Poster - #KUMCW4 - Pre-op ERAS Medication Compliance

Pre-op ERAS Medication Compliance

J. Groskurth MD, W. Keller MD, K Zachariasen MD, K. Foerster MD, G. Winter MD, K. Vincent MD
KU School of Medicine-Wichita

BACKGROUND
The purpose of this project was to improve the pre-operative compliance with Enhanced Recovery after Surgery (ERAS) medications in ERAS appropriate patients with a single colorectal surgeon at a single site. ERAS protocols have been proven to shorten length of hospital stay and decrease complications.

Baseline measurement/ Assessment
Three months of data were queried prior to any intervention to measure the baseline compliance of ERAS medications including acetaminophen, gabapentin and Entereg. 6% did not receive Entereg while 22% did not receive gabapentin in the pre-op setting.

Intervention:
Retrospective chart review pre and post intervention was used to gather data and to identify the number of patients that were eligible for ERAS protocol. We specifically looked at a single surgeon at a single site to quantify the number of patients that received pre op medications including Entereg, acetaminophen and gabapentin. Ileostomy closures were excluded from our study. Our intervention consisted of including above stated medications in the pre-op order set the surgeon’s office sent to the hospital for patient’s that met ERAS criteria.

Results:
Following the intervention, 4% of patients did not receive Entereg and 11% did not receive gabapentin.

Conclusion:
Some anesthesia providers were hesitant to prescribe gabapentin based on patient comorbidities and side effects of the medication. Following the intervention, gabapentin had increased administration. This is speculated to be because of surgeon request. Pre-op orders from the surgeon’s office appear to be effective in improving ERAS compliance.