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Enhanced Recovery After Surgery (ERAS) is a multidisciplinary, evidence-based practice that utilizes standardized guidelines to improve patient outcomes such as length of stay, surgical complications, readmissions, and cost of care.1 In our setting, 3 metrics that consistently had low compliance were daily weights, mobilization, and nutritional supplement intake. These depend on nursing intervention and documentation for successful completion. A visual management board was created to track patient progress for the first 96 hours after surgery. The clinical nurse leader audits documentation each morning and places metric-specific magnets on the board. These come in 3 colors: green for met goals, yellow for partial completion, and red if no progress was made. A second audit occurs in the afternoon and is followed by an ERAS huddle with nursing staff. Progress is discussed and barriers are identified. If teammates are unfamiliar with ERAS expectations or patients are refusing interventions, targeted education is provided. A Mann-Whitney test was used to compare pre- and postintervention compliance. Overall compliance increased from a median of 43.9% to 65.4% (P = .001). Daily weight compliance increased from 60.6% to 78.9% (P = .005), mobilization increased from 51% to 67.7% (P = .009), and nutritional supplement documentation increased from 26.1% to 44.1% (P = .055).




1. Ljungqvist O, Scott M, Fearon KC. Enhanced Recovery After Surgery: a review. JAMA Surg. 2017;152(3):292-298. doi:10.1001/jamasurg.2016.4952 [Context Link]