Comparative Study of Fast-Track vs Traditional Peri-Operative Care Protocols in Gastrointestinal Surgeries

Yeung, J., Gillies, M. A., & Pearse, R. M.
(2018). Pragmatic trials in peri‐operative
medicine: why, when and how?.
Ball, J. E., Bruyneel, L., Aiken, L. H.,
Sermeus, W., Sloane, D. M., Rafferty, A. M.,
... & Griffiths, P. (2018). Post-operative
mortality, missed care and nurse staffing in
nine countries: a cross-sectional study.
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Macleod, J. B. (2016). Critical care in
Africa: A surgical intensivist perspective.
East and Central African Journal of
Surgery, 21(1), 3-10.
Traditional practices
Trad Prolonged preoperative fasting
(nil by mouth), bowel cleansing,
and reintroduction of oral
nutrition
Multimodal care/Current
practices
Trad Enhanced recovery after surgery
Trad Anaesthetic regime
Trad Preoperative counselling
Trad Optimisation of nutrition
Trad Standardised analgesics
Trad Early mobilisation
Nanavati, A. J., & Prabhakar, S. (2014). A comparative study of
‘fast-track’versus traditional peri-operative care protocols
in gastrointestinal surgeries. Journal of gastrointestinal
surgery, 18(4), 757-767
Steenhagen, E. (2016).
Enhanced Recovery After
Surgery: it’s time to change
practice!. Nutrition in Clinical
Practice, 31(1), 18-29.
American society of Anaesthiologist- PACU
 Provision of oxygen.
 Measurement and recording of vital signs by the nurse
 A report by the anaesthesiologist to
the PACU nurse (Brief medical history,
preanesthetic assessment including allergies,
anticipated need for pain medications, Pre-
transfer laboratory data)
 Postanesthetic orders (e.g.
oxygen administration, fluid
administration, antiemetic and
analgesic treatment).
Trad WHO guidelines post
operative care
Patient education
Allegranzi, B., Zayed, B., Bischoff, P., Kubilay, N. Z., de Jonge, S., de Vries, F.,
... & Abbas, M. (2016). New WHO recommendations on intraoperative and
postoperative measures for surgical site infection prevention: an evidence-based
global perspective. The Lancet Infectious Diseases, 16(12), e288-e303.
Florence
Nightingale
John snow
Careful patient selection, pain
prevention by inhalation, careful
observation, maintenance of respiration
Careful patient observation, antiseptic
technique, wound infection prevention
Dandy and Firor
Three bed neurosurgical unit
Leave patients comfortably after anaesthesia, use pillows
for head and shoulder. Leave patient without movement
for recovery
NICE guidelines
Trad Wound care, infection prevention,
patient monitoring
National Safety and Quality
Health Service Standards
Kitney, P., Tam, R., Bennett, P., Buttigieg, D., Bramley, D., & Wang, W.
(2016). Handover between anaesthetists and post-anaesthetic care unit nursing
staff using ISBAR principles: A quality improvement study. ACORN: The
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