[ERAS Implementation] ERAS教育及推廣之專家共識

ERAS® Society成員於2018年在World Journal of Surgery期刊上發表了第一篇針對ERAS教育及推廣內容的建議指引。透過delphi method取得58名來自11ERAS各領域的專家意見,並經過反覆的討論與修正,最後建立共識。

World Journal of Surgery (Published: 04 January 2018)

Consensus on Training and Implementation of EnhancedRecovery After Surgery: A Delphi Study (Nader K. Francis et. al.)

https://www.ncbi.nlm.nih.gov/pubmed/29302724

針對ERAS教育訓練課程設計,專家們認為最重要的題:

針對如何教育ERAS課程,專家們認為最有效的方式:

Team-based training with a multidisciplinary faculty (96.67%)

Face-to-face training (93.33%)

Online modules/e-learning with integrated assessment (76.67%)

As part of the undergraduate nursing and medical curricula (76.67%)

Continual audit and feedback should be performed to demonstrate the benefits of teaching methods (73.33%).

針對ERAS成功導入,專家們認為要最重要的因素為:

針對ERAS的成功導入,專家們認為跨團隊合作最重要的因素為:

Development of an effective system of feedback (97%)

Strong leadership and vision (90%)

Regular scheduled meetings (80%)

Clearly aligned goals for patient care (80%)

Collaborative development of ERAS pathways (77%)

針對ERAS的成功導入,專家們認為ERAS leader最重要的因素為:

They must be passionate and positive about ERAS (97%)

Locally respected and able to influence clinical and management colleagues (97%).

針對ERAS的成功導入,專家們認為機構端要最重要的因素為:

Senior management engagement (87%)

Linking clinical outcomes of ERAS to organizationalobjectives (87%)

Including a senior manager within the ERAS team (80%)

Sharing the positive outcomes of ERAS with senior management (77%)

針對ERAS的成功導入,專家們認為ERAS nurse/facilitator最重要的因素為:

Enthusiastic team members with correct skills, abilities and time for role (86.67%)

Have clear roles and responsibilities (83.33%)

針對ERAS執行成果的評鑑,專家們認為最需要收集的資料為:

針對ERAS的資料收集,專家們認為最大阻礙與困難為:

A lack of human resources (4.13)

A lack of time (4.10)

Non-automated or inefficient processes (4.00)

針對ERAS的資料收集,專家們認為最佳的執行角色為:

針對ERAS教育訓練學程效率,專家們認為需要被評核的項目為:

針對ERAS教育訓練的評核,專家們認為最佳的資料收集方式為:

Prompt feedback from participants after each course (96.67%)

Follow-up of ‘‘trained’’ centres using faculty feedback (76.67%)

Feedback provided by faculty using standardized online feedback forms (70.00%)

針對ERAS訓練中心的成功,專家們認為最重要的條件為:

針對成功ERAS訓練中心,專家們認為機構應該達到的標準為

Publication of data (87.10%)

Scheduled observation visits (77.42%)

Both attendance and presentation at national or international meetings (74.19%).