Effectiveness A Nurse Guided Enhanced Recovery Pathway on Postoperative Respiratory Tract Infection in Hepatico-Pancreatic –Biliary Surgery

Background: Postoperative pulmonary are the most serious complication following upper abdominal surgery complications as result of significant consequences including increased mortality, hospital costs, and prolonged hospitalization. Enhanced recovery after surgery (ERAS) could shorten hospital stay and decrease postoperative complications for patients undergoing colorectal surgery. Objectives: Evaluate the effect of a nurse guided enhanced recovery pathway on postoperative respiratory tract infection in Hepatico-Pancreatic –Biliary surgery [ pre-operative patient counselling for postoperative respiratory physiotherapy techniques and emphasis on perfect training]. Design: Quasi-experimental study. Setting: The study was conducted in the surgical department, operation unit and intensive care unit at AlRajhy liver hospital. Subjects: Sixty patients undergoing hepatobiliary pancreatic surgeries. The sample was divided into two groups: control and study group (30patient each). The control started the first then the study group. Tools: Three tools were used. Tool I: Patient assessment sheet. Tool II: Clinical pathway protocol. Tool III: Clinical outcome evaluation. The control group received tools I and III only while the study group received the three tools including clinical pathway protocol [tool II]. Results: There was a statically significant difference between control and study groups regarding the respiratory tract infection and oxygen therapy with acceptance ABG in first 12 hour and first day after surgery and no statically significant difference regarding fever, admission and readmission to ICU and length of stay in hospital. Conclusions: Implementation a nurse guided enhanced recovery pathway has beneficial effects on postoperative respiratory tract infection in Hepatico-Pancreatic –Biliary surgery. Recommendations: A guided enhanced recovery pathway should be carried out as routine care in Hepatico-Pancreatic –Biliary surgery.