Evaluate Bowel Function with implementation of ERAS Protocol

Abstract The purpose of this Quality Improvement project was to develop and implement an enhanced recovery after surgery (ERAS) protocol for cystectomy patients at a regional hospital in central Illinois. Specific goals included reducing patient’s length of hospital stay, reducing occurrence of postoperative ileus after surgery as well as educating the nurses involved in patient care about effective implementation the protocol. An educational presentation and knowledge assessment via testing was developed and subsequently presented to the nurses both inpatient and outpatient at the host facility. A specific protocol was crafted after discussion with stakeholders and the ERAS protocol was finalized and implemented at the facility as well. The outcome measures examined were the patient’s length of stay and occurrence of postoperative ileus. In addition, a blinded post education survey was provided to nursing staff to evaluate knowledge of the ERAS protocol. The findings demonstrated a positive trend toward decreased length of stay with no occurrence of postoperative ileus which was at 53.3% prior to implementation. Post education evaluation for the nurses also showed significant improvement in knowledge base of ERAS protocol. Limitations of this project are secondary to the lower number of post ERAS patients for the project compared to the retrospective group. However, Post ERAS patients demonstrated significantly improved postoperative outcomes thereby entrenching the ERAS protocol as the standard of care for all urology surgeries at this institution