Understanding enhanced recovery after surgery (ERAS) in perioperative nursing

Enhanced Recovery After Surgery (ERAS) is a patient-centered, evidence-based approach to achieve the best surgical outcomes by enhancing the recovery process. Originally developed for colorectal surgeries, ERAS protocols have expanded across various surgical specialties and most ERAS principles can be safely implemented with most perioperative patients. The goal of ERAS is to minimize the physiological and psychological stress of surgery – promoting faster recovery, reducing complications, and shortening hospital stays.

What is the role of perioperative nurses in ERAS?

Perioperative nurses are at the center of successful implementation of ERAS protocols. Their responsibilities span across the entire surgical journey – from preoperative education to postoperative care. Here’s a closer look at the key roles perioperative nurses fulfill in ERAS:

1. Preoperative education and preparation:
• Patient education: Perioperative nurses educate patients and their families about the surgical process, ERAS protocols, and what to expect before, during, and after surgery. This includes instructions on preoperative fasting, carbohydrate loading, early mobilization, and educating patients about their pain management plan.
• Health optimization: Nurses assess patients' health status and collaborate with the healthcare team to improve conditions such as nutrition, hydration, and management of comorbidities before surgery.


2. Intraoperative care:
• Maintaining normothermia: Perioperative nurses work to maintain the patient’s body temperature during surgery to reduce the risk of hypothermia, which is associated with increased surgical site infections and delayed recovery.
• Fluid management: Proper fluid balance is essential to prevent complications such as fluid overload or dehydration. Nurses are prepared to assist anesthesia providers to monitor and manage intraoperative fluids according to ERAS guidelines.


3. Postoperative care:
• Early mobilization: Encouraging early mobilization after surgery is a cornerstone of ERAS. Nurses assess patients' readiness to move and provide the necessary support to ensure safe and effective early mobilization.
• Pain management: Effective pain control is critical for recovery. Perioperative nurses educate their patients on multimodal analgesia techniques to manage pain while minimizing opioid use, which is a key aspect of ERAS.

How do periop nurses implement ERAS?

Nurses can serve in the roles of ERAS Coordinators and ERAS Nurse Navigators and play a key role in ERAS interdisciplinary teams. To successfully implement ERAS protocols, perioperative nurses need to be well-versed in the specific guidelines and best practices associated with ERAS. Here are some key considerations:

• Evidence-based practice: Nurses should stay updated with the latest evidence supporting ERAS protocols, understanding the rationale behind each intervention.
• Interdisciplinary collaboration: Effective ERAS implementation requires close collaboration and clear communication with the entire surgical team – surgeons, anesthesiologists, and other healthcare professionals – to ensure that ERAS protocols are followed consistently.
• Patient-centered care: Each patient’s needs and preferences should be considered when implementing ERAS. Nurses should tailor the care plan to the individual, ensuring that the patient feels supported and informed throughout their surgical journey.

What will nurses learn at the AORN Guidelines Workshops about ERAS?

The Association of periOperative Registered Nurses (AORN) Guidelines Workshops provide perioperative nurses with the knowledge and tools – based on the AORN Guidelines for Perioperative Practice – needed to implement ERAS protocols effectively. At these workshops, nurses can expect to learn:

• Comprehensive ERAS guidelines, including specific protocols for different types of surgeries.
• Best practices in preoperative care, like the latest evidence on preoperative fasting, carbohydrate loading, and patient education to prepare patients effectively.
• Intraoperative and postoperative management, such as best practices for maintaining normothermia, managing fluids, and promoting early mobilization, all of which are crucial for successful ERAS implementation.
• Interdisciplinary collaboration with strategies for working effectively with the entire surgical team to ensure ERAS protocols are followed consistently and patient care is seamless from start to finish.

When and where are the Guidelines Workshops?

ERAS represents a significant advancement in perioperative care, and perioperative nurses are at the forefront of its successful implementation. By understanding the goals of ERAS, embracing their role in the process, and staying informed through continuous education like the AORN Guidelines Workshops, nurses can help ensure that patients experience the best possible outcomes after surgery. The ongoing commitment to evidence-based practice and patient-centered care will continue to drive improvements in surgical recovery and overall patient satisfaction.

Guidelines Workshops Event Information