A Cross-Sectional Study of Pediatric Enhanced Recovery After Surgery in 23 Medical Institutions Across 17 Provinces and Cities in China

Objectives: The study aims to assess the current state of enhanced recovery after surgery (ERAS) in children across 23 medical institutions in China, providing data to support the management and policy-making of ERAS. Methods: In April 2023, a survey was conducted using convenience sampling among the pediatric surgical units of the National Medical Center's Pediatric Nursing Alliance. Data were collected using a specifically designed pediatric ERAS questionnaire, which included information on hospital demographics, surgical volumes, nurse-to-bed ratios, ERAS implementation status, and the primary challenges and obstacles in implementing ERAS programs. Results: The survey revealed that 21 out of the 23 hospitals (91.3%) had implemented ERAS programs, but only 6 (26.1%) had dedicated ERAS nurses. The challenges faced in implementing ERAS included the lack of ERAS clinical guidelines for specific diseases, the absence of unified quality control plans in hospitals, insufficient understanding of ERAS among medical staff, and the lack of hospital-level policy support. Conclusions: While the implementation of ERAS is a growing trend in pediatric surgical care, there is a significant shortage of specialized ERAS nurses, and various obstacles still hinder the widespread adoption of pediatric ERAS. Future research should focus on developing disease-specific ERAS clinical guidelines and establishing uniform ERAS quality control standards. Hospital administrators should provide policy support following ERAS implementation in their departments to facilitate the progression of ERAS.