학술논문

Implementation of the Enhanced Recovery After Surgery (ERAS®) program in neurosurgery.
Document Type
Article
Source
Acta Neurochirurgica. Nov2023, Vol. 165 Issue 11, p3137-3145. 9p.
Subject
*ENHANCED recovery after surgery protocol
*NEUROSURGERY
*NEUROSURGEONS
*POSTOPERATIVE care
*PITUITARY tumors
*NEUROENDOCRINE tumors
Language
ISSN
0001-6268
Abstract
Background: Over the past decade, Enhanced Recovery After Surgery (ERAS®) guidelines have been proven to simplify postoperative care and improve recovery in several surgical disciplines. The authors set out to create and launch an ERAS® program for cranial neurosurgery that meets official ERAS® Society standards. The authors summarize the successive steps taken to achieve this goal in two specific neurosurgical conditions and describe the challenges they faced. Methods: Pituitary neuroendocrine tumors (Pit-NET) resected by a transsphenoidal approach and craniosynostosis (Cs) repair were selected as appropriate targets for the implementation of ERAS® program in the Department of Neurosurgery. A multidisciplinary team with experience in managing these pathologies was created. A specialized ERAS® nurse coordinator was hired. An ERAS® certification process was performed involving 4 seminars separated by 3 active phases under the supervision of an ERAS® coach. Results: The ERAS® Pit-NET team included 8 active members. The ERAS® Cs team included 12 active members. Through the ERAS® certification process, areas for improvement were identified, local protocols were written, and the ERAS® program was implemented. Patient-centered strategies were developed to increase compliance with the ERAS® protocols. A prospective database was designed for ongoing program evaluation. Certification was achieved in 18 months. Direct costs and time requirements are reported. Conclusion: Successful ERAS® certification requires a committed multidisciplinary team, an ERAS® coach, and a dedicated nurse coordinator. [ABSTRACT FROM AUTHOR]