Nursing Unit:

  • Identify patient as ERAS

  • Patient Guide to ERAS Booklet

      • Ask to see their booklet

      • Remind patient importance of documenting in booklet

      • Check diaries frequently for ambulation, diet, etc- Document info recorded in Dimensions

  • Multimodal Analgesia:

      • Acetaminophen 1 g PO or IV Q8 (if dosing meets 3g/24hr limit, contact pharmacy to reschedule; do not skip dose)

      • Celebrex 200 mg PO BID (Toradol 15mg IV Q6 may be given instead )

      • Gabapentin 300 mg PO QHS (hold for >65 years old)

      • LidoPatch daily: Lidocaine 3.6% -menthol 1.25% patch

      • Methocarbamol 750mg PO TID (hold for >65 years old)

      • Oxycodone 5 mg PO VPS 3-4

      • Oxycodone 10 mg VPS 5-7

      • IV opioid if 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***

  • PONV

      • Zofran 4-8 mg IV PRN

  • GI ppx:

      • Colace, miralax, senokot, Dulcolax

  • Incentive spirometry

      • x10 Q 1hr while awake

  • Foley

      • D/C at 6 hrs postop

  • Diet

    • Regular diet POD 0

    • Encourage gum chewing

    • Document all PO liquid and solid intake in Dimensions-please document type of diet being consumed

  • Ambulance

      • DOCUMENT in Dimensions as "Ambulation in Hall" NOT "Up Ad Lib"

      • POD 0: ambulate in hallway at least 1x

      • POD 1 until D/C: Ambulate QID (this is PT and nursing staff combined)

      • Up to chair for all meals

      • 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

  • Defined discharge criteria (to be named):

      • Cleared by PT

      • Pain controlled with PO meds

      • Tolerating adequate PO intake

      • Ambulating without difficulty

      • Ability to urinate

      • No s/s infection

      • Understanding of d/c instructions