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Enhanced Recovery After Surgery (ERAS) programmes are an innovative approach to optimising patient outcomes in the perioperative period and have been implemented in various surgical departments across a range of specialties, with varying degrees of success. ERAS is an evidence-based, multimodal programme that has repeatedly demonstrated a reduction in post-operative complications and reduced the length of hospital stays following elective surgery. However, despite extensive evidence to support these benefits, several barriers to ERAS implementation have been identified. This article outlines the components of ERAS, focusing on the barriers to its implementation and how these could be overcome. It also discusses the implications of ERAS for patients, nurses and healthcare organisations. [ABSTRACT FROM AUTHOR]

The article provides insights from several experts in ophthalmology about subconjunctival minimally-invasive glaucoma surgery (MIGS) procedures and the appropriate use of antimetabolites to enhance surgical success. Topics covered include how the expansion of new treatment options changed their goals of glaucoma therapy, five features that characterize an MIGS procedure, and the advantages and disadvantages of supraciliary outflow MIGS.

Postoperative pain continues to be a significant issue in healthcare, with a considerable proportion of patients experiencing severe pain after surgery and finding pain management at home challenging. There are several barriers to effective pain management, involving both patients and healthcare professionals. Patient education may be a useful way to overcome many of these barriers. This article outlines the four stages of the education process, which can be used to provide patient education: assessing the patient's educational needs and potential barriers to learning; setting educational objectives; teaching; and evaluating the patient's learning. This article discusses the issue of postoperative pain and how structured patient education, from admission to discharge, provided by skilled healthcare professionals, may improve postoperative recovery. [ABSTRACT FROM AUTHOR]

Aim The aim of this literature review was to explore the reasons why some patients are not suitable for discharge following day surgery. Method A pragmatic, mixed-methods approach was used to undertake a critical evaluation of the literature and current practice to determine what is already known about discharge following day surgery. Thematic analysis was used to identify the main themes and issues, enabling recommendations to be made to reduce the incidence of patients unable to be discharged following day surgery. Findings The main themes or reasons for delayed discharge following day surgery identified from the literature review were: post-operative nausea and vomiting, post-operative pain, going late to theatre and social factors. These themes were supported by the findings of an unpublished audit carried out in one day surgery unit in an NHS healthcare organisation in the south of England between June and August 2014, which indicated that 54 out of 1,180 day surgery patients required an overnight stay during this 12-week period. The audit also showed that a patient going late to theatre had the greatest effect on discharge outcomes. Conclusion Recommendations for practice include: the introduction of post-operative nausea and vomiting risk scoring and prophylactic protocols; reorganisation of theatre lists to ensure patients have enough time to recover; and provision of information during the pre-assessment process about the requirement for a responsible adult escort to take patients home and stay with them for the first 24 hours. These changes may help NHS organisations to improve discharge outcomes for day surgery patients and reduce unplanned costs. [ABSTRACT FROM AUTHOR]