TTP3.04 Revisiting Enhanced Recovery (ERAS) in the Post-Operative Phase – A Quality Improvement Project at A District General Hospital

Aim To re-assess our current practice of enhanced recovery (ERAS) pathway based on the 2018 ERAS Society recommendations Method First cycle of the audit included patients who underwent elective colorectal resections between January – March 2024. Post-operative elements of the ERAS pathway were assessed including analgesia, nutrition, mobilisation, venous thromboemboli (VTE) prophylaxis, and prophylaxis for post-operative nausea and vomiting (PONV). Data was analysed by descriptive statistics. Educational and nutritional interventions were introduced, and second cycle of the audit was completed between September – October 2024. Results A total of 46 patients and 20 patients were included in the first and second cycle of audit respectively. ERAS recommendationsCycle 1 (n=46)Cycle 2 (n=20)Early mobilisation – referral to physiotherapy100%85%Resumption of oral intake from day of surgery100%100%Oral nutritional supplements (ONS) from day of surgery0%75%VTE prophylaxis for 28 days98%100%Prescription of PONV prophylaxis70%85% Conclusion There was good compliance in most aspects of ERAS with successful introduction of ONS to improve post-operative nutrition. Continued re-assessment of ERAS pathway is recommended with the development of interventions, such as e-prescription bundle, to improve outcomes.