Cesarean Section Via Enhanced Recovery
| Status: | Recruiting |
|---|---|
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 2/1/2019 |
| Start Date: | January 15, 2019 |
| End Date: | September 1, 2019 |
| Contact: | Adam Sturdivant, MPH |
| Email: | Adamsturdivant@uabmc.edu |
| Phone: | 205-934-4042 |
Clinical Outcomes in Patients Undergoing Cesarean Section Via the Enhanced Recovery After Surgery (ERAS) Pathway: a Retrospective Study
Enhanced Recovery After Surgery (ERAS) protocols have been proven to be very successful in
specific patient populations. An example is with ERAS for colorectal surgery. ERAS protocols
in this patient population have been shown to reduce overall morbidity and hospital length of
stay (LOS). At the University of Alabama at Birmingham (UAB), the institution has had
successful implementation of ERAS protocols for several surgical specialties including
colorectal, breast, spine, gynecology, and gynecology-oncology. However, the institution
currently does not have a protocol in place for the most commonly performed surgical
procedure - cesarean delivery. At UAB, the institution performs approximately 1,000 cesarean
deliveries per year.
The investigators believe that an ERAS protocol will be beneficial for these patients.
Currently, there is very little data published on ERAS protocols. Although this patient
population is ideal for an ERAS protocol, there are several barriers that have to be
overcome. The data published show promising results for ERAS protocols with cesarean
delivery. A larger tertiary care center showed earlier discharge with lower re-admission
rates with an ERAS pathway.
Currently, the investigators have created a multidisciplinary group at UAB to establish an
ERAS protocol for patients undergoing cesarean delivery. This group includes
anesthesiologists, obstetricians, nursing, neonatology, pharmacy, and informatics. Once the
investigators have implemented this protocol, the investigators would like to perform a
retrospective analysis to determine if there are any significant changes in our desired
outcomes the investigators will study. Our goal is to demonstrate significantly improved
outcomes in the investigators' measured endpoints. The investigators believe that this
information will be very useful because although there is a national interest in creating
ERAS protocols for cesarean deliveries, there currently is very little published on the
subject. The investigators would like to publish the investigators' results and protocol as a
resource for other institutions to adopt.
specific patient populations. An example is with ERAS for colorectal surgery. ERAS protocols
in this patient population have been shown to reduce overall morbidity and hospital length of
stay (LOS). At the University of Alabama at Birmingham (UAB), the institution has had
successful implementation of ERAS protocols for several surgical specialties including
colorectal, breast, spine, gynecology, and gynecology-oncology. However, the institution
currently does not have a protocol in place for the most commonly performed surgical
procedure - cesarean delivery. At UAB, the institution performs approximately 1,000 cesarean
deliveries per year.
The investigators believe that an ERAS protocol will be beneficial for these patients.
Currently, there is very little data published on ERAS protocols. Although this patient
population is ideal for an ERAS protocol, there are several barriers that have to be
overcome. The data published show promising results for ERAS protocols with cesarean
delivery. A larger tertiary care center showed earlier discharge with lower re-admission
rates with an ERAS pathway.
Currently, the investigators have created a multidisciplinary group at UAB to establish an
ERAS protocol for patients undergoing cesarean delivery. This group includes
anesthesiologists, obstetricians, nursing, neonatology, pharmacy, and informatics. Once the
investigators have implemented this protocol, the investigators would like to perform a
retrospective analysis to determine if there are any significant changes in our desired
outcomes the investigators will study. Our goal is to demonstrate significantly improved
outcomes in the investigators' measured endpoints. The investigators believe that this
information will be very useful because although there is a national interest in creating
ERAS protocols for cesarean deliveries, there currently is very little published on the
subject. The investigators would like to publish the investigators' results and protocol as a
resource for other institutions to adopt.
The investigators are implementing an enhanced recovery after surgery (ERAS) protocol for
patients undergoing cesarean delivery. The purpose of the ERAS protocol is to optimize care
provided to patients (patient education, nutrition, pain management, early ambulation, etc.).
The anticipated date of protocol initiation is May 2018. Once this protocol has been in place
for approximately 6 months to one year, the investigators would like to retrospectively
review data on these patients and compare outcomes to a similarly-matched group of patients
the year preceding protocol implementation. Specific outcomes the investigators will assess
are: hospital length of stay, post-operative pain scores, opioid consumption, patient
satisfaction [through IRB-approved survey (protocol X300001121)], surgical site infection
rates, readmission rates, and unscheduled clinic and maternal evaluation unit (MEU) visits
before the first scheduled postpartum visit. The investigators also plan to track compliance
monthly with the adherence to the protocol. Since the investigators want to track compliance
(both as a quality improvement project as well as research), the investigators are requesting
(Institutional Review Board) IRB approval now.
patients undergoing cesarean delivery. The purpose of the ERAS protocol is to optimize care
provided to patients (patient education, nutrition, pain management, early ambulation, etc.).
The anticipated date of protocol initiation is May 2018. Once this protocol has been in place
for approximately 6 months to one year, the investigators would like to retrospectively
review data on these patients and compare outcomes to a similarly-matched group of patients
the year preceding protocol implementation. Specific outcomes the investigators will assess
are: hospital length of stay, post-operative pain scores, opioid consumption, patient
satisfaction [through IRB-approved survey (protocol X300001121)], surgical site infection
rates, readmission rates, and unscheduled clinic and maternal evaluation unit (MEU) visits
before the first scheduled postpartum visit. The investigators also plan to track compliance
monthly with the adherence to the protocol. Since the investigators want to track compliance
(both as a quality improvement project as well as research), the investigators are requesting
(Institutional Review Board) IRB approval now.
Inclusion Criteria:
Any patient 18 years or older whom is scheduled for an elective cesarean section from one
of the participating clinics: Prime Care, Maternal Fetal Medicine (MFM), Obstetrics
Complications Clinic (OBCC).
Exclusion Criteria:
1. Age less than 18 years old;
2. urgent or emergent cesarean delivery;
3. diagnosis of preeclampsia;
4. coagulopathy that contraindicates neuraxial block placement;
5. abnormal placentation;
6. opioid abuse disorder;
7. type C diabetic or greater.
We found this trial at
1
site
1720 2nd Ave S
Birmingham, Alabama 35233
Birmingham, Alabama 35233
(205) 934-4011
Principal Investigator: Mark Powell, MD
Phone: 205-934-4042
University of Alabama at Birmingham The University of Alabama at Birmingham (UAB) traces its roots...
Click here to add this to my saved trials
