Three years ago, Baptist Health first introduced a new set of protocols before, during and after surgery that have since shown to reduce complications, shorten length of hospital stays, and help patients feel better and return to normal activities faster.
It’s called Enhanced Recovery After Surgery (ERAS) and it encourages patients to play an active role in improving their own outcomes and changes many long-established practices, such as nothing by mouth or NPO after midnight.
Baptist Health has already implemented ERAS care pathways in several surgical specialties, most recently in obstetrics because all deliveries can benefit from an Enhanced Recovery After Delivery (ERAD) pathway.
ERAD promotes patient participation in a step-by-step plan and starts as soon as delivery is anticipated. ERAD also helps reduce anxiety, decrease pain, promotes healing and helps increase energy levels during and after labor.
ERAD has three stages:
During the pre-delivery stage, nutrition, pain management and patient and family education are important. Hydration is also key component. Patients are now encouraged to consume clear liquids during labor to avoid dehydration and quench thirst.
Leading up to delivery, the recommended daily dietary allowance of protein is encouraged. On the morning of a scheduled induction or Cesarean section delivery, clear liquids are allowed two hours before arrival time at the hospital.
With safety in mind, during labor nonsurgical patients are encouraged to continue consuming clear liquids until the time of delivery approaches.
Early hydration is also part of the postpartum phase of delivery, as are early removal of intravenous fluids and catheters and multiple methods of pain management that utilize opioid-sparing techniques to optimize recovery.
“The enhanced recovery pathway enables patients to move, drink and eat more quickly after delivery,” said Francine Marabell, MSN, director of Safety and Clinical Quality for Baptist Health. “ERAD patients can expect to walk on the day of delivery and several times a day before leaving the hospital.”
“The adoption of ERAS in the obstetric patient population is rapidly gaining popularity,” said Catherine McIntyre, MD, a board-certified obstetrician and gynecologist with North Florida OB/GYN who practices at Baptist Medical Center Jacksonville and Wolfson Children’s Hospital.
“ERAD is the newest standard of evidenced-based practice, when it comes to obstetrics. Moms feel better, they are better able to bond with their babies, and they get to go home earlier,” Dr. McIntyre added. “Patients are kept comfortable while avoiding use of narcotic pain medication, which can slow their recovery. More importantly, ERAD improves patient outcomes by decreasing complications, and speeding healing.”
Implementing ERAD requires a concerted effort by health care providers in many disciplines, as well as the participation of the patient. Because patient education is crucial to ERAD, Baptist Health patients receive step-by-step informational flyers from their doctor’s office prior to their scheduled delivery and while in the hospital. We are partnering with our patients to provide a positive birth experience.
For more information, visit Baptistjax.com/ERAS.