Table 5.
Comparison of compliance with individual guidelines before, during and after implementation of the intervention
| Guideline | Compliance, %; study phase | p value | ||||
|---|---|---|---|---|---|---|
|
|
|
|||||
| Baseline n = 158 |
Implementation n = 87 |
Sustainability n = 87 |
Baseline v. implementation | Implementation v. sustainability | Baseline v. sustainability | |
| Patient education | 99.4 | 100 | 100 | NS | NS | NS |
|
| ||||||
| Carbohydrate beverage | 0.00 | 71.3 | 70.1 | < 0.001 | NS | < 0.001 |
|
| ||||||
| No bowel preparation | 29.1 | 82.8 | 79.3 | < 0.001 | NS | < 0.001 |
|
| ||||||
| Antibiotic prophylaxis | 98.1 | 97.7 | 100 | NS | NS | NS |
|
| ||||||
| VTE prophylaxis | 93.6 | 100 | 97.7 | 0.016 | NS | NS |
|
| ||||||
| Short-acting anesthetic agents | 98.7 | 98.9 | 96.6 | NS | NS | NS |
|
| ||||||
| Epidural (for open surgery) | 85.2 | 87.8 | 81.6 | NS | NS | NS |
|
| ||||||
| Fluid restriction | 22.3 | 67.8 | 69.0 | < 0.001 | NS | < 0.001 |
|
| ||||||
| Laparoscopy | 12.1 | 17.2 | 13.8 | NS | NS | NS |
|
| ||||||
| Normothermia | 99.4 | 98.8 | 95.4 | NS | NS | NS |
|
| ||||||
| IV fluids discontinued on POD1 | 15.2 | 83.7 | 62.1 | < 0.001 | < 0.001 | < 0.001 |
|
| ||||||
| No NG tubes | 100 | 100 | 100 | NS | NS | NS |
|
| ||||||
| Multimodal PONV management | 93.6 | 94.3 | 96.6 | NS | NS | NS |
|
| ||||||
| Foley catheter | 14.7 | 64.0 | 57.0 | < 0.001 | NS | < 0.001 |
|
| ||||||
| Clear fluids on POD0 | 43.6 | 80.5 | 69.0 | 0.002 | 0.08 | < 0.001 |
|
| ||||||
| DAT on POD1 | 98.7 | 64.4 | 62.1 | < 0.001 | NS | < 0.001 |
|
| ||||||
| Multimodal pain management | 79.1 | 94.1 | 96.6 | 0.002 | NS | < 0.001 |
|
| ||||||
| Mobilization on POD1 | 12.0 | 63.2 | 45.3 | < 0.001 | 0.02 | < 0.001 |
|
| ||||||
| Chewing gum | 0 | 69.0 | 28.7 | < 0.001 | < 0.001 | < 0.001 |
DAT = diet as tolerated; IV = intravenous; NG = nasogastric; NS = nonsignificant; POD = postoperative day; PONV = postoperative nausea and vomiting management; VTE = venous thromboembolism.