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Enhanced recovery for elective caesarean section: The patient's perspective
Abstract Number: SA-24
Abstract Type: Original Research
Enhanced recovery has been used for over 10 years in many surgical specialties, improving outcomes and reducing length of stay . Use in obstetrics is more recent, but has shown similar benefits . The introduction of an enhanced recovery pathway in our hospital has led to demonstrably improved practice measures, such as reduced fasting times, earlier ambulation and skin to skin contact. Although welcome, these outcomes are not the whole story. We were interested to explore individual patient experiences.
We prospectively evaluated 50 consecutive patients over a 4 week period, all of whom underwent enhanced recovery elective caesarean section. This was done using a patient satisfaction questionnaire on Day 1 post delivery, and then a telephone interview on Day 10-14. Patient responses were collated and thematically analyzed by 2 independent practitioners. Themes were then compared and a consensus arrived at. The main themes are shown in Figure 1.
39 patients completed the satisfaction questionnaire. Of these, 30 agreed to telephone follow up and were contacted. Especially popular interventions were early ambulation and catheter removal, the latter allowing for greater ease of infant care. Comments were not universally positive, for example a few patients reported that they would have appreciated more assistance with mobilising, and suggested that increased staffing levels may have been helpful to this end. However, the overall quality of care provided by staff was highly praised. Interestingly, reporting of post operative pain was highly variable- some patients were pain free by Day 2, whereas a number still reported significant pain at 2 weeks. Nonetheless, overall satisfaction levels were high, with all patients rating their experience as good or excellent.
Enhanced recovery has proved highly popular with our patients, notably so amongst women who previously underwent elective caesarean section prior to it's introduction. Such positive patient experiences reinforce the peri-operative benefits previously reported.
.Lucas DN, Gough KL. Enhanced recovery in obstetrics- a new frontier? Int J Obstet Anesth 2013; 22: 92-5.
.Jan H, Long O, Garratt C, et al. Outcomes following introduction of an enhanced recovery in obstetric surgery (EROS) protocol for elective caesarean sections; RCOG World Congress 2013, www.epostersonline.com/rcog2013/?q=node/ 1852&posterview=true