Türkiye’de Hemşirelik Alanında ERAS Protokolü Uygulamaları ile Yapılan Lisansüstü Tezlerin İncelenmesi

Yıl 2024, Sayı: 23, 596 - 612, 31.08.2024

Gülseren Maraş , Yeliz Sürme

Öz

Amaç: Bu çalışma ülkemizde hemşirelik alanında Ameliyat Sonrası Hızlı İyileşme Protokolü̈ (Enhanced Recovery After Surgery-ERAS) uygulamaları ile yapılan lisansüstü tezlerin incelenmesi amacıyla planlanmıştır.
Yöntem: Bu retrospektif tipteki literatür araştırmasında 2011-2023 yılları arasında hemşirelik alanında ERAS uygulamalarının kullanıldığı tezler incelenmiştir. Yükseköğretim Kurulu Ulusal Tez Merkezi veri tabanında incelenen tezlerin araştırmaya alınma ölçütleri; tez başlıklarında "Cerrahi sonrası hızlandırılmış iyileşme protokolü ", "Hızlandırılmış iyileşme", “Oral karbonhidrat”, "ERAS" anahtar kelimeleri yer alması, Hemşirelik ve/veya Hemşirelik anabilim dalları tarafından yapılmış olmasıdır. Tezler yüksek lisans ve doktora tezleri olarak ayrıldıktan sonra kronolojik sırayla incelenmiştir.
Bulgular: Tarama sonucunda 2011-2023 yılları arasında tam metnine ulaşılan 21 tez içerisinden 20 tez değerlendirmeye alınmıştır. Türkiye’de ERAS uygulamaları kullanılarak yapılan ilk hemşirelik tezinin 2011 yılında yapıldığı saptanmıştır. Tezlerin tamamının son 12 yılda yazıldığı ve 3 tezin doktora, 17 tezin yüksek lisans düzeyinde olduğu tespit edilmiştir. Çalışma desenleri incelendiğinde 1’i meta-analiz, 13’ü tanımlayıcı, 6’sı deneysel yöntem kullanılarak yürütülmüştür. Çalışmaların %75’i hastalarla, %10’u sağlık çalışanlarıyla, %10’u hemşirelik öğrencileri ile yürütülmüştür. Tezler kolorektal, kardiyak, bariyatrik, hepatobiliyer, tiroid, jinekolojik, ortopedik cerrahi ve sağlık çalışanlarının ERAS konusundaki bilgi düzeylerini içermektedir.
Sonuç: ERAS konusunda yapılan hemşirelik tezlerinde ERAS uygulamalarının kullanım amaçlarına göre etkili olduğu sonuca ulaşılmıştır. Aynı zamanda sağlık çalışanlarının ERAS uygulamaları konusunda bilgi düzeyinin yeterli olmadığı saptanmıştır. Bu kapsamda, ERAS uygulamalarının yaygınlaştırılması amacıyla hemşirelik alanında yapılan kanıt düzeyi yüksek deneysel çalışma sayılarının artırılması ve farkındalık yaratılması önerilmektedir.

Anahtar Kelimeler

Cerrahi, ERAS, Hemşirelik, Hızlandırılmış İyileşme, Protokol

Examination of Postgraduate Theses on ERAS Protocol Applications in the Field of Nursing in Türkiye

Öz

Aim: This study is designed to examine postgraduate theses conducted in the field of nursing in Türkiye focusing on the Enhanced Recovery After Surgery (ERAS) protocols.
Method: In this retrospective literature review, theses conducted in the field of nursing between 2011-2023, focusing on the utilization of ERAS practices, were examined. The inclusion criteria for the theses retrieved from the National Thesis Center database of the Higher Education Council were as follows: having key terms such as "Postoperative enhanced recovery protocol," "Enhanced recovery," "Oral carbohydrate," or "ERAS" in their thesis titles, and being conducted by departments of Nursing and/or Nursing Science. After categorizing the theses into master's and doctoral theses, they were examined in chronological order.
Results: The screening process identified 21 theses conducted between 2011-2023, excluding one thesis that was inaccessible for full text. All theses were written within the last 12 years, with 3 theses at the doctoral level and 17 at the master's level. When examining the study designs, one these was a meta-analysis, 13 were descriptive, and 6 were conducted using experimental methods. Among the studies, 75% were conducted with patients, 10% with healthcare workers, and 10% with nursing students.
Conclusion: The nursing theses conducted on ERAS have concluded that ERAS practices are effective based on their intended purposes. Additionally, it has been determined that healthcare professionals have insufficient knowledge regarding ERAS practices. Therefore, it is recommended to increase the number of studies conducted in the field of nursing to promote the widespread implementation of ERAS practices and raise awareness.

Anahtar Kelimeler

Surgery, ERAS, Nursing, Enhanced Recovery, Protocol

Kaynakça

• 1. Brindle M, Nelson G, Lobo DN, Ljungqvist O, Gustafsson UO. Recommendations from the ERAS® Society for standards for the development of enhanced recovery after surgery guidelines. BJS Open. 2020;4(1):157-163. doi: 10.1002/bjs5.50238.
• 2. Gündoğdu H. Enhanced recovery after surgery: Change in perioperative care. In: Alkış N, Gündoğdu H eds. ERAS Book Evidence Based Surgery. Ankara; byte; 2023;(1):1-5.
• 3. Bölükbaş N, Birlikbaş S. ERAS guidelines enhanced recovery protocols after surgery. Ordu University Journal of Nursing Studies. 2019;2(3):194-205.
• 4. Parks L, Routt M, De Villiers A. Enhanced recovery after surgery. Journal of the Advanced Practitioner in Oncology. 2018;9(5):511. PMID: 31086687.
• 5. Mendes DIA, Ferrito CRDAC, Gonçalves MIR. Nursing interventions in the enhanced recovery after surgery®: Scoping review. Revista Brasileira de Enfermagem. 2018;71:2824-2832. doi: 10.1590/0034-7167-2018-0436.
• 6. Önalan E. The effect of preoperative oral carbonhydrate administration on insulin resistance and comfort level in patient undergoing surgery. [Master's Thesis.] Karabük University Institute of Health Sciences; 2017.
• 7. Akbuğa G. The effect of oral liquid carbohydrate intake upon blood glucose, hunger-thirst and fatigue levels among patients who underwent arthroscopy before spinal anesthesia. [Doctoral Thesis.] Erciyes University Institute of Health Sciences; 2018.
• 8. Ertural F. Effects of oral carbohydrate solution administred before hip arthroplasty on preoperative anxiety and postoperative patient comfort. [Master's Thesis.] Nevşehir Hacı Bektaş Veli University Institute of Science and Technology; 2022.
• 9. Kavalcı G. The effect of implementation of enhanced recovery protocol on colorectal surgery patients' comfort level. [Master's Thesis.] Istanbul Medipol University Institute of Health Sciences; 2021.
• 10. Arpag N. The effect of the visit of the operating room nurse before cardiac surgery on anxiety and pain management. [Doctoral Thesis.] Istanbul University-Cerrahpaşa Graduate Education Institute; 2021.
• 11. Aykul ET. Comparison of the effects of the eras protocol application and the effects of the traditional method on the patient healing process in obesity surgery: A randomized controlled study. [Master's Thesis]. Bahçeşehir University Graduate Education Institute; 2022.
• 12. Şanlıer Büyükçamsarı N. The effect of enhanced recovery protocols on patient outcomes in patients with cardiovascular surgery: A systematic review and meta analysis. [Doctoral Thesis.] Bahçeşehir University Graduate Education Institute; 2023.
• 13. Özkeçeci F. Evaluation of perioperative practices according to EROS protocol in elective cesarean surgery. [Master's Thesis]. University of Health Sciences Institute of Health Sciences; 2017.
• 14. Tunçel N. Evaluation of the compliance of practices with the ERAS protocol and patient outcomes in patients undergoing cardiovascular surgery. [Master's Thesis.] Manisa Celal Bayar University Institute of Health Sciences; 2022.
• 15. Bulut A. Determination of factors affecting early mobilisation of patients who have undergone knee and hip arthroplasty. [Master's Thesis.] Uludağ University Institute of Health Sciences; 2019.
• 16. Yıldırım Ç. Evaluation of applications in women with gynecologic surgery according to ERAS protocol. [Master's Thesis.] University of Health Sciences Institute of Health Sciences; 2017.
• 17. Çelebi Ş. Evaluation of compliance of the perioperative practices of the i̇npatients i̇n the surgery clinic with Eras protocol and effects on patient outcomes. [Master's Thesis.] Afyonkarahisar Health Sciences University Graduate Education Institute; 2019.
• 18. Gezer T. Evaluation of the compliance of perioperative practices to eras protocol, its effect on the patient results and barriers to implementation of eras protocol in colorectal surgery. [Master's Thesis.] Izmir Kâtip Çelebi University Institute of Health Sciences; 2020.
• 19. Karakuş M. Comparison of nutrition, quality of recovery and development of complications in colorectal surgery patients with and without eras protocol. [Master's Thesis.] Izmir University of Economics Graduate Education Institute; 2023.
• 20. Sezen Sayan N. The level of knowledge of surgical TEAM members about the components of enhanced recovery after surgery during surgery. [Master's Thesis.] Haliç University Graduate Education Institute; 2022.
• 21. Afşar T. Approaches of nurses about enhanced recovery after surgery. [Master's Thesis.] Uludağ University Institute of Health Sciences; 2020.
• 22. Çetin T. ERAS protocols implementation status and views of health personnel working in gynecology and obstetrics clinic. [Master's Thesis.] Dokuz Eylül University Institute of Health Sciences; 2021.
• 23. Hoxha J. Determining the approaches of nursing students to enhanced recovery practices after surgery. [Master's Thesis.] Bursa Uludağ University Health Sciences Institute; 2022.
• 24. Yemişçi S. Examination of the knowledge and perception levels of senior nursing students regarding the eras protocol. [Master's Thesis.] Bahçeşehir University Graduate Education Institute; 2023.
• 25. Tekin N. Evaluation of perioperative applications in hepatobiliary surgery according to ERAS protocol and determination of nursing practices.[Master's Thesis.] Uludağ University Institute of Health Sciences; 2022.
• 26. Lam JY, Howlett A, McLuckie D, et al. Developing implementation strategies to adopt Enhanced Recovery After Surgery (ERAS®) guidelines. BJS Open. 2021;5(2):zraa011. doi: 10.1093/bjsopen/zraa011.
• 27. Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: a review. JAMA Surg. 2017;152:292. doi: 10.1001/jamasurg.2016.4952.
• 28. Liu VX, Rosas E, Hwang J, et al. Enhanced recovery after surgery program implementation in 2 surgical populations in an integrated health care delivery system. JAMA Surg. 2017;152:e171032. doi: 10.1001/jamasurg.2017.1032.
• 29. Bisch SP, Jago CA, Kalogera E, et al. Outcomes of enhanced recovery after surgery (ERAS) in gynecologic oncology–A systematic review and meta-analysis. Gynecologic Oncology. 2021;161(1):46-55. doi: 10.1016/j.ygyno.2020.12.035.
• 30. Noba L, Rodgers S, Chandler C, Balfour A, Hariharan D, Yip VS. Enhanced recovery after surgery (ERAS) reduces hospital costs and improve clinical outcomes in liver surgery: A systematic review and meta-analysis. Journal of Gastrointestinal Surgery. 2020;24:918-932. doi: 10.1007/s11605-019-04499-0.
• 31. Gündoğdu H. ERAS: History and philosophy. Medical Journal of Istanbul Kanuni Sultan Süleyman. 2018;8(10):1-4. doi: 10.5222/iksst.2018.04935.
• 32. Li J, Zhao F, Gao J, et al. Enhanced recovery after surgery (ERAS) protocol in geriatric patients underwent unicompartmental knee arthroplasty: A retrospective cohort study. Medicine. 2023;102(6):e32941. doi: 10.1097/MD.0000000000032941.
• 33. Sevgi G, Katran HB, Arpag N, Öztekin D, Akyüz N. Surgical nurses’ evaluations on enhanced recovery after surgery protocol applications in general surgery clinics. Istanbul Gelisim University Journal of Health Sciences. 2023;19:224-239.
• 34. Xue B, Yu H, Luo X. Knowledge of enhanced recovery after surgery and influencing factors among abdominal surgical nurses: a multi-center cross-sectional study. Contemporary Nurse. 2022;58(4):330-342. doi: 10.1080/10376178.2022.2112723.
• 35. Ellis DB, Agarwala A, Cavallo E, et al. Implementing ERAS: How we achieved success within an anesthesia department. BMC Anesthesiology. 2021;21(1):1-6. doi: 10.1186/s12871-021-01260-6.