An investigation on the compliance of perioperative practices using ERAS protocols and barriers to the implementation of the ERAS protocols in colorectal surgery

Abstract

Background

Although ERAS protocols have many benefits, there are some deficiencies in their understanding and implementation by healthcare professionals. The present study was conducted to investigate the compliance of the current perioperative practices of healthcare professional with the ERAS protocols and to assess barriers to the implementation of ERAS protocols in colorectal surgery.

Methods

This cross-sectional descriptive study conducted in the surgical clinics and operating rooms of a training and research hospital between January 2020 and September 2020 included 110 physician and nurse members of surgical teams. Data were collected using the Questionnaire for Evaluating the Use of the ERAS Protocol and Identifying Barriers to Implementation in Colorectal Surgery.

Results

The compliance of the current perioperative practices by healthcare professionals with the ERAS protocols ranged between 15.5% (routinely leaving nasogastric tubes in situ following colorectal resection) and 61.8% (being aware of the concept of balanced analgesia). Variables such as the healthcare professional’s profession, title, years in practice and colorectal surgery experience led to a difference between them in terms of their compliance of the practices with the ERAS protocols (p < 0.05). Based on the healthcare professionals’ comments about barriers to the implementation of the ERAS protocol, themes such as education, teamwork, communication and lack of resources were created.

Conclusion

Healthcare professionals’ compliance level of the current perioperative practices with the ERAS protocols was mostly low. Barriers to the implementation of the ERAS protocols had a multi-factor structure that concerns the multidisciplinary team.

Keywords:

• Colorectal surgery
• enhanced recovery after surgery
• perioperative care
• perioperative period

Acknowledgments

The authors thank the health personnel who participated in the study.

Authors’ contrıbutıons

Study conception and design: Turna Özbay, Deniz Şanlı; Material preparation and data collection: Turna Özbay, Deniz Şanlı; Data analysis and interpretation: Turna Özbay, Deniz Şanlı; The first draft of the manuscript: Turna Özbay, Deniz Şanlı, Jeremy E. Springer; Commented on previous versions of the manuscript: Turna Özbay, Deniz Şanlı, Jeremy E. Springer; Read and approved the final manuscript: Turna Özbay, Deniz Şanlı, Jeremy E. Springer

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets generated during and analyzed during the current study are available from the corresponding author on reasonable request.