Creation of an Enhanced Recovery After Surgery (ERAS) Guideline for neonatal intestinal surgery patients: a knowledge synthesis and consensus generation approach and protocol study

IntroductionEnhanced Recovery After Surgery (ERAS) guidelines integrate evidence-based practices into multimodal care pathways designed to optimise patient recovery following surgery. The objective of this project is to create an ERAS protocol for neonatal abdominal surgery. The protocol will identi...

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Bibliographic Details
Published in:	BMJ open Vol. 8; no. 12; p. e023651
Main Authors:	Gibb, Ashleigh C N, Crosby, Megan A, McDiarmid, Caraline, Urban, Denisa, Lam, Jennifer Y K, Wales, Paul W, Brockel, Megan, Raval, Mehul, Offringa, Martin, Skarsgard, Erik D, Wester, Tomas, Wong, Kenneth, de Beer, David, Nelson, Gregg, Brindle, Mary E
Format:	Journal Article
Language:	English
Published:	England BMJ Publishing Group LTD 01-12-2018 BMJ Publishing Group
Subjects:	Abdomen Abdominal surgery Acceleration Clinical outcomes Consensus Delphi Technique Digestive System Surgical Procedures - standards Early Ambulation Efficiency Evidence-Based Medicine Experts Female Health Services Research Humans Infant, Newborn Intensive care Internationality Knowledge Male Medicin och hälsovetenskap Newborn babies Patients Pediatrics Postoperative Care - standards Practice Guidelines as Topic Quality R&D Recovery (Medical) Recovery of Function Research & development Societies, Medical Surgeons Treatment Outcome Canada Sweden Calgary Alberta Canada United Kingdom > UK United States > US China eras paediatric surgery
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Summary:	IntroductionEnhanced Recovery After Surgery (ERAS) guidelines integrate evidence-based practices into multimodal care pathways designed to optimise patient recovery following surgery. The objective of this project is to create an ERAS protocol for neonatal abdominal surgery. The protocol will identify and attempt to bridge the gaps between current practices and best evidence. Our study is the first paediatric ERAS protocol endorsed by the International ERAS Society.MethodsA research team consisting of international clinical and family stakeholders as well as methodological experts have iteratively defined the scope of the protocol in addition to individual topic areas. A modified Delphi method was used to reach consensus. The second phase will include a series of knowledge syntheses involving a rapid review coupled with expert opinion. Potential protocol elements supported by synthesised evidence will be identified. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system will be used to determine strength of recommendations and the quality of evidence. The third phase will involve creation of the protocol using a modified RAND/UCLA Appropriateness Method. Group consensus will be used to rate each element in relation to the quality of evidence supporting the recommendation and the appropriateness for guideline inclusion. This protocol will form the basis of a future implementation study.Ethics and disseminationThis study has been registered with the ERAS Society. Human ethics approval (REB 18–0579) is in place to engage patient families within protocol development. This research is to be published in peer-reviewed journals and will form the care standard for neonatal intestinal surgery.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1
ISSN:	2044-6055 2044-6055
DOI:	10.1136/bmjopen-2018-023651