Transition from hospital to home after elective colorectal surgery performed in an enhanced recovery program: An integrative review.
Marie-Christine Ruel, Maria-Pilar Ramirez Garcia, Caroline Arbour
PMID 34102021WHAT IT FOUND
Patients after ERAS colorectal surgery often feel vulnerable at home, needing personalised information, family support and an easy way to contact a nurse.
Telephone and text follow-up were feasible, but their effect on readmission is not proven.
Key findings
01After discharge from an ERAS colorectal surgery programme, patients commonly feel vulnerable at home because they must take full responsibility for recovery while still dealing with symptoms and self-care.
02Patients want easy access to a trusted follow-up contact, but many avoid contacting nurses because they do not want to disturb.
03Few nursing interventions have been tested; extra pre-operative counselling by an ERAS nurse may reduce length of stay, but its impact on readmission, morbidity and mortality could not be established.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a review of heterogeneous studies, not a single controlled trial, so it cannot show that any one intervention caused the outcomes reported. The included qualitative studies were often small, and some were done by clinicians involved in patient care, which may have affected responses. Many quantitative studies were descriptive, small, uncontrolled, or used unvalidated outcome measures. The review did not pool results statistically, so there is no combined estimate of effect. The search was limited to English and French articles, and theoretical studies were not included.
Declared interests
The authors declared no conflicts of interest and no funding.
The easy way to misread this
Do not conclude that nurse-led telephone, text or hospital-at-home follow-up has been proven to reduce readmission. The review found only small or pre-experimental studies, and the effect on readmission, complications and mortality was not established.