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Implementing a Frailty-Specific Postoperative Order Set to Improve Postoperative Outcomes in Frail Adults After
Amani Allen1, Mary Ann Francisco, Jessica Jatis
1Author Affiliations: The University of Chicago Pritzker School of Medicine (Dr Allen), Department of Public Health Sciences (Dr Nordgren), Department of Anesthesia and Critical Care (Dr Rubin), Section of Geriatrics and Palliative Medicine, Department of Medicine (Drs Huisingh-Scheetz and Gleason), Section of Thoracic Surgery, Department of Surgery (Drs Bryan, Donington, Ferguson, and Madariaga), University of Chicago, Chicago, Illinois; and Department of Nursing Research and Evidence Based Practice (Mss Francisco, Jatis, and Turner), University of Chicago Medical Center, Chicago, Illinois.
Implementing a frailty-specific postoperative order set (FPOS) improved nurses' knowledge and utilization of specialized care for frail surgical patients, enhancing postoperative outcomes.
Area of Science:
- Geriatric Surgery
- Patient Outcomes
- Healthcare Quality Improvement
Background:
- Frailty is a significant predictor of adverse surgical outcomes.
- Current postoperative care protocols often overlook frailty status.
- Lack of standardized care for frail patients leads to suboptimal outcomes.
Purpose of the Study:
- To address the absence of a standardized protocol for optimizing postoperative care in frail patients.
- To implement and evaluate a frailty-specific postoperative order set (FPOS) at an academic medical center.
Main Methods:
- Utilized a quasi-experimental pre-/postimplementation study design.
- Employed the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework.
- Developed and implemented a frailty-specific postoperative order set (FPOS) with tailored interventions.
Main Results:
- Significant improvements observed in nurses' self-reported familiarity with frailty (P = .003).
- Increased awareness of the FPOS among nursing staff (P < .001).
- Higher utilization of orders for delirium prevention, nutrition, sleep, and sensory support (P < .001).
Conclusions:
- Implementation of an FPOS effectively enhanced nurse knowledge and awareness regarding frailty.
- The FPOS led to increased utilization of targeted postoperative interventions for frail patients.
- This initiative demonstrates a successful strategy for improving specialized postoperative care for frail individuals.
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