Date of Publication

2022

Abstract

Utilizing Enhanced Recovery After Surgery (ERAS) Protocol to Improve Perioperative Outcomes for Patients Sustaining Traumatic Hip Fracture.

Kristen Knight, DNP(c), RN

Project Team:

Project Advisor: Marcia Bosek, DNSc, RN

Site Mentor: Kat Gouldy, MSN, RN

Abstract

Background: Enhanced Recovery After Surgery (ERAS) pathways have improved perioperative outcomes for patients undergoing surgical care for traumatic hip fracture without increasing rates of complication or mortality. These protocols are not instituted at all hospitals.

Purpose: Improve perioperative outcomes for patients sustaining traumatic hip fracture by (1) creating an evidence-based pathway, ERAS Orthopedic Pathway (ERAS-OP), to guide perioperative care for traumatic hip fracture, (2) investigating barriers to pathway adoption and (3) evaluating the implementation of the post-operative phase of the ERAS- OP.

Methods: Data were collected on post-operative traumatic hip fracture patients at a Midwest trauma II hospital treated with ERAS-OP (ERAS: June–September 2021), and compared to a retrospective cohort managed without ERAS-OP (Control: June-September 2020). The primary outcomes studied were total cost of care, opioid consumption and length of stay (LOS).

Results: The ERAS-OP was implemented Summer 2021, barriers related to NPO status and regional anesthesia were identified. A total of 128 hip fracture patients met the eligibility criteria (66 ERAS, 62 control). Compared to the control group, patients belonging to the ERAS-OP exhibited a statistically significant lower total cost of inpatient care (p < .01), without significant change to LOS (p=.94) or reduced opioid consumption (p=.09).

Conclusions: The post-operative ERAS-OP significantly decreased cost of care. Further research is needed to understand barriers to NPO guidelines, regional anesthesia administration and compliance with components of ERAS-OP.

Document Type

Project

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