NURSING UNIT
- Identify patient as ERAS
- Diet
Immediately allow regular diet or patient specific diet if tolerating clears
Document all PO liquid and solid intake in Dimensions-please document type of diet being consumed
- Ambulation
DOCUMENT in Dimensions as "Ambulation in Hall" NOT "Up Ad Lib"
POD 0: Ambulate at least 1x in hallway
POD 1: Ambulate 3-4x in hallway, OOB 6 hrs in chair or ambulating
POD 2: Ambulate 4-6x in hallway, OOB 8 hrs in chair or ambulating
If patient is unable to ambulate due to fatigue, nausea, or refuses, please make note on Activity flowsheet. If patient does refuse, remind them they were educated on this prior to surgery, benefits of ambulation and risk of not ambulating
- HOB
elevated 30 degrees at all times
- Incentive spirometry
10x/hr while awake, able to decrease frequency with increase ambulation
- IVF
D/C if tolerating PO intake, if IVF needed, balanced crystalloid (LR) preferred over 0.9% NS
- VTE prophylaxis
Lovenox POD 1, if not already started
SCD usage while in bed or chair until discharge
- Foley
D/C on or before POD 1
- Multimodal, non-opioid analgesics as first line
Acetaminophen 1 g PO Q8 (if dosing meets 3g/24hr limit, contact pharmacy to reschedule; do not skip dose)
Gabapentin 300 mg PO QHS starting POD 0
Ketorolac 15 mg IV Q6 (not for more than 5 days)
Oxycodone 5-10 mg PO Q4 PRN pain β€7
IV opioids for severe breakthrough pain (VPS >7)
***Ensure appropriate medication given for patient's current pain score (take "Patient's Stated Pain Goal" into account too). ERAS Goal is to limit opioids***
***If any of the multimodal medications are not ordered or not ordered correctly, contact surgeon ASAP for correction***
- Glycemic control
FSBS <200
- Consult
Wound nurse POD 0 if necessary
- Defined discharge criteria
Discussed preoperatively and from POD0
Reinforce expectations with patient and family
Anticipate discharge needs
Follow-up appointments