Implementation of a multidisciplinary perioperative protocol in major emergency abdominal surgery.

Purpose: Enhanced recovery after surgery programs is widely implemented in elective settings, however, until recently, rarely in emergency surgery. The purpose of this study was to present detailed contents and data on implementation of an emergency abdominal perioperative protocol on the basis of c...

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Publicado en:European Journal of Trauma & Emergency Surgery Vol. 47; no. 2; pp. 467 - 478
Autores principales: Burcharth, Jakob, Abdulhady, Luka, Danker, Jakob, Ekeloef, Sarah, Jørgensen, Thomas, Lauridsen, Halfdan, Lunen, Thomas Bech, Lyngesen, Malene, Puggaard, Iben, Mathiesen, Ole, Gögenur, Ismail
Formato: research tables/charts Journal Article
Publicado: Springer Nature Apr2021
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: European Journal of Trauma & Emergency Surgery
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      dt: Apr2021
      vid: 47
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00068-019-01238-7
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        atl: Implementation of a multidisciplinary perioperative protocol in major emergency abdominal surgery.
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          Burcharth, Jakob
          Abdulhady, Luka
          Danker, Jakob
          Ekeloef, Sarah
          Jørgensen, Thomas
          Lauridsen, Halfdan
          Lunen, Thomas Bech
          Lyngesen, Malene
          Puggaard, Iben
          Mathiesen, Ole
          Gögenur, Ismail
        affil: Department of Surgery, Centre for Surgical Science, Zealand University Hospital, Lykkebaekvej 1, 4600, Koege, Denmark
      sug:
        subj:
          Multidisciplinary Care Team
          Perioperative Care
          Protocols
          Laparotomy
          Enhanced Recovery After Surgery
          Emergency Service
          Implementation Science
          Program Implementation
          Human
          Preoperative Care
          Intraoperative Care
          Postoperative Care
          Professional Compliance
          Program Evaluation
          Surgical Patients
          Emergency Patients
          Time Factors
          Referral and Consultation
          Descriptive Statistics
      ab: Purpose: Enhanced recovery after surgery programs is widely implemented in elective settings, however, until recently, rarely in emergency surgery. The purpose of this study was to present detailed contents and data on implementation of an emergency abdominal perioperative protocol on the basis of compliance. Methods: A multidisciplinary perioperative bundle for major emergency abdominal surgery was developed and implemented in March 2017 covering surgical, emergency, anesthesiological, radiological, physiotherapy, and nutritional support. The bundle consisted of preoperative-, intraoperative-, and postoperative initiatives. Fifteen core protocol items were identified for audit and compliance rates for each protocol item and overall compliance rates were evaluated and quarterly stratified throughout the first year of implementation. Results: A total of 227 consecutive patients underwent major emergency abdominal surgery from March 2017 throughout February 2018. The specific protocol items showed high individual compliance rates throughout all quarters of the first year. Time to suspicion of diagnosis at the emergency department, rate of perioperative thoracic epidural, and postoperative referral to physiotherapy showed the lowest compliance rates. The overall compliance rate of all 15 protocol items was 83% (min–max 71.4–100%). Conclusion: We found it possible to implement a comprehensive detailed perioperative protocol in emergency abdominal surgery across multiple specialties with an overall good compliance of protocol items.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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