The Activities on these Portfolio Pages correspond with the learning objectives of the Guided Learning unit published in Nursing Times 105: 28 (21 July, 2009) and 105: 29 (28 July, 2009). The full reference list for this unit follows Activity 4.
Before starting to work through these Activities, save this document onto your computer, then print the completed work for your professional portfolio. Alternatively, simply print the pages if you prefer to work on paper, using extra sheets as necessary.
Recording your continuing professional education
To make your work count as part of your five days’ CPD for each registration period, make a note in the box below of the date and the total number of hours you spent on reading the unit and any other relevant material, and working through the Activities.
Hours: / Date:11
Nursing Times Portfolio Pages: Enhanced recovery pathway in colorectal surgery 1
enhanced recovery pathway in colorectal surgeryACTIVITY 1
Learning objective: Understand the principles of an enhanced recovery programme and the associated surgical procedures.
Activity: Explain how an enhanced recovery programme might benefit the following patients and their families:
· A recently widowed 82 year-old with a history of ischaemic heart disease;
· A 15 year-old who is a county cross country runner.
RESPONSEBegin your response here.
11
Nursing Times Portfolio Pages: Enhanced recovery pathway in colorectal surgery 1
enhanced recovery pathway in colorectal surgery11
Nursing Times Portfolio Pages: Enhanced recovery pathway in colorectal surgery 1
enhanced recovery pathway in colorectal surgeryACTIVITY 2
Learning objective: Understand the post-operative care for patients on the enhanced recovery programme.
Activity: Explain the variations between enhanced recovery and traditional care in the pre- and post-operative period.
rESPONSEBegin your response here.
3
Nursing Times Portfolio Pages: Unit Title
enhanced recovery pathway in colorectal surgery3
Nursing Times Portfolio Pages: Unit Title
enhanced recovery pathway in colorectal surgery4
Nursing Times Portfolio Pages: Enhanced recovery pathway in colorectal surgery 4
enhanced recovery pathway in colorectal surgeryACTIVITY 3
4
Nursing Times Portfolio Pages: Enhanced recovery pathway in colorectal surgery 4
enhanced recovery pathway in colorectal surgeryLearning objective: Know the signs and symptoms that might occur indicating a post-operative complication.
Activity: Outline the signs and symptoms of different post-operative complications in colorectal surgery.
4
Nursing Times Portfolio Pages: Enhanced recovery pathway in colorectal surgery 4
enhanced recovery pathway in colorectal surgeryRESPONSE
Begin your response here.
4
Nursing Times Portfolio Pages: Enhanced recovery pathway in colorectal surgery 4
enhanced recovery pathway in colorectal surgery4
Nursing Times Portfolio Pages: Enhanced recovery pathway in colorectal surgery 4
enhanced recovery pathway in colorectal surgeryACTIVITY 4
Learning objective: Identify the cause and treatment of post-operative complications related to colorectal surgery.
Activity: What considerations would be important when caring for a post-operative patient who has undergone colorectal surgery?
If a patient had abdominal distension and felt nauseous, what nursing care would be necessary?
RESPONSEBegin your response here.
5
Nursing Times Portfolio Pages: Unit Title
enhanced recovery pathway in colorectal surgery7
Nursing Times Portfolio Pages: Enhanced recovery pathway in colorectal surgery 7
enhanced recovery pathway in colorectal surgery7
Nursing Times Portfolio Pages: Enhanced recovery pathway in colorectal surgery 7
enhanced recovery pathway in colorectal surgeryFULL REFERENCE LIST
Billyard, J. et al (2007) Implementing an enhanced recovery programme in a district general hospital. Gastrointestinal Nursing; 5: 9, 32–39.
Bisanz, A. et al (2008) Characterizing postoperative paralytic ileus as evidence for future research and clinical practice. Gastroenterology Nursing; 31: 5, 336–344.
British National Formulary (2009) BNF 57. London: BMJ Group and RPS Publishing. www.bnf.org/bnf
Chan, M.K.Y., Law, W.L. (2007) Use of chewing gum in reducing postoperative ileus after elective colorectal resection: a systematic review. Diseases of the Colon and Rectum; 50: 2149–2157.
de Castro, S.M.M. et al (2008) A systematic review of the efficacy of gum chewing for the amelioration of postoperative ileus. Digestive Surgery; 25: 39–45.
Faiz, O. et al (2009) A cohort study of results following elective colonic and rectal resection within an enhanced recovery programme. Colorectal Disease; 11: 4, 366–372.
Fearon, K.C.H. et al (2005) Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection. Clinical Nutrition; 24: 466–477.
Fearon, K.C.H., Luff, R. (2003) The nutritional management of surgical patients: enhanced recovery after surgery. Proceedings of the Nutritional Society; 62: 807–811.
Francis, N.K. (2008) The enhanced recovery programme and laparoscopic surgery: a new era for colorectal cancer management. Gastrointestinal Nursing Journal; 6: 5, 24–28.
Frost, E.A.M. (2008) Strategies to prevent postoperative ileus associated with opioid administration. Topics in Pain Management; 24: 4, 1–7.
Gatt, M. et al (2005) Randomized clinical trial of multi-modal optimization of surgical care in patients undergoing major colonic resection. British Journal of Surgery; 92: 1354–1362.
Han-Geurts, I.J.M. et al (2007) Randomized clinical trial of the impact of early enteral feeding on postoperative ileus and recovery. British Journal of Surgery; 94: 555–561.
Hendry, P.O. et al (2009) Determinants of outcome after colorectal resection within an enhanced recovery programme. British Journal of Surgery; 96: 197–205.
Holte, K.H., Kehlet, H. (2005) Diverse therapeutic solutions to a challenging problem: a multi-modal approach to postoperative ileus. Contemporary Surgery; 61: 8–11.
Kehlet, H., Wilmore, D.W. (2002) Multimodal strategies to improve surgical outcome. American Journal of Surgery; 183: 630–641.
King, P.M. et al (2006a) Randomized clinical trial comparing laparoscopic and open surgery for colorectal cancer within an enhanced recovery programme. British Journal of Surgery; 93: 300–308.
King, P.M. et al (2006b) The influence of an enhanced recovery programme on clinical outcomes, cost and quality of life after surgery for colorectal cancer. Colorectal Disease; 8: 506–513.
Leaper, D. (2003) Infectious complications of surgery in general. In: Leaper, D.J., Peel, A.L.G. (eds) Handbook of Postoperative complications. Oxford: Oxford University Press.
Leier, H. (2007) Does gum chewing help prevent impaired gastric motility in the postoperative period? Journal of the American Academy of Nurse Practitioners; 19: 3, 133–136.
Mackay, M. et al (2005) Randomised clinical trial of physiotherapy after open abdominal surgery in high risk patients. Australian Journal of Physiotherapy; 51: 151–159.
Nielsen, K.G. et al (2003) Effects of posture on postoperative pulmonary function. Acta Anaesthesiologica Scandinavica; 47: 1270–1275.
Parnaby, C.N. et al (2009) Sham feed or sham? A meta-analysis of randomized clinical trials assessing the effect of gum chewing on gut function after elective colorectal surgery. International Journal of Colorectal Disease; 24: 5, 585–592.
Schoetz, D.J. et al (1997) Ideal length of stay after colectomy: whose ideal? Diseases of the Colon and Rectum; 40: 806–810.
Schuster, R. et al (2006) Gum chewing reduces ileus after elective open sigmoid colectomy. Archives of Surgery; 141: 2, 174–176.
Schuster, T.G., Monte, J.E. (2002) Postoperative ileus after abdominal surgery. Urology; 59: 4, 465–471.
Soop, M. et al (2006) Optimizing perioperative management of patients undergoing colorectal surgery: what is new? Current Opinion in Critical Care; 12: 166–170.
van Dam, R.M. et al (2008) Initial experience with a multimodal enhanced recovery programme in patients undergoing liver resection. British Journal of Surgery; 95: 969–975.
Wald, H.L. et al (2008) Indwelling urinary catheter use in the postoperative period: analysis of the national surgical infection prevention project data. Archives of Surgery; 143: 6, 551–557.
Wind, J. et al (2006) Systematic review of enhanced recovery programmes in colonic surgery: results of a multicentre study. British Journal of Surgery; 93: 800–809.
Wu, L., Griffiths, P. (2005) Early postoperative feeding and abdominal gynaecological surgery. British Journal of Nursing; 14: 1, 42–46.
Zeitz, K. (2004) Post-operative complications in the first 24 hours: a general surgery audit. Journal of Advanced Nursing; 46: 6, 633–640.
7
Nursing Times Portfolio Pages: Enhanced recovery pathway in colorectal surgery 7
enhanced recovery pathway in colorectal surgery7
Nursing Times Portfolio Pages: Enhanced recovery pathway in colorectal surgery 7
enhanced recovery pathway in colorectal surgery7
Nursing Times Portfolio Pages: Enhanced recovery pathway in colorectal surgery 7