Patients take charge of recovery through nurse-led programme

Friday, 9 October 2009

A nurse-led programme which helps bowel surgery patients take charge of their recovery and get out of hospital faster has been successfully piloted at North Bristol NHS Trust (NBT).
So far, nearly 200 patients have benefited from the Trust's Enhanced Recovery Programme, which aims to get patients back to full health as quickly as possible after their planned surgery.
Results from the programme - which is the only one of its kind in Bristol - mean that on average, bowel surgery patients are ready to be discharged after only four or five days, compared to the national average of 10.5 days.
Benefits include a quicker return of mobility and normal bowel function, decreased fatigue, reduced chest infections, and less risk of developing blood clots after surgery.
The programme consists of three parts:
* Pre-surgery assessment: A discussion about diet and exercise, and planning for any home help needed after the operation. Patients may also talk to specialists including dieticians, anaesthetists (for those with pre existing conditions) or specialist nurses (for specific issues like stoma care)
* Minimising surgical intervention: Smaller surgical incisions (such as keyhole surgery) and shorter anaesthetics to reduce pain and improve recovery time
* Post-surgery recovery programme: A six day programme including light exercise, eating and drinking guidelines, and breathing exercises. This includes follow-up phone calls for four days after leaving hospital.
Nurses Lisa Hayward and Dawn Gane set up the programme last year and have received tremendous feedback from patients. Peter Yeates, who recently underwent bowel surgery at Frenchay Hospital, said:
"I think it's a bit of a miracle - people I've spoken to who have had this kind of operation said they were in hospital for weeks. I had my operation on Friday, and was home and eating normally by the following Tuesday.
"Physically, the faster you get your system working, the faster you recover, and the programme supports you to do this.
"And there was definitely a competitive streak in the ward which helped my recovery along - in that we all wanted to be the first to go home!"

Enhanced Recovery nurse Lisa Heyward:
"Research shows that after surgery, the earlier people get out of bed and start exercising, eating and drinking, the faster they'll recover. The added bonus is that there is also less chance of complications.
"So instead of following the traditional approach, where a patient stays in bed and sips water for days after surgery, the programme supports patients to focus on small milestones each day - things like doing breathing exercises, leg exercises, and eating and drinking normally.
"Having this kind of focus really shifts their mindsets and gets them back to health faster."