Journals / Izmir Democracy University Health Sciences Journal / 2026 / Cilt: 6 Sayı: 1

THE ENHANCED RECOVERY AFTER SURGERY PROTOCOL IMPLEMENTATION STATUS OF THE HEALTH STAFF WORKING IN THE GYNECOLOGY-OBSTETRIC CLINICS

KADIN DOĞUM KLİNİĞİNDE ÇALIŞAN SAĞLIK PERSONELLERİNİN CERRAHİ SONRASI HIZLANDIRILMIŞ İYİLEŞME PROTOKOLLERİNİ UYGULAMA DURUMU

Tuğçe Çetin(İZMİR KATİP ÇELEBİ ÜNİVERSİTESİ, KATİP ÇELEBİ UYGULAMA VE ARAŞTIRMA MERKEZİ)0000-0002-6648-279X
Hande Yağcan(DOKUZ EYLÜL ÜNİVERSİTESİ, HEMŞİRELİK FAKÜLTESİ)0000-0001-9658-0449
Pages
131–148
Publication Date
2023-05-26
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

ERAS protocols awareness were found not enough in health personnels.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:This study was performed to determine Enhanced Recovery After Surgery Protocols (ERAS) protocols implementation status before and after surgery by the health personnel working in gynecology and obstetrics clinics.
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Key Findings & Data:This descriptive quantitative study was performed in gynecology and obstetrics clinics of two university hospital and applied to 151 health personnel in between December 2020 and January 2021.
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Conclusion & Impact:ERAS protocols awareness were found not enough in health personnels.
🔬Design:Survey & Empirical Study
📍Scope:2020 Verileri
⚙️Variables:Health Personnel · Enhanced Recovery After Surgery · Perioperative Care

Abstract

This study was performed to determine Enhanced Recovery After Surgery Protocols (ERAS) protocols implementation status before and after surgery by the health personnel working in gynecology and obstetrics clinics. This descriptive quantitative study was performed in gynecology and obstetrics clinics of two university hospital and applied to 151 health personnel in between December 2020 and January 2021. Data of study were collected by “ERAS Protocols Implemantation Status of Health Personnel Working in Gynecology and Obstetric Clinics Questionnaire”. The health personnel’s 86.8% didn’t know the protocol. Those who know it was 65% men, 75% in 20-30 age range, 65% had undergraduate education and doctors, 33.3% have experienced difficulties in practice. Significant association was found between participants' gender, reading articles about the protocol, believing in usefulness, learning resources and knowing it (p<0.005). The items with the protocol most frequently applied by health personnel in the preoperative period were 86.1% taking informed consent from patients, 90.7% giving prophylactic antibiotics and 94.4% preparing the patient for operation. In post-op period, most frequently applied items were 100% checking vital signs, 89.4% starting normal diet within first 24 hours after surgery and 78.1% giving paracetamol. ERAS protocols awareness were found not enough in health personnels.

Özet

Bu çalışma, kadın doğum kliniğinde çalışan sağlık personellerinin ERAS protokollerini ameliyat öncesi ve sonrası süreçte uygulama durumlarını belirlemek amacıyla yapılmıştır. Tanımlayıcı tipte olan bu çalışma Aralık 2020-Ocak 2021 tarihleri arasında, iki üniversite hastanesinde kadın doğum kliniğinde çalışan 151 sağlık personeline uygulanmıştır. Çalışmanın verileri “Kadın Doğum Kliniği Sağlık Personellerinin ERAS Protokollerini Uygulama Durumu Anketi” kullanılarak toplanmıştır. Sağlık personellerinin %86.8’i ERAS kriterlerini bilmediğini belirtmiştir. ERAS’ı bilenlerin %65’i erkek, %75’i 20-30 yaş aralığında, %65’i lisansüstü eğitim almış ve hekim, %60’ı 5 yıllık çalışan , %70’i yararlılığına inanıyor, %33.3’ü ekip içi çatışmadan ötürü uygulamada zorluk yaşadıklarını belirtmiştir. Katılımcıların cinsiyetleri, protokolle ilgili makale okuma, yararlılığına inanma ve öğrenme kaynakları ile ERAS bilme durumları arasında istatistiksel olarak anlamlı bir fark bulunmuştur (p<0.005). Preop dönemde sağlık personeli tarafından en sık uygulanan protokol maddeleri; %94.4 operasyon için hastayı hazırlama, %90.7 profilaktik antibiyotik uygulama ve %86.1 operasyon hakkında yazılı veya sözlü bilgilendirmedir. Postoperatif dönemde sağlık personeli tarafından en sık uygulanan protokol maddeleri; %100 yaşam bulguları takibi, %89.4 cerrahi sonrası ilk 24 saat içerisinde normal diyete geçme ve %78.1 parasetamol uygulamasıdır. Sağlık personelinde ERAS protokolleri farkındalığının yeterli olmadığı saptanmıştır.

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Cite This Article

Çetin, T., Yağcan, H. (2023). THE ENHANCED RECOVERY AFTER SURGERY PROTOCOL IMPLEMENTATION STATUS OF THE HEALTH STAFF WORKING IN THE GYNECOLOGY-OBSTETRIC CLINICS. Izmir Democracy University Health Sciences Journal, Cilt: 6 Sayı: 1, 131–148. https://doi.org/10.52538/iduhes.1242971

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References (40)

  1. Agarwal, R., Rajanbabu, A., Nitu, P. V., Goel, G., Madhusudanan, L. & Unnikrishnan, U. G. (2019). A prospective study evaluating the impact of implementing the ERAS protocol on patients undergoing surgery for advanced ovarian cancer. Int J Gynecol Cancer, 29(3), 605-12. http://dx.doi.org/10.1136/ijgc-2018-000043.
  2. Aksoy, A. & Vefikuluçay Yılmaz, D. (2018). A new approach to evidence based practices in gynecological surgery: ERAS protocol and nursing. Turkiye Klinikleri Journal of Nursing Sciences, 10(1), 2-8. [Turkish] http://dx.doi.org/10.5336/nurses.2017-56268
  3. Akyüz, E. & Tunçbilek. Z. (2018). Nurses role and responsibilities on management of antiembolism stockings: Antiembolism stocking care protocol. Turk J Cardiovasc Nurs, 9(20), 96-104. [Turkish] http://dx.doi.org/10.5543/khd.2019.68077
  4. American Collage of Obstetricians and Gynecologists (ACOG). (2018). Perioperative pathways: Enhanced recovery after surgery. Obstet Gynecol, 132(3), 120-130. http://dx.doi.org/10.1097/AOG.0000000000002818.
  5. Bilgiç, D., Yağcan, H., Güler, B. & Aypar, N. N. (2019). Preoperative and postoperative evidence based practices in gynecologic surgery. Health Care Acad J, 6(2), 114-121. [Turkish] https://dergipark.org.tr/tr/download/article-file/742385
  6. Bisch, S. P., Kooy, J., Glaze, S., Cameron, A., Chu, P., Ghatage, P., Nation, J., Nelson, G., Fitzmaurice GM. Impact of transversus abdominis plane blocks versus non-steroidal anti-inflammatory on post-operative opioid use in ERAS ovarian cancer surgery. International Journal of Gynecologic Cancer, 29(9), 1372-1376. http://dx.doi.org/10.1136/ijgc-2019-000724.
  7. Carey, E.T. & Moulder, J. K. (2018). Perioperative management and implementation of enhanced recovery programs in gynecologic surgery for benign indications. Obstet Gynecol, 132(1), 137–46. http://dx.doi.org/10.1097/AOG.0000000000002696
  8. Celebi, E. & Ilce, A. (2019). Determination of knowledge levels of nurses working in surgical clinics on ERAS protocols. In: 3. International, 11. National Turkish Surgical and Operating Room Nursing Congress Book (pp. 392-400). Istanbul. Accessed April 11, 2019, Retrieved from https://www.researchgate.net/publication/337919761_Cerrahi_Kliniklerde_Calisan_Hemsirelerin_ERAS_Protokolleri_Hakkindaki_Bilgi_Duzeylerinin_Belirlenmesi.
  9. Cohen, R. & Gooberman-Hill, R. (2019). Staff experiences of enhanced recovery after surgery: systematic review of qualitative studies. BMJ Open, 9(2), e022259. http://dx.doi.org/10.1136/bmjopen-2018-022259
  10. Cuschieri, S. (2019). The STROBE guidelines. Saudi J Anaesth. 13(Suppl 1), 31-34. http://dx.doi.org/10.4103/sja.SJA_543_18.
  11. Çi̇li̇ngi̇r, D. & Candaş, B. (2017). Enhanced recovery after surgery protocol and nurse’s role. Journal of Anatolia Nursing and Health Science, 20(2), 137-143. [Turkish] https://dergipark.org.tr/tr/download/article-file/348666
  12. De Groot, J. J. A., Ament, S. M. C., Maessen, J. M. C., Dejong, C. H. C., Kleijnen, J. M. P. & Slangen, B. F. M. (2016). Enhanced recovery pathways in abdominal gynecologic surgery: A systematic review and meta-analysis. Acta Obstet Gynecol Scand, 95(4), 382–95. http://dx.doi.org/10.1111/aogs.12831.
  13. Deng, G. (2019). Integrative medicine therapies for pain management in cancer patients. Cancer Journal Sudbury Mass, 25(5), 343–348. http://dx.doi.org/10.1097/PPO.0000000000000399
  14. Devoto, G., Alessandria, S., Lange, J., Torres, G., Tatti, S. & Bermúdez, A. (2019). 372 implementation of the ERAS protocol (enhanced recovery alter surgery) at a gynecologic oncology unit in a low resource setting. International Journal of Gynecological Cancer, 29(3), 159-197. http://dx.doi.org/10.1136/ijgc-2019-IGCS.372
  15. ERAS Turkey Association (ETA). (2019). Key Elements of the ERAS Protocol. Accessed May 3, 2019, Retrieved from http:// eras. org.tr/page. php?id= 10&saglik Calisani=true [Turkish].
  16. ERAS Turkey Association (ETA). (2020). Ankara Atatürk Education and Research Hospital General Surgery Clinic ERAS Protocol Application Checklist, Accessed June 3, 2020, Retrieved from http://eras.org.tr/public/files/eras_kontrol.pdf, [Turkish]
  17. Ferrari, F., Forte, S., Sbalzer, N., Mauri, M., Zizioli, V., Sartori, E. & Odicino, F. (2019). Validation of an ERAS protocol in gynecological surgery: interim analysis of an italian randomized controlled trial. International Journal of Gynecological Cancer, 29(A40), 10-15. http://dx.doi.org/10.1136/ijgc-2019-ESGO.44
  18. Gustafsson, U. O., Scott, M. J., Hubner, M., Nygren, J., Demartines, N., Francis, N., Rockall, T. A., Young-Fadok, T. M., Hill, A. G., Soop, M., de Boer, H. D., Urman, R. D., Chang, G. J., Fichera, A., Kessler, H., Grass, F., Whang, E. E., Fawcett W. J., Carli, F., Lobo, D. N., Rollins, K. E., Balfour, A., Baldini, G., Riedel, B., Ljungqvist O. (2019). Guidelines for perioperative care in elective colorectal surgery: enhanced recovery after surgery (ERAS®) society recommendations 2018. World Journal of Surgery, 43(3), 659-95. http://dx.doi.org/10.1007/s00268-018-4844-y
  19. Güzel, N. & Yava, A. (2019). The determination of knowledge and attitudes on enhanced recovery after surgery protocol of the nurses who working on surgical units. Journal of Zeugma Health Science, 1(1), 15-23. [Turkish]
  20. Harrison, R., Iniesta, M. D., Cain, K., Siverand, A., Pitcher, B., Lasala, J., Ramires, P. T., Meyer LA. (2019). 373 Outcomes of obese patients undergoing gynecologic surgery on an enhanced recovery after surgery (ERAS) program. International Journal of Gynecologıcal Cancer, 29, A154. http://dx.doi.org/10.1136/ijgc-2019-IGCS.373
  21. Henson, L. A., Maddocks, M., Evans, C., Davidson, M., Hicks, S. & Higginson, I. J. (2020). Palliative care and the management of common distressing symptoms in advanced cancer: pain, breathlessness, nausea and vomiting, and fatigue. Journal of Clinical Oncology, 38(9), 905–914. http://dx.doi.org/10.1200/JCO.19.00470
  22. Johnson, K., Razo, S., Smith, J., Cain, A. & Soper, K. (2019). Optimize patient outcomes among females undergoing gynecological surgery: A randomized controlled trial. Appl Nurs Res, 45(11), 39–44. http://dx.doi.org/10.1016/j.apnr.2018.12.005
  23. Kalogera, E. & Dowdy, S. C. (2019). Enhanced recovery after surgery and acute postoperative pain management. Clin Obstet Gynecol, 62(4), 656–65. http://dx.doi.org/10.1097/GRF.0000000000000475
  24. Lawal, O.D., Gold, J., Murthy, A., Ruchi, R., Bavry, E., Hume, A.L., Lewkowitz, A. K., Brothers, T., Wen X. (2020). Rate and risk factors associated with prolonged opioid use after surgery: A systematic review and meta-analysis. JAMA Network Open, 3(6), e207367. http://dx.doi.org/10.1001/jamanetworkopen.2020.7367.
  25. Liu, Q., Jiang. H., Xu, D. & Jin, J. (2017). Effect of gum chewing on ameliorating ileus following colorectal surgery: A meta-analysis of 18 randomized controlled trials. International Journal of Surgery, 47, 107–115. http://dx.doi.org/10.1016/j.ijsu.2017.07.107
  26. Nathan, N. (2020). Management of postoperative nausea and vomiting: the 4th consensus guidelines. Anesthesia and Analgesia, 131(2), 410. http://dx.doi.org/10.1213/ANE.0000000000004833
  27. Nelson, G., Altman, A. D., Nick, A., Meyer, L. A., Ramirez, P.T., Achtari, C., Antrobus, J., Huang, J., Scott, M., Acheson, N., Ljungqvist, O., Dowdy S. C. (2016). Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: Enhanced recovery after surgery (ERAS) society recommendations– Part I. Gynecol Oncol. 140(2), 313-322. http://dx.doi.org/10.1016/j.ygyno.2015.11.015
  28. Nelson, G., Bakkum-Gamez, J., Kalogera, E., Glaser, G., Altman, A., Meyer, L. A., Taylor, J. S., Iniesta, M., Lasala, J., Mena, G., Scott, M., Gillis, C, Elias, K., Wijk, L., Huang, J., Nygren, J., Ljungqwist, O., Ramirez, P. T., Dowdy S., C. (2019). Guidelines for perioperative care in gynecologic/oncology: Enhanced Recovery after Surgery (ERAS) Society recommendations 2019 update. Int J Gynecol Cancer, 29(4), 651–68. http://dx.doi.org/10.1136/ijgc-2019-000356.
  29. Ongun, P. & Ak, E. S. (2020). Assessment of knowledge levels of nurses working in surgical clinics about eras protocol. Med J Bakirkoy, 16(3), 287-94. [Turkish] http://dx.doi.org/10.5222/BMJ.2020.81300
  30. Pache, B., Joliat, G. R., Hübner, M., Grass, F., Demartines, N., Mathevet, P. & Achtari, C. (2019). Cost-analysis of enhanced recovery after surgery (ERAS) program in gynecologic surgery. Gynecol Oncol, 54(2), 388–93. http://dx.doi.org/10.1016/j.ygyno.2019.06.004
  31. Phillips, E., Archer, S., Montague, J. & Bali, A. (2019). Experiences of enhanced recovery after surgery in general gynaecology patients: An interpretative analysis. Health Psychol Open, 6(2), 2055102919860635. http://dx.doi.org/10.1177/2055102919860635
  32. Pissetti, V. C., Nunes, R. D., Zomer, M. T. & Kondo, W. (2017). Fast-track surgery in intestinal deep infiltrative endometriosis. J Endometr Pelvic Pain Disord, 9(4), 263–9. http://dx.doi.org/10.5301/jeppd.5000308
  33. Polit, D. E. & Beck, C. T. (2006). Essentials of Nursing Research. Philadelphia: Lippincott Williams & Wilkins.
  34. Rollins, K. E. & Lobo, D. N. (2016). Intraoperative goal-directed fluid therapy in elective major abdominal surgery: a meta-analysis of randomized controlled trials. Ann Surg, 263(3), 465–476. http://dx.doi.org/10.1097/SLA.0000000000001366
  35. Rungsiprakarn, P., Laopaiboon, M., Sangkomkamhang, U. S., Lumbiganon, P. & Pratt, J. J. (2015). Interventions for treating constipation in pregnancy. Cochrane Database of Systematic Reviews, 9(CD011448), 1-33. http://dx.doi.org/10.1002/14651858.CD011448.pub2
  36. Sachdeva, A., Dalton, M. & Lees, T. (2018). Graduated compression stockings for prevention of deep vein thrombosis. Cochrane Database of Systematic Reviews, 11(CD001484). http://dx.doi.org/10.1002/14651858.CD001484.pub4
  37. Tan, S. J., Zhang, Z. G. & Wu, G. H. (2020). Advances in the prevention and treatment of postoperative ileus. Chinese Journal of Surgey, 58(8), 642-645. http://dx.doi.org/10.3760/cma.j.cn112139-20200216-00090
  38. Turkish Republic Ministry of Health (TR-MoH). (2020). Use of Blood Thinners and Thinners During the Operation Period. Accessed May 7, 2020, Retrieved from https://kosuyolueah.saglik.gov.tr/TR,366082/ameliyat-doneminde-kan-sulandirici-ve-inceltici-kullanimi.html. [Turkish]
  39. Uğurlu, A. K., Kula Şahin, S., Seçginli, S. & Eti Aslan, F. (2017). The effect of standing up early in the first 24 hours after surgery on rapid ımprovement: Systematic review. Turkiye Klin J Nurs. 9(4), 280–8. http://dx.doi.org/10.5336/nurses.2016-53678
  40. Wodlin, N. B. & Nilsson, L. (2013). The development of fast-track principles in gynecological surgery. Acta Obstet Gynecol Scand, 92(1), 17–27. http://dx.doi.org/10.1111/j.1600-0412.2012.01525.x