Archive September 2018 XIX, No. 9

Pain Control: Cruising Down the ERAS Pathway

Texas Health Presbyterian Hospital likes the way the Enhanced Recovery After Surgery program handles its patients' pain.

COMFORTABLY NUMB
Texas Health Presbyterian Hospital COMFORTABLY NUMB IV lidocaine played a key role in Texas Health Presbyterian Hospital's multimodal, opioid-sparing pain management protocol.
Award Winner

OR Excellence Award Winner

You've probably heard of ERAS — the acronym for Enhanced Recovery After Surgery — but you might not know the buzz-worthy concept involves standardizing patient care to optimize outcomes, send patients home sooner after surgery and lower readmission rates. Texas Health Presbyterian Hospital in Dallas has earned the 2018 OR Excellence Award for Pain Control for using those abstract ideas to develop an opioid-sparing pain control program that has achieved some tangible — and impressive — results:

  • Patient-controlled analgesia pump use before implementation of the ERAS pathway was about 37%. By June of this year, zero ERAS patients received PCA pumps to manage their post-op pain.
  • During early implementation of the ERAS pathway, patients received just over 150 morphine equivalent dosing through post-op day 3. The ERAS program helped slash that amount in half.

That reduction in morphine equivalent dosing is important because leadership at Presbyterian Hospital launched the program in 2016 during the nation's opioid crisis. That year, according to the U.S. Department of Health and Human Services, 116 Americans died every day from opioid-related overdoses and 11.5 million people nationwide misused prescription opioids. The opioid crisis was a major factor in the decision to launch the ERAS pathway, according to Nikita Preston, BSN, RN, nurse manager of the hospital's bariatric unit. "We want to get surgical patients into and out of the hospital with a reasonable amount of pain that they'd be able to manage at home," she says.

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