The use of the ERAS protocol in malnourished and properly nourished patients undergoing elective surgery: a questionnaire study.

INTRODUCTION: Enhanced recovery after surgery (ERAS) is a modern approach to perioperative management. This study aimed to evaluate compliance with certain aspects of the ERAS protocol in malnourished and properly nourished patients undergoing elective surgery. MATERIAL AND METHODS: A questionnaire study was conducted among 197 patients undergoing elective surgery at the university hospital. We divided patients into two groups according to nutritional status. RESULTS: The study's results showed that 67 patients (34%) lost weight before admission (the weight-loss group). Twenty-five participants (37%) in the weight-loss group and 15 patients (12%) in the preserved-weight group underwent surgery due to cancer ( P < 0.001). More patients in the weight loss group (45 of 67) than in the preserved-weight group (40 of 129, P < 0.001) limited their food intake a week before the surgery. The preserved-weight group participants were mobilized earlier than the weight-loss group ( P = 0.04). The median number of hours since drinking their last fluids and eating their last meals before the surgery were 12.2 hours and 25.4 hours for both groups, respectively. Only eight patients received preoperative carbohydrate loading. We found higher serum protein concentrations in the preserved-weight group (7.10 [0.5] vs. 6.92 [0.71], P = 0.023); however, white blood cell count was higher in the weight-loss group (7.85 (2.28) vs.7.10 (0.50), P = 0.04). Both groups were highly satisfied with their hospital treatments. CONCLUSIONS: Our study revealed relatively high malnutrition in patients undergoing elective surgery. As a standard of perioperative care in the studied centre, the ERAS protocol implementation level is low.

Job satisfaction among anesthetic and intensive care nurses - multicenter, observational study.

BACKGROUND: It is known that job satisfaction has an important impact on efficacy or burnout syndrome of medical personnel. Many studies have concerned job satisfaction among critical care nurses. Not as many have focused on anesthesia nurses working in operating theaters. In Poland, anesthesia and intensive care is a combined specialty for nurses. However, nurses work in an intensive care unit (ICU) or in an operating room (OR), and very rarely in both settings. We would like to compare satisfaction between ICU and OR nurses. METHODS: It was a multicenter cross-sectional study. 406 nurses from thirteen hospitals participated in this study. All respondents filled in the questionnaire that contained fifteen Likert-like questions reflecting different aspects of job satisfaction. Demographic data were also collected. RESULTS: We did not find a significant difference between ICU and OR nurses in the overall job satisfaction. Furthermore, the type of hospital did not significantly influence satisfaction of our study participants. The most important factor which differentiated the level of satisfaction among nurses was the region of Poland in which they worked. Interestingly, nurses who worked in ICUs were significantly younger in comparison to their colleagues from ORs. CONCLUSION: The results of our study suggest that the region of the country in which nurses work might play a very important role in their satisfaction.