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Enhanced Recovery after Surgery (ERAS) Implementation and Barriers among Healthcare Providers in France: A Cross-Sectional Study.

作者信息

Clet Augustin, Guy Marin, Muir Jean-François, Cuvelier Antoine, Gravier Francis-Edouard, Bonnevie Tristan

机构信息

Université Rouen Normandie, Normandie Univ, GRHVN UR 3830, F-76000 Rouen, France.

ADIR Association, Rouen University Hospital, F-76000 Rouen, France.

出版信息

Healthcare (Basel). 2024 Feb 8;12(4):436. doi: 10.3390/healthcare12040436.


DOI:10.3390/healthcare12040436
PMID:38391811
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10887527/
Abstract

The implementation of Enhanced Recovery After Surgery (ERAS) is a challenge for healthcare systems, especially in case of patients undergoing major surgery. Despite a proven significant reduction in postoperative complications and hospital lengths of stay, ERAS protocols are inconsistently used in real-world practice, and barriers have been poorly described in a cohort comprising medical and paramedical professionals. This study aims to assess the proportion of French healthcare providers who practiced ERAS and to identify barriers to its implementation amongst those surveyed. We conducted a prospective cross-sectional study to survey healthcare providers about their practice of ERAS using an online questionnaire. Healthcare providers were contacted through hospital requests, private hospital group requests, professional corporation requests, social networks, and personal contacts. The questionnaire was also designed to explore barriers to ERAS implementation. Identified barriers were allocated by two independent assessors to one of the fourteen domains of the Theoretical Domains Framework (TDF), which is an integrative framework based on behavior change theories that can be used to identify issues relating to evidence on the implementation of best practice in healthcare settings. One hundred and fifty-three French healthcare providers answered the online questionnaire (76% female, median age 35 years (IQR: 29 to 48)). Physiotherapists, nurses, and dieticians were the most represented professions (31.4%, 24.2%, and, 14.4%, respectively). Amongst those surveyed, thirty-one practiced ERAS (20.3%, 95%CI: 13.9 to 26.63). Major barriers to ERAS practice were related to the "Environmental context and resources" domain (57.6%, 95%CI: 49.5-65.4), e.g., lack of professionals, funding, and coordination, and the "Knowledge" domain (52.8%, 95%CI: 44.7-60.8), e.g., ERAS unawareness. ERAS in major surgery is seldom practiced in France due to the unfavorable environment (i.e., logistics issues, and lack of professionals and funding) and a low rate of procedure awareness. Future studies should focus on devising and assessing strategies (e.g., education and training, collaboration, institutional support, the development of healthcare networks, and leveraging telehealth and technology) to overcome these barriers, thereby promoting the wider implementation of ERAS.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1095/10887527/f28b99d8bfde/healthcare-12-00436-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1095/10887527/fd8c013e79aa/healthcare-12-00436-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1095/10887527/f28b99d8bfde/healthcare-12-00436-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1095/10887527/fd8c013e79aa/healthcare-12-00436-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1095/10887527/f28b99d8bfde/healthcare-12-00436-g002.jpg

相似文献

[1]
Enhanced Recovery after Surgery (ERAS) Implementation and Barriers among Healthcare Providers in France: A Cross-Sectional Study.

Healthcare (Basel). 2024-2-8

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
[Patient experience in the implementation of enhanced recovery after surgery strategy after radical gastric cancer surgery].

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[10]
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引用本文的文献

[1]
Knowledge, attitudes and practices regarding perioperative enhanced recovery after surgery in video-assisted thoracoscopic lobectomy among healthcare professionals.

Sci Rep. 2025-7-3

[2]
Current state and future education implication of enhanced recovery after surgery (ERAS) among Chinese anesthesiologists: national repeated cross-sectional surveys from 2019 to 2023.

BMC Med Educ. 2025-5-23

[3]
Breaking surgical barriers: ERAS in action in Romania.

J Med Life. 2025-3

[4]
Role of modified enhanced recovery after surgery (mERAS) in awake craniotomy performed under monitored anesthesia care (MAC); a single center retrospective study.

BMC Anesthesiol. 2025-4-4

[5]
Effectiveness of the enhanced recovery after surgery (ERAS) program after lobectomy for lung cancer: a single-center observational study using propensity score matching in Vietnam.

J Thorac Dis. 2024-11-30

本文引用的文献

[1]
Implementation of a perioperative care App in elective thoracic surgery.

Cir Esp (Engl Ed). 2023-4

[2]
Early mobilisation and rehabilitation in the PICU: a UK survey.

BMJ Paediatr Open. 2022-6

[3]
Feasibility of a tele-prehabilitation program in high-risk patients with colon or rectal cancer undergoing elective surgery: a feasibility study.

Perioper Med (Lond). 2022-7-26

[4]
A Systematic Review and Meta-Analysis of Enhanced Recovery for Open Abdominal Aortic Aneurysm Surgery.

Vasc Endovascular Surg. 2022-5-4

[5]
Barriers to implementation of enhanced recovery after surgery (ERAS) by a multidisciplinary team in China: a multicentre qualitative study.

BMJ Open. 2022-3-14

[6]
Implementation of an enhanced recovery after surgery protocol for bariatric surgery - A qualitative study.

Am J Surg. 2022-7

[7]
Implementing an enhanced recovery after thoracic surgery programme in the Netherlands: a qualitative study investigating facilitators and barriers for implementation.

BMJ Open. 2022-1-5

[8]
Level of ERAS understanding affects practitioners' practice and perception of early postoperative resumption of oral intake: a nationwide survey.

BMC Anesthesiol. 2021-11-12

[9]
Effects of exercise training in people with non-small cell lung cancer before lung resection: a systematic review and meta-analysis.

Thorax. 2022-5

[10]
Enhanced Recovery After Surgery and Radical Cystectomy: A Systematic Review and Meta-Analysis.

Res Rep Urol. 2021-7-29

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