EP291 - Drinking, Eating, Mobilising after elective colorectal surgery- ‘DrEaMing’, a CQUIN project

Abstract Introduction DrEAMing- Early drinking, eating and mobilising after elective surgery, is a simplified and key part of enhanced recovery programmes. It helps decrease post operative complications and length of hospital stay. It also helps reduce the backlog of patients waiting for surgery. Objectives As per commissioning for quality and innovation (CQUIN) 2023/2024 guidelines, our aim was to ensure that at least 80 percent of patients are supported to DrEaM- Drink, Eat, Mobilise, within 24 hours of surgery. Our audit includes only colorectal surgeries. Methods 21 patients underwent elective colorectal surgery from July-September,2023. Patient’s notes, post operative notes and nursing notes were analysed to identify the inadequacies in each of the three limbs of DrEaMing. Results Free fluids were ordered for 21/21 (100%) and administered to 17/21 (81%) patients. Food was ordered for 16/21 (76%) and given to 12/21(57%) patients. Lastly, 16/21 patients had orders for mobilisation and 10/21 (48%) were supported for the same. The results were discussed at clinical governance meeting and interventions were advised for better implementation and compliance to guidelines. Conclusion There is a deficiency in effective implementation of DrEaMing project and this can be improved by better communication between surgeons and nurses. Surgeons should clearly document patients who aren’t suitable for enhanced recovery programme. We also requested changes to the built operative notes about post operative orders so that the instructions are not missed. We intend to adopt these measures and repeat the cycle of this QIP.