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PA.07 Enhanced recovery programme for elective caesarean section
  1. S Halder1,
  2. C Onwere2,
  3. C Brennan2,
  4. N Singh2,
  5. M Cox1,
  6. SM Yentis1
  1. 1Magill Department of Anaesthesia, Chelsea and Westminster Hospital, London, UK
  2. 2Obstetric Department, Chelsea and Westminster Hospital, London, UK

Abstract

Introduction Enhanced recovery (ER) for elective caesarean sections (CS) provides an opportunity to aid the time for patients to return to normal function.1 After trialling a pilot ER pathway for elective CS; we introduced an ER programme.

Methods In February 2013, 30 patients having low-risk elective CS were assessed; reviewing time spent in theatre and recovery, resumption of oral intake starvation, and hospital discharge. Patient satisfaction was also assessed. We introduced the ER pathway in May 2013 and reviewed data from 30 patients on the pathway. Timing data were statistically analysed using Mann-Whitney U tests and satisfaction data using Chi-squared tests.

Results After ER pathway introduction increase in patient satisfaction and reduction in resumption of oral intake and hospital discharge times were noted (Table 1).

Abstract PA.07 Table 1

Outcome data pre- and post-introduction of the ER pathway. Satisfaction data are number (and percentage) of patients satisfied

Discussion Following ER pathway introduction, median length of hospital admission reduced by 1 day. Estimated cost per postnatal day in our maternity unit is ~£300 and we have around 600 low-risk elective CS per year. Therefore a potential yearly saving could be ~£180,000. We conclude that the introduction of the ER pathway for elective CS has been effective in our department to decrease hospital admission times, thereby reducing cost, while most importantly increasing patient satisfaction.

Reference

  1. Lucas DN, Gough KL. Enhanced recovery in obstetrics – a new frontier? IJOA 2013;22:92–95

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