An investigation on the compliance of perioperative practices using ERAS protocols and barriers to the implementation of the ERAS protocols in colorectal surgery

Although ERAS protocols have many benefits, there are some deficiencies in their understanding and implementation by healthcare professionals. The present study was conducted to investigate the compliance of the current perioperative practices of healthcare professional with the ERAS protocols and to assess barriers to the implementation of ERAS protocols in colorectal surgery. This cross-sectional descriptive study conducted in the surgical clinics and operating rooms of a training and research hospital between January 2020 and September 2020 included 110 physician and nurse members of surgical teams. Data were collected using the Questionnaire for Evaluating the Use of the ERAS Protocol and Identifying Barriers to Implementation in Colorectal Surgery. The compliance of the current perioperative practices by healthcare professionals with the ERAS protocols ranged between 15.5% (routinely leaving nasogastric tubes in situ following colorectal resection) and 61.8% (being aware of the concept of balanced analgesia). Variables such as the healthcare professional’s profession, title, years in practice and colorectal surgery experience led to a difference between them in terms of their compliance of the practices with the ERAS protocols (<i>p</i> &lt; 0.05). Based on the healthcare professionals’ comments about barriers to the implementation of the ERAS protocol, themes such as education, teamwork, communication and lack of resources were created. Healthcare professionals’ compliance level of the current perioperative practices with the ERAS protocols was mostly low. Barriers to the implementation of the ERAS protocols had a multi-factor structure that concerns the multidisciplinary team.

尽管加速康复外科（Enhanced Recovery After Surgery，ERAS）方案具备诸多临床优势，但医疗从业人员对其的认知水平与执行效果仍存在明显不足。本研究旨在调研当前医疗从业人员的围手术期操作符合加速康复外科方案的情况，并评估结直肠外科领域中加速康复外科方案落地实施的阻碍因素。本研究为横断面描述性研究，于2020年1月至9月在某教学研究医院的外科门诊与手术室开展，共纳入110名外科团队的医师与护理人员。研究采用《结直肠外科加速康复外科方案应用评价与实施障碍识别问卷》收集数据。医疗从业人员当前围手术期操作符合加速康复外科方案的比例介于15.5%（结直肠切除术后常规保留鼻胃管）至61.8%（知晓平衡镇痛概念）之间。医疗从业人员的职业、职称、从业年限及结直肠外科相关经验等变量，均会导致其操作符合加速康复外科方案的程度存在显著差异（P<0.05）。基于医疗从业人员对加速康复外科方案实施阻碍的反馈，研究归纳出教育、团队协作、沟通及资源匮乏等主题类别。医疗从业人员当前围手术期操作符合加速康复外科方案的整体水平普遍偏低。加速康复外科方案的实施阻碍呈现多因素结构，且涉及多学科团队相关的诸多问题。