Skip to main content

Table 5 Degree of program implementation

From: Does implementation of an enhanced recovery after surgery program for hip replacement improve quality of recovery in an Australian private hospital: a quality improvement study

Program item

Pre-implementation

Post-implementation

Difference or RR (95% CI)

p-value

1. Duration of fasting (hours): median (Q1; Q3)

    

 Preoperative

11.8 (9.92; 13.42)

10.9 (7.67; 13.00)

Diff −0.83 (− 1.96, 0.29)

0.147

 Postoperative

1.25 (0.82; 3.00)

1.48 (0.80; 3.02)

Diff 0.25 (− 0.30, 0.80)

0.368

2. Spinal anesthesia: n (%)

101 (88.6)

103 (89.6)

RR 1.01 (0.92, 1.11)

0.815

3. General anesthesia: n (%)

55 (47.7)

44 (38.9)

RR 0.81 (0.60, 1.10)

0.180

4. Intraoperative antiemetic prophylaxis: n (%)

45 (39.1)

64 (55.7)

RR 1.53 (1.16, 2.02)

0.003

 PONV day 1

44 (38.3)

30 (26.6)

RR 0.57 (0.43, 0.76)a

< 0.001

 PONV day 2

21 (18.3)

22 (19.1)

RR 0.84 (0.51, 1.40)a

0.501

5. Intraoperative tranexamic acid: n (%)

68 (59.1)

96 (83.5)

RR 1.41 (1.18, 1.68)

< 0.001

 Intraoperative blood loss (ml): median (Q1; Q3)

250 (150; 450)

250 (150; 475)

Diff 0.00 (−66.2 to 66.2)

> 0.999

 Blood transfusion day 1

3 (2.6)

0 (0.0)

  

 Blood transfusion day 2

4 (3.5)

2 (1.7)

  

6. Forced air warming: n (%)

113 (98.3)

114 (99.1)

RR 1.01 (0.98, 1.04)

0.562

Fluid warming: n (%)

110 (95.7)

104 (90.4)

RR 0.95 (0.88, 1.02)

0.123

PACU temperature (°C): mean (SD)

35.6 (0.59)

35.6 (0.52)

Diff −0.04 (−0.18, 0.11)

0.611

7. Oral analgesia: n (%)

Paracetamol

Day 1

109 (94.8)

114 (99.1)

RR 1.05 (1.00, 1.10)

0.057

 

Day 2

107 (93.0)

114 (99.1)

RR 1.06 (1.01, 1.12)

0.019

NSAIDs/cox2i

Day 1

50 (43.5)

72 (62.6)

RR 1.44 (1.12, 1.85)

0.005

 

Day 2

59 (51.3)

65 (56.5)

RR 1.10 (0.87, 1.40)

0.429

Tramadol

Day 1

37 (32.2)

41 (35.7)

RR 1.11 (0.77, 1.59)

0.579

 

Day 2

27 (23.7)

23 (20.0)

RR 0.84 (0.52, 1.38)

0.502

Gabapentinoids

Day 1

22 (19.1)

34 (29.6)

RR 1.55 (0.97, 2.47)

0.070

 

Day 2

19 (16.7)

31 (27.0)

RR 1.62 (0.97, 2.69)

0.065

Intravenous analgesia: n(%)

    

Opioid PCA

Day 1

5 (4.4)

5 (4.4)

  
 

Day 2

2 (1.7)

1 (0.87)

  

Ketamine

Day 1

1 (0.09)

2 (1.7)

  
 

Day 2

1 (0.09)

1 (0.09)

  

Epidural or nerve block: n(%)

0 (0.0)

4 (3.5)

  

8. Cessation of intravenous fluid on day 1: n(%)

96 (83.5)

93 (80.9)

1.13 (0.65, 1.97)

0.673

9. Postoperative physiotherapy assessment: n (%)

 Day 0

34 (29.6)

66 (57.4)

RR 1.87 (1.36, 2.59)

< 0.001

 Day 1

76 (66.1)

113 (98.3)

RR 1.44 (1.26, 1.63)

< 0.001

 Day 2

113 (98.3)

114 (99.1)

RR 1.00 (0.98, 1.02)

0.995

10. Postoperative mobilisation ≥ 3 m: n (%)

 Day 0

10 (9.0)

26 (22.6)

RR 2.51 (1.27, 4.97)

0.008

 Day 1

76 (68.5)

94 (81.7)

RR 1.19 (1.02, 1.39)

0.024

 Day 2

99 (89.2)

112 (97.4)

RR 1.09 (1.02, 1.17)

0.016

  1. Abbreviations: PACU Post-anesthesia care unit, PCA Patient controlled analgesia, Q1 25th percentile, Q3 75th percentile
  2. aadjusted for history of PONV