Early Recovery after Surgery (ERAS):
|
|
- Trevor Reynolds
- 5 years ago
- Views:
Transcription
1 Early Recovery after Surgery (ERAS): Applying Consistently What We ve Known for 20 Years Dr. Kurt Heiss, MD Objectives Laying Foundation: Who, Why Explore Components: What Start a Program: How and When Dealing with Resistance: Teams and Audits Why ERAS? Enhanced Recovery after Surgery 20 yrs old Henrik Kehlet: Why is the patient [still] in the hospital? Bundling Kehlet et al.. Br J Surg Feb;86(2):
2 Enhanced Recovery After Surgery (ERAS) 13 Randomized Controlled Trials Hundreds of publications ERAS Society ERAS results in: 2-3 day reduction in the length of stay Decreased rate of complications by 20-30% No increase in readmission!!! Reduced LOS Decrease in nonsurgical complications No increase in readmissions 2
3 Objectives Laying Foundation: Who, Why Explore Components: What Start a Program: How and When Dealing with Resistance: Teams and Audits The major influence over fluids, nutrition and electrolytes of the ERAS protocol is: ERAS 22 Crit Care Clinics 26 (2010): a. Routine full liquid diet on post op day 1 b. Intraoperative use of LR at 10 cc/kg/hr to avoid fluid/salt overload c. Use of NuLytely as a non osmotic bowel prep d. Pre op fluid and carbohydrate loading e. Early removal of the NG tube on POD 2 Enhanced Recovery uses Innovative multi-modal pain control by: Fluid/ electrolytes/ nutritional status a. Routine use of low-dose Dilaudid PCA s b. Narcotic-Sparing pain control using gabapentin, NSAIDs and Tylenol c. Acupuncture for post operative pain control d. Limiting Tylenol to avoid toxicity e. Routine use of lumbar epidurals 3
4 One component of the ERAS protocol that prevents Healthcare Associated Complications (HAC s) is: Pain control a. 5 day Lovenox use to prevent Venous Thromboembolism b. Early Removal of Foley c. Limiting Antibiotic Treatment to 5 days post op d. Use of prophylactic Bactrim while foley is in e. Post op referral to Physical Therapy Enhanced Healthcare Value is generated by the ERAS protocol by helping patients return to function by: Prevention of complications a. Pre op Counseling with Patient Goals b. Limiting NG use to 2 days c. Long acting pre meds to reduce anxiety d. Early mobilization and feeding e. Early discharge to rehab facilities for PT f. Decreasing narcotics charges by standard epidural use and Discussion Return of function 4
5 Objectives Laying Foundation: Who, Why Explore Components: What Start a Program: How and When Dealing with Resistance: Teams and Audits CHOA ERAS Early Data Routine audit of component compliance by the ERAS team Teaming with Anesthesia and Nursing 5
6 Possible Agenda Immature Program Agenda Mature Program 1 Who did we do and How did we do last month? Who is coming up this month? What do we expect? Anything unusual? What needs improvement? show the YouTube videos look over the Patient Goal Sheet Some component of Teaching and Teaming and Celebration YouTube Video. Patient Journey Agenda Mature Program 2 Agenda Mature Program 3 Agenda Mature Program 4 Objectives Laying Foundation: Who, Why Explore Components: What Start a Program: How and When Dealing with Resistance: Teams and Audits 6
7 How to Start an ERAS Program Identify Team members Go to a SAGES or NSQIP meeting Watch some ERAS YouTube videos Read literature on ERASSociety.org website Give a talk to your division inviting them to join in Find an anesthesia colleague who wants to play Engage one of your Nurse Clinicians Ask the Residents on Gen Surgery Try it with one of your CR patients How to Start an ERAS Program - 2 Involve Quality in your hospital Get them to help measure Write guidelines Use quality tools to solve problems P-D-C-A Spread to other services Bariatrics, HPB, Craniofacial, Ortho. and Discussion Let s do an ERAS-walk for a patient See in Clinic, recommend surgery, teach PNP contacts patient, gives HO, scripts, drinks Pre op Clinic repeats protocol, gets Goal Sheet Oral antibiotics on day b4 surgery Drinks CHO clears, pain med cocktail in pre op Regional anesthetic and GDFT 4 cc/kg/hr No narcotics ERAS-walk 2 Intra op Decadron and Zofran Remove foley and NG Early drinks Scheduled Zofran, tylenol, Tordol and Gaba Early ambulation Avoid fluid boluses Regular diet POD 1 with stimulant Protocol-based discharge 7
8 8
Enhanced Recovery after Surgery
Enhanced Recovery after Surgery AKA ERAS What is Enhanced Recovery (ER)? Paradigm shift in surgery and surgical care of the patient Philosophy of care Perioperative continuum Multidisciplinary Patient
More informationERAS. Presented by Timothy L. Beard MD, FACS, CPI Bend Memorial Clinic
ERAS Presented by Timothy L. Beard MD, FACS, CPI Bend Memorial Clinic Outline Definition Justification Ileus Pain Outline Specifics Data BMC Data Worldwide Data Implementation What is ERAS? AKA Fast-track
More informationIf you reduce variability in volume administration, HOW. you can reduce post-surgical complications, LOS and associated costs 1-4
A large body of clinical evidence* demonstrates If you reduce variability in volume administration, you can reduce post-surgical complications, LOS and associated costs 1-4 Complications Too Dry Too Wet
More informationEMERGING EVIDENCE AND BEST PRACTICES TO PREVENT SSI IN COLON PROCEDURES
EMERGING EVIDENCE AND BEST PRACTICES TO PREVENT SSI IN COLON PROCEDURES Clifford Ko, MD, MS, MSHS, FACS, FASCRS Professor of Surgery UCLA Director, ACS NSQIP, American College of Surgeons EVIDENCE Ban
More informationPresentation at ACS NSQIP National Conference in July Surgical Site Infection Reduction Strategies
Presentation at ACS NSQIP National Conference in July 2015 Surgical Site Infection Reduction Strategies PeaceHealth Sacred Heart Medical Center at RiverBend Level II Trauma Center 379 Beds 15,060 cases
More informationEnhanced Recovery After Discharge: does it happen?
Enhanced Recovery After Discharge: does it happen? Nader K Francis ERAS-UK Southampton 14 th November 2014 BJS 2014 Functional / symptoms Length of hospital stay 37 Readmission 29 Pain 16 Fatigue 9 BJS
More informationClick to edit Master subtitle style
Does Enhanced Recovery Improve Outcomes? Click to edit Master subtitle style Kaare Weber, MD Director of Surgery Associate Medical Director, Surgery A MEMBER OF THE MONTEFIORE HEALTH SYSTEM mes? Click
More information7/31/2015. Enhanced Recovery After Surgery: Change Your Mind, Change Your Practice. Objectives. Enhanced Recovery Society
Enhanced Recovery After Surgery: Change Your Mind, Change Your Practice Margaret Odhner MS, ANP-BC, COCN Kim Meacham, MSN FNP-C, CWON Objectives 1. Describe the Enhanced Recover After Surgery (ERAS) pathway.
More informationSimone Targa. Impact of an ERAS Colorectal Program on clinical outcomes and costs
Impact of an ERAS Colorectal Program on clinical outcomes and costs Simone Targa U.O. di Clinica Chirurgica Azienda Ospedaliero-Universitaria di Ferrara Arcispedale S. Anna ERAS Protocol ENHANCED RECOVERY
More informationA high-volume surgical unit experience with enhanced recovery after surgery (ERAS)
A high-volume surgical unit experience with enhanced recovery after surgery (ERAS) Catalina Mosquera, Nicholas J. Koutlas, Nasreen A. Vohra, Emmanuel E. Zervos, Timothy L. Fitzgerald East Carolina University,
More informationImproving Colectomy Outcomes in the Enhanced Recovery In NSQIP (ERIN) Pilot
Improving Colectomy Outcomes in the Enhanced Recovery In NSQIP (ERIN) Pilot Julia R. BerianMD; Kristen A. Ban MD; Sanjay MohantyMD,MS; Jennifer L. ParuchMD,MS; Clifford Y. KoMD,MS,MSHS; Julie K. Thacker
More informationEnhanced Recovery After Surgery: Where Do Pharmacists Come In?
Enhanced Recovery After Surgery: Where Do Pharmacists Come In? Melinda C. Joyce, Pharm.D., FAPhA, FACHE Vice President, Corporate Support Services Med Center Health Bowling Green, Kentucky Annual Meeting
More informationAdvances in Joint Replacement
Advances in Joint Replacement Seth Greenky, MD Chairman, Musculoskeletal Services, St. Joseph s Hospital Partner, Syracuse Orthopedic Specialists Associate Clinical Professor, Upstate Medical Center CoMedical
More informationCreating an Early Recovery Order Set for Colorectal Surgery-It s the Journey as well as the Destination
Creating an Early Recovery Order Set for Colorectal Surgery-It s the Journey as well as the Destination Jason D. Sciarretta, MD, FACS Grand Strand Medical Center, Myrtle Beach, SC University of South Carolina
More informationENHANCED RECOVERY AFTER SURGERY (ERAS) PATHWAYS PARESH C. SHAH MD FACS VICE CHAIR OF SURGERY DIRECTOR OF GENERAL SURGERY
Department of Surgery Divison of General Surgery ENHANCED RECOVERY AFTER SURGERY (ERAS) PATHWAYS PARESH C. SHAH MD FACS VICE CHAIR OF SURGERY DIRECTOR OF GENERAL SURGERY December 2016 Disclosure Paresh
More informationIntro Who should read this document 2 Key practice points 2 What is new in this version 3 Background 3 Guideline Subsection headings
Enhanced Recovery for Major Urology and Gynaecological Classification: Clinical Guideline Lead Author: Dr Dominic O Connor Additional author(s): Jane Kingham Authors Division: Anaesthesia Unique ID: DDCAna3(12)
More informationEnhanced Recovery Thoracic Surgery. Esophagus Pathway
Enhanced Recovery Thoracic Surgery Esophagus Pathway Preoperative Patient Education/Expectations for Hospital and Home Medical Risk Consultation: Cardiac Clearance and PFTs for All Patients Surgery Wellness
More informationOutpatient Total Knee Arthroplasty: Anesthetic Implications
Outpatient Total Knee Arthroplasty: Anesthetic Implications Anthony Edelman, MD, MBA Clinical Assistant Professor Director, Division of Orthopedic Anesthesia Disclosures None Objectives Examine current
More informationAnesthetic Techniques for Rapid Recovery in Total Knee Arthroplasty
Anesthetic Techniques for Rapid Recovery in Total Knee Arthroplasty Scott T. Ball, MD Chief, Adult Joint Reconstruction Department of Orthopaedic Surgery University of California, San Diego Disclosures
More informationOptimising Perioperative Pain Management And Surgical Outcomes
Optimising Perioperative Pain Management And Surgical Outcomes Dr Chew Ghee Kheng MBBS FRCOG MD FAMS Senior Consultant Gynaecologist Subspecialist in Gynaecology Oncology Surgery Singapore General Hospital
More informationTo staple or to sew. Zeng Xuan Hu
To staple or to sew Zeng Xuan Hu Fast Track Surgery Multimodal Rehabilitation Accelerated recovery Accelerated rehabilitation Enhanced recovery Optimize perioperative care by reducing the expected stress
More informationEnhanced Recovery After Surgery Getting it Right
Enhanced Recovery After Surgery Getting it Right Aalok Agarwala, M.D., M.B.A. Division Chief, General Surgery Anesthesia Associate Director, Quality and Safety, MGH DACCPM Assistant Professor, Harvard
More informationGastrointestinal Feedings Post Op: What s the deal on beginning oral feedings?
Gastrointestinal Feedings Post Op: What s the deal on beginning oral feedings? Kate Willcutts, DCN, RD, CNSC University of Virginia Health System Charlottesville, VA kfw3w@virginia.edu Objectives 1. Discuss
More informationANICOLAU.RO. Enhanced Recovery after Colorectal Surgery. Irina Grecu, Alexandru E. Nicolau, Olle Ljungqvist*
Enhanced Recovery after Colorectal Surgery Irina Grecu, Alexandru E. Nicolau, Olle Ljungqvist* Clinical Emergency Hospital of Bucharest, Romania *Karolinska Institute, Stockholm, Sweden ERAS - Enhanced
More informationThe effect of laxative use in length of hospital stay and complication rate in patients undergoing elective colorectal surgery within an ERAS setting.
The effect of laxative use in length of hospital stay and complication rate in patients undergoing elective colorectal surgery within an ERAS setting. { Thalia Petropoulou, Clinical Fellow Paul Hainsworth,Colorectal
More informationEnhanced Recovery in Pediatric Surgery
Enhanced Recovery in Pediatric Surgery Diana L Diesen, M.D., FACS Assistant Professor, Department of Surgery University of Texas Southwestern Medical Center Children s Health Dallas Dallas, Tx Disclosures
More informationOperational Efficiency in Colon Surgery Enhanced Recovery Pathways: 23 hour laparoscopic colectomy
Enhanced Recovery Pathways: 23 hour laparoscopic colectomy Conor P. Delaney MD MCh PhD Chairman, Digestive Disease Institute Professor of Surgery, Cleveland, Ohio Disclosure Slide Conor Delaney MD PhD
More informationPerioperative pathophysiology and the objectives behind Enhanced Recovery Care
Perioperative pathophysiology and the objectives behind Enhanced Recovery Care Francesco Carli, MD, MPhil McGill University Montreal, Canada franco.carli@mcgill.ca 60 patients (74 yo) Open colon resection
More informationEnhanced Recovery After Colorectal Surgery at Royal Inland Hospital Kamloops, BC. Our Data Experience
Enhanced Recovery After Colorectal Surgery at Royal Inland Hospital Kamloops, BC Our Data Experience No Disclosures 1/26/2015 2 Purpose To tell our story of how we collect and share our ERACS data 1/26/2015
More informationAssessment. Consults & Referrals
University of Virginia Health System Clinical Pathway: Whipple Enhanced Recovery After () LOS: 4-5 days Date of Origin/Revision: June 29, 2016/September 6, 2017/January 31, 2018 : SAS : : : D1 D2 D 3/
More informationPre-operative Assessment
Pre-operative Assessment Dr Craig Taylor Andrea Harris On behalf of the WM RTC Audit Group A good example of an audit cycle...... or is it!!?? Identify Better Blood Transfusion 2002 2007 West Midlands
More informationEducational Learning Objectives. Evidence into Practice. Audience. Case Presentation. Outline. Multimodal Approach to Colorectal Surgery
Educational Learning Objectives Multimodal Approach to Colorectal Surgery Value and Impact of Nutrition Interventions May 5, 2011 Dr. Corilee A. Watters, MSc, RD, PhD, CNSC Asst. Prof, Nutrition, University
More informationExpectations for Ostomy Patients Discharged to a SNF
Expectations for Ostomy Patients Discharged to a SNF Following your surgery and hospital stay you will enter a Skilled Nursing Facility (SNF) to continue your recovery. This material has 3 parts: 1. Precautions
More informationERAS: Enhanced Recovery After Surgery. Christopher L. Wu, M.D. Professor of Anesthesiology The Johns Hopkins University; Baltimore, Maryland
ERAS: Enhanced Recovery After Surgery Christopher L. Wu, M.D. Professor of Anesthesiology The Johns Hopkins University; Baltimore, Maryland Overview History and basic principles of ERAS Review published
More informationDisclosures. Personalized Approaches to Gastrointestinal Cancers. Objectives. What is personalized cancer care. Go through some genomic studies
Personalized Approaches to Gastrointestinal Cancers Emily Groves, MD Colorectal Surgery Assistant Professor, Division of Surgical Oncology Disclosures None Objectives What is personalized medicine and
More informationWelcome Charles Kennedy
Welcome Charles Kennedy Comoderators Girish P. Joshi, MBBS, MD, FFARCI Professor of Anesthesiology and Pain Management University of Texas Southwestern Medical Center Dallas, Texas David E. Beck, MD, FACS
More informationBaptist Health Lexington. ERAS Protocols
Baptist Health Lexington ERAS Protocols Enhanced Recovery After Surgery BHLex Colorectal ERAS Protocol Preoperative Patient/Family Education: PAT and office, ERAS brochure & educational flyer/checklist
More informationDisclosures. Total knee and Total Hip Replacement, a Fast Track. Outline of my talk. What is Fast Track Arthroplasty? I have nothing to disclose
Total knee and Total Hip Replacement, a Fast Track Muhammad I Shaikh M.D.,Ph.D. Associate Professor of Anesthesiology, UCSF Outline of my talk Definition of Fast Track Principles of FT as applied to Orthopedics
More informationChirurgia del Colon in Week Surgery?
Chirurgia del Colon in Week Surgery? dr. V. Fiscon dr. G. Portale Chir. Generale, Cittadella -PD- ULSS 6 Euganea E il colon??? Kraft K et al., J C Visc 2013 Discharge early Colon in week surgery Readiness
More informationThe Pain of a Fractured Neck of Femur. Ms Fiona Nielsen- Project Lead
The Pain of a Fractured Neck of Femur - Project Lead Our health service 75,000 in-patients 165,000 out-patients 900 beds 6,200 staff 70,000 emergency attendances #NOF Presentations 2010-2011- 262 2011-2012-
More informationAmbulatory Knee Arthroplasty
Ambulatory Knee Arthroplasty Harlan B. Levine, MD Hartzband Center for Hip & Knee Replacement Hackensack University Medical Center Hackensack, New Jersey Disclosure Zimmer Consultant Biomet Consultant
More informationEnhanced Recovery to Optimize Perioperative Alternatives to Opioids
Enhanced Recovery to Optimize Perioperative Alternatives to Opioids Women in Government, Annual Healthcare Summit Th 05 November 2017, Washington DC Timothy E. Miller, MB, ChB, FRCA Duke University Department
More informationEvaluating the Effectiveness of Current Orthopaedic Pain Management Strategies
Evaluating the Effectiveness of Current Orthopaedic Pain Management Strategies TOPICS: Impact of Health Care Changes Current Strategies in Surgical Pain Management Implementing and Evaluating Pain Management
More informationIleal Conduit Diversion Surgery
Here are some words and pictures to help you understand this surgery: Bladder: the bladder stores urine that is made by the kidneys Bowels: the bowels are the parts of the body that digest food and fluids.
More informationLaparoscopic Colorectal Surgery
Laparoscopic Colorectal Surgery 20 th November 2015 Dr Adam Cichowitz General Surgeon Laparoscopic Colorectal Surgery Introduced in early 1990s Uptake slow Steep learning curve Requirement for equipment
More informationANICOLAU.RO. What is ERAS? Enhanced Recovery After Surgery. A.E.Nicolau*,Irina Grecu** Spitalul Clinic de Urgenta
Spitalul Clinic de Urgenta ANICOLAU.RO What is ERAS? Enhanced Recovery After Surgery A.E.Nicolau*,Irina Grecu** *Clinica de Chirurgie **Clinica de Anestezie Terapie Intensiva ERAS = Fast-track surgery
More informationLumbar Fusion. Reference Guide for PACU CLINICAL PATHWAY. All patient variances to the pathway are to be circled and addressed in the progress notes.
Reference Guide for PACU Lumbar Fusion CLINICAL PATHWAY All patient variances to the pathway are to be circled and addressed in the progress notes. This Clinical Pathway is intended to assist in clinical
More informationEvery Day Counts: Interventions to Improve VTE and Length of Stay in Patients Undergoing Radical Cystectomy
Every Day Counts: Interventions to Improve VTE and Length of Stay in Patients Undergoing Radical Cystectomy John A. Brockman, Steven B. Brandes, Arnold D. Bullock, Robert L. Grubb III, Gurdarshan Sandhu,
More informationColorectal Surgery SSI Prevention Bundle and ERAS. NYSPFP Webinar
Colorectal Surgery SSI Prevention Bundle and ERAS NYSPFP Webinar Christopher Mantyh, MD Duke University Medical Center Professor of Surgery Chief of Colorectal Surgery Chief of Quality Who Cares About
More informationEnhanced Recovery after Surgery - A Colorectal Perspective. R Sim Centre for Advanced Laparoscopic Surgery, TTSH
Enhanced Recovery after Surgery - A Colorectal Perspective R Sim Centre for Advanced Laparoscopic Surgery, TTSH Conventional Surgery Postop care Nasogastric tube Enteral feeds when ileus resolves Opioid
More informationThe 3 P s (Pain, Poop, Physical Therapy) for Post-Op Spinal Fusions
The 3 P s (Pain, Poop, Physical Therapy) for Post-Op Spinal Fusions Pain control is a key part of your care after surgery. It can help speed recovery and improve the results of your surgery. This handout
More informationAPPLYING ENHANCED RECOVERY PRINCIPLES: EARLY TESTING IN UPPER GI CANCER
APPLYING ENHANCED RECOVERY PRINCIPLES: EARLY TESTING IN UPPER GI CANCER William Allum Consultant Surgeon, Royal Marsden NHS Foundation Trust ? POSSIBLE Major procedure Painful Anastomotic complications
More informationLocal Offer Annual
Local Offer Annual Report 2016 @WestSussex.LocalOffer @LocalOfferWS localoffer@westsussex.gov.uk January West Sussex Pilot Study Co-production from the beginning with the West Sussex Parent Carer Forum
More informationFast Track Surgery and Surgical Carepath in Optimising Colorectal Surgery. R Sim Centre for Advanced Laparoscopic Surgery, TTSH
Fast Track Surgery and Surgical Carepath in Optimising Colorectal Surgery R Sim Centre for Advanced Laparoscopic Surgery, TTSH Conventional Surgery Postop care Nasogastric tube Enteral feeds when ileus
More informationEnhanced Recovery After Surgery (ERAS)
Enhanced Recovery After Surgery (ERAS) Brad White, D.O. Anesthesiology Residency Program Director Oklahoma State University Medical Center Assistant Clinical Professor of Anesthesiology Oklahoma State
More information(Page 1 of 5) Diagnosis: Procedure: Right Total Knee Replacement Unicompartmental Knee Left Total Hip Revision Total Shoulder
(Page 1 of 5) Allergies/Sensitivities/Reactions: Height: Inches cm Weight: Kg Pounds = Automatic = Physician s option, Check off to Order Diagnosis: Procedure: Right Total Knee Replacement Unicompartmental
More informationManagement of Acute Pain in the Chronic Pain Patient. Eric Cannon, MD Mountain West Anesthesia December 1, 2017
Management of Acute Pain in the Chronic Pain Patient Eric Cannon, MD Mountain West Anesthesia December 1, 2017 Objectives 1. Describe the unique challenges of managing acute pain episodes in patients being
More information5 th ERAS UK Conference. Advances in Pain Management. Jayne Balson Advanced Nurse Specialist Pain Management Western General Hospital Edinburgh
5 th ERAS UK Conference Advances in Pain Management Jayne Balson Advanced Nurse Specialist Pain Management Western General Hospital Edinburgh Pre-op information Optimised organ function No nutritional
More informationBackground and Context
Background and Context People affected by cancer need information that is timely and relevant to enable them to make decisions. It can be difficult for patients and others affected by cancer to identify
More informationAt Home After Surgery
Now that your surgery is done, your focus should be on healing. If you follow the recommendations listed in this section, you will help ensure that your new hip will last for the rest of your life. patients.d-h.org/ortho/hips
More informationESPEN Congress Vienna Nutrition after discharge from hospital: The surgeon s responsability. O. Ljungqvist (Sweden)
ESPEN Congress Vienna 2009 Nutrition after discharge from hospital: The surgeon s responsability O. Ljungqvist (Sweden) Nutrition after discharge from hospital: The surgeon s responsability Olle Ljungqvist
More informationThe Changing Landscape of ASCs: Cash Cow or Troubled Venture for Surgeons?
The Changing Landscape of ASCs: Cash Cow or Troubled Venture for Surgeons? Richard D. Guyer, M.D. Chairman, Texas Back Institute RF Associate Clinical Professor UT Southwestern Medical School Disclosures
More informationEnhanced Recovery After Surgery (ERAS) Diary
Cardiac Surgery Enhanced Recovery After Surgery (ERAS) Diary Patient s Name: Options available If you d like a large print, audio, Braille or a translated version of this leaflet then please call: 01253
More informationNon-Narcotic Multimodal Analgesia in Head and Neck Surgery:
Non-Narcotic Multimodal Analgesia in Head and Neck Surgery: Feasibility, Safety and Impact on Physician Prescribing Practices Aru Panwar, MD FACS Methodist Estabrook Cancer Center, Omaha, Nebraska 2018
More informationAnesthesia for OutPatient Spine Surgery. Michael A. Kellams, D.O.
Anesthesia for OutPatient Spine Surgery Michael A. Kellams, D.O. DISCLOSURE None! Hot Topics 2017 -Multimodal Analgesia/ERAS -TAP block -Inpatient procedures outpatient (Fusions) Multimodal Analgesia -Using
More informationPhillip Schnell, Resident at The New Jewish Home ENGAGING RESIDENTS & EXPANDING THERAPY TO ACHIEVE A REDUCTION IN READMISSION
Phillip Schnell, Resident at The New Jewish Home ENGAGING RESIDENTS & EXPANDING THERAPY TO ACHIEVE A REDUCTION IN READMISSION ABOUT THE PROJECT ABOUT THE NEW JEWISH HOME With more than 160 years of experience
More informationDevelopment and Utilization of Standardized Hip Fracture Guidelines
Development and Utilization of Standardized Hip Fracture Guidelines Sally Knight RN Clinical Quality Nurse Lori Smith RN Clinical Quality Nurse Deborah Newall RN Orthopedic Program Coordinator Wallace
More informationFracture Surgery. Post-Operative Care. And. Rehabilitation Protocol
PATIENT NAME: Fracture Surgery Post-Operative Care And Rehabilitation Protocol After Surgery Care and Information Many questions arise during the first week after surgery. There are many new sensations
More informationSame Day Total Joint Replacement A Byproduct of Synergy from a Comprehensive Approach. Disclosures. Just 25 Years Ago
Total Joint Replacement A Byproduct of Synergy from a Comprehensive Approach Richard Berger, MD Rush Medical Center Chicago, IL Disclosures Zimmer, Inc Microport, inc Just 25 Years Ago Arthroscopic ACL
More informationWelcome and thank you for viewing What s your number? Understanding the Long- Stay Catheter Inserted/Left in Bladder Quality Measure.
Welcome and thank you for viewing What s your number? Understanding the Long- Stay Catheter Inserted/Left in Bladder Quality Measure. This presentation is one in a series of videos explaining the 13 quality
More informationBest Practices for Fast Track in Bariatric Surgery: Enhanced Recovery After Bariatric Surgery
Best Practices for Fast Track in Bariatric Surgery: Enhanced Recovery After Bariatric Surgery Abdelrahman Nimeri, MBBCh, FACS, FASMBS ACS NSQIP Surgeon Champion Chief of General, Thoracic & Vascular Surgery
More informationThe Surgical Patient. Objectives:
The Surgical Patient Objectives: 1. Discuss the effect of surgery on the body systems. 2. Explain the etiological factors, nursing assessment, and management of potential problems during the postoperative
More informationPain Management for TKA and THA in David F. Dalury M.D.
Pain Management for TKA and THA in 2016 David F. Dalury M.D. Patient s number 1 fear: Pain. Pain Paena Latin Punishment from God THA much less painful than TKA Principles and protocols the same Acute pain
More information2013 Monthly Trauma Edu Brief
2013 Monthly Trauma Edu Brief Care of the Hip Fx Patient Kelly Simon BSN, RN Pete Benolken MSN, RN, CEN, CPEN, PHN Click here to progress to the next slide. Target Audience This lesson is intended for
More informationEffect of steroid in local infiltrative analgesia in one-stage bilateral total knee arthroplasty. A paired-randomized controlled study
Effect of steroid in local infiltrative analgesia in one-stage bilateral total knee arthroplasty. A paired-randomized controlled study Vincent Chan 1, Chan PK 1, Chiu KY 1, Yan CH 1, FU CH 1, Chan CW 2
More informationOpioid reduction strategies in an academic tertiary medical center
Opioid reduction strategies in an academic tertiary medical center Terry Bosen, PharmD Medication Safety Program Director Vanderbilt University Medical Center Tennessee MME data per capita MME = Morphine
More informationImproving Healthcare Utilization in Injured Older Adults
Improving Healthcare Utilization in Injured Older Adults G ERIATRIC T R A U MA I N I T I AT I V E S AT S TA N F O R D H E A LT H C A R E J U LY 12, 2018 Objectives Background on Geriatric Trauma Population
More informationBasic pathophysiology of recovery: the role of endocrine metabolic response. Franco Carli McGill University Montreal, Canada
Basic pathophysiology of recovery: the role of endocrine metabolic response Franco Carli McGill University Montreal, Canada ASER, Washington, 2016 postoperative recovery, 1950 Loss of body weight, less
More informationEFFECT OF AN ENHANCED RECOVERY AFTER SURGERY PROGRAM ON OPIOID USE AND PATIENT-REPORTED OUTCOMES
EFFECT OF AN ENHANCED RECOVERY AFTER SURGERY PROGRAM ON OPIOID USE AND PATIENT-REPORTED OUTCOMES Obstetrics & Gynecology Vol. 132, No. 2, August 2018 KUSMW OBGYN Journal Club Thomas Greaves, MD, PGY4 August
More informationAcute Peri-Operative Pain Management Strategies
Slide 1 Acute Peri-Operative Pain Management Strategies Phillip Gallegos, MD USAP Pinnacle Anesthesiologist Director of Anesthesia and Peri-Operative Medicine BOSHA Slide 2 ERAS Enhanced Recovery After
More informationAffordability AMGA - MIPS Webinar
Affordability AMGA - MIPS Webinar Beth Averbeck, MD Senior Medical Director Primary Care, HealthPartners Consumer-governed, non-profit HealthPartners Medical Group Primary Care: 500,000 patients 29 locations
More informationThe Roles and Responsibilities of Nurse Before and After Laparoscopic Urologic Surgery
+ The Roles and Responsibilities of Nurse Before and After Laparoscopic Urologic Surgery Elif GEZGINCI Gulhane Military Medical Academy School of Nursing Ankara 1 + 2 PREOPERATİVE + Preoperative (Patient
More informationRegulations: Minimal Sedation. Jason H. Goodchild, DMD
Regulations: Minimal Sedation Jason H. Goodchild, DMD August 2016 Caveats 1. The regulations about to be presented are accurate and current as of today. 2. This could change tomorrow. 3. It is up to every
More informationADJUSTABLE GASTRIC BAND Home Care Instructions
ADJUSTABLE GASTRIC BAND Home Care Instructions These instructions are to help you care for yourself when you go home. Call: If you have any problems. Call 336-387-8100 and ask for the surgeon on call If
More informationTHORACIC SURGERY CHECKLIST Please review this checklist prior to surgery
THORACIC SURGERY CHECKLIST Please review this checklist prior to surgery Clearance: Prior to surgery you will need surgical clearance from your Primary Care Physician and/ or Cardiologist, if recommended.
More informationAbdominal surgery for Crohn's disease. Brought to you in association with EIDO Healthcare and endorsed by the Royal College of Surgeons England.
Abdominal surgery for Crohn's disease Brought to you in association with EIDO Healthcare and endorsed by the Royal College of Surgeons England. Discovery has made every effort to ensure that we obtained
More informationProcedure Specific Information Sheet Open Radical Prostatectomy
Procedure Specific Information Sheet Open Radical Prostatectomy Dr Vasudevan has recommended that you have an open radical prostatectomy. This document gives you information on what to expect before, during
More informationTable of Contents: What is a laparoscopic nissen fundoplication?...3. Where will surgery be performed?...3
Table of Contents: What is a laparoscopic nissen fundoplication?...3 Planning and preparing for the surgery...3-4 Where will surgery be performed?...3 What to expect during surgery and your hospital stay.
More informationReducing Adverse Drug Events Related to Opioids: An Interview with Thomas W. Frederickson MD, FACP, SFHM, MBA
Reducing Adverse Drug Events Related to Opioids: An Interview with Thomas W. Frederickson MD, FACP, SFHM, MBA Iyer Hi, this is a podcast from the Physician-ient Alliance for Health & Safety. The podcast
More informationThe Role of the Diabetes Educator within the Patient-Centered Medical Home & Future Roles
The Role of the Diabetes Educator within the Patient-Centered Medical Home & Future Roles Linda M. Siminerio, RN, PhD, CDE Professor of Medicine University of Pittsburgh School of Medicine & Nursing Objectives
More informationBrian P. McKeon MD Jason D. Rand, PA-C, PT Patient Information Sheet: Total Knee Replacement
Brian P. McKeon MD Jason D. Rand, PA-C, PT Patient Information Sheet: Total Knee Replacement This is a general information packet for patients undergoing Total Knee Replacement. Osteoarthritis (OA) is
More informationKeck School of Medicine of USC
To: Patients undergoing colorectal surgery From: Kyle Cologne, MD Welcome to USC! I m glad you have chosen us here at USC for your surgical care. I understand this can be a very difficult time filled with
More informationColonic (Large Intestine) Manometry
Patient and Family Education Colonic (Large Intestine) Manometry Manometry measures the pressure of contractions of the digestive tract. What is colonic manometry? The colon (also known as the large intestine)
More informationERAS Society. Enhanced Recovery After Surgery & how metabolism is key State of the art lecture
ERAS Society Enhanced Recovery After Surgery & how metabolism is key State of the art lecture Olle Ljungqvist MD, PhD Professor of Surgery Örebro University Hospital & Karolinska Institutet, Sweden IrSPEN
More informationObjectives 9/7/2012. Optimizing Analgesia to Enhance the Recovery After Surgery CME FACULTY DISCLOSURE
Optimizing Analgesia to Enhance the Recovery After Surgery Francesco Carli, M.D.. McGill University, Montreal, QC, Canada. ASPMN, Baltimore, 2012 CME FACULTY DISCLOSURE Francesco Carli has no affiliation
More informationOptimal Perioperative Management of the Geriatric Patient: A Best Practices Guideline from the ACS NSQIP/American Geriatrics Society
Optimal Perioperative Management of the Geriatric Patient: A Best Practices Guideline from the ACS NSQIP/American Geriatrics Society Sanjay Mohanty, MD; Ronnie A. Rosenthal, MS,MD; Marcia M. Russell, MD;
More informationSurgery in Frail Elders. Emily Finlayson, MD, MS Department of Surgery University of California, San Francisco September, 2011
Surgery in Frail Elders Emily Finlayson, MD, MS Department of Surgery University of California, San Francisco September, 2011 What we re going to cover Mortality after surgery in the elderly Fact v Fantasy
More information-DVT and PE Reduction Strategy in AWR- Can We Win? Luciano Tastaldi, MD
-DVT and PE Reduction Strategy in AWR- Can We Win? Luciano Tastaldi, MD Summary of the Project Objectives Present Numbers Evolution Challenges of Implementation Discuss Future Directions -Problem at CCF-
More informationEnglish for living in the UK. The Cervical Smear
English for living in the UK The Cervical Smear At a glance... Objective This class is aimed at teaching new arrivals to the UK about the need for cervical screening and to reduce the anxiety a smear test
More informationPatellar Tendon / Quad Tendon Repair Surgery Discharge Instructions
Matthew T. Mantell, MD 128 Medical Circle Winchester, VA 22601 Phone: 540-667-8975 Email: mattmantellmd@gmail.com Web: www.mattmantellmd.com Patellar Tendon / Quad Tendon Repair Surgery Discharge Instructions
More information