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Objective: Quality of preoperative and postoperative care is crucial to improve postoperative outcome of cancer surgery and to ensure that neither complications nor a poor general condition delays any subsequent radiochemotherapy or recovery. On this background, the Danish Gynecological Cancer Database (DGCD) established a nursing database in 2011. The aim of DGCD Nursing is to monitor the quality of preoperative and postoperative care and to generate data for research., Material and Methods: In accordance with the current data protection legislation, real-time data are entered by clinical nurses at all national cancer centers. The DGCD Nursing includes data of preoperative and postoperative care, and nurses are independently represented in the steering committee. The aim of the present article is to present the first results from DGCD Nursing and the national care improvements that have followed., Results: With national coverage of an average of 94%, 5726 patients have been registered since 2011. In patients undergoing surgery for ovarian, endometrial, and cervical cancer, 436 different variables monitor central preoperative and postoperative care elements within mobilization, nutritional status, pain score, vital functions, and psychosocial support., Conclusions: At national level, DGCD offers a comprehensive overview of the total patient pathway within gynecological cancer surgery. The DGCD Nursing has added to the quality and implementation of evidence-based preoperative and postoperative care and in addition supported formation of professional networks. With a continued validation of data, DGCD Nursing now constitutes a sound and unique basis for research within the field of preoperative and postoperative cancer care.

Background: Postoperative mobilisation is an important part of fundamental care. Increased mobilisation has positive effect on recovery, but immobilisation is still a challenge in postoperative care. Aims: To report how the establishment of a national nursing database was used to measure postoperative mobilisation in patients undergoing surgery for ovarian cancer. Methods: ‘Mobilisation’ was defined as at least 3 hours out of bed on postoperative day 1, with the goal set at achieving this in 60% of patients. Data entry was performed by clinical nurses on 4400 patients with ovarian cancer. Findings: 46.7% of patients met the goal for mobilisation on the first postoperative day, but variations in duration and type of mobilisation were observed. Of those mobilised, 51.8% had been walking in the hallway. Conclusions: A national nursing database creates opportunities to optimise fundamental care. By comparing nursing data with oncological, surgical and pathology data it became possible to study mobilisation in relation to cancer stage, comorbidity, treatment and extent of surgery. [ABSTRACT FROM AUTHOR]

Introduction: Length of hospital stay after birth has decreased during the last decades, but nationwide data on length of hospital stay after cesarean section are lacking. Elements of Enhanced Recovery Programs were reported to reduce the length of hospital stay. The aim of this nationwide study was to describe the length of hospital stay after cesarean section in Denmark from 2004 to 2016 taking into account birth‐ and health‐related factors as well as demographic changes and, further, to assess potential differences between the five Danish regions. Material and methods: Length of hospital stay was assessed in 164 209 deliveries by cesarean section in Denmark from 2004 to 2016. Data were obtained from the Danish National Patient Register. All deliveries by cesarean section at gestational age <22 weeks were excluded. Median length of hospital stay was reported based on crude and adjusted analyses. Results: The median length of hospital stay was significantly reduced by 39 hours (95% confidence interval [CI] 37.9‐40.1), from 97 hours (4.0 days) in 2004 to 58 hours (2.4 days) in 2016. Reductions were observed among both planned and emergency cesarean sections. When birth‐ and health‐related factors as well as demographic changes were accounted for, median length of hospital stay was reduced by 30 hours (95% CI 29.3‐30.8) in the period. The decrease in length of hospital stay from 2004 to 2016 varied between the five Danish regions, with adjusted reductions between 19 and 46 hours. Conclusions: A nationwide decrease in length of hospital stay after cesarean section was observed from 2004 to 2016 across all five regions but with significant regional variations. Further studies on the optimal length of hospital stay are needed, especially with regard to implementation of enhanced recovery programs. [ABSTRACT FROM AUTHOR]

Background: Enhanced recovery after surgery (ERAS) programmes have been adopted to a varying degree by most surgical departments, not only in Denmark, but worldwide. Aims: To report the process from a local ERAS unit in a tertiary university hospital to accelerate implementation of ERAS programmes in all surgical specialties. Methods: All surgical departments receive twice-yearly procedure-specific data on length of stay (LOS), readmission rates and death within 30 days, based on surgical codes and the Danish National Patient Register. The ERAS unit and clinical experts review data followed by a clinical audit where appropriate. Findings: Setting up data presentation for clinical and nurse leaders has documented progress in implementing ERAS. The combination of outcome data, together with audits have been essential. Conclusion: The local ERAS unit has been shown to accelerate implementation of ERAS programmes in all surgical specialties, facilitated by procedure-specific LOS and re-admission data, combined with audit data. [ABSTRACT FROM AUTHOR]

Background: Enhanced Recovery After Surgery (ERAS) is widely accepted in current surgical practice due to its positive impact on patient outcomes. The successful implementation of ERAS is challenging and compliance with protocols varies widely. Continual staff education is essential for successful ERAS programmes. Teaching modalities exist, but there remains no agreement regarding the optimal training curriculum or how its effectiveness is assessed. We aimed to draw consensus from an expert panel regarding the successful training and implementation of ERAS.Methods: A modified Delphi technique was used; three rounds of questionnaires were sent to 58 selected international experts from 11 countries across multiple ERAS specialities and multidisciplinary teams (MDT) between January 2016 and February 2017. We interrogated opinion regarding four topics: (1) the components of a training curriculum and the structure of training courses; (2) the optimal framework for successful implementation and audit of ERAS including a guide for data collection; (3) a framework to assess the effectiveness of training; (4) criteria to define ERAS training centres of excellence.Results: An ERAS training course must cover the evidence-based principles of ERAS with team-oriented training. Successful implementation requires strong leadership, an ERAS facilitator and an effective MDT. Effectiveness of training can be measured by improved compliance. A training centre of excellence should show a willingness to teach and demonstrable team working.Conclusions: We propose an international expert consensus providing an ERAS training curriculum, a framework for successful implementation, methods for assessing effectiveness of training and a definition of ERAS training centres of excellence. [ABSTRACT FROM AUTHOR]